Everybody knows that service jobs have replaced industrial jobs and that a huge part of those service jobs, about 20 million, are in health care—in hospitals, clinics, nursing homes, and home care. But the interrelated process through which that happened and the consequences for labor markets are rarely as palpable as they are in Gabriel Winant's new book on Pittsburgh, The Next Shift: The Fall of Industry and the Rise of Health Care in Rust Belt America. Epic in scope, Winant explores the inner and outer workings of two iconic industries across the entire period from World War II to today, showing how union-won health insurance birthed and shaped the US health care system. By focusing on one city, or metropolitan area, Winant is able to combine the complicated economics of steel and health care with sensitive, often intimate,...

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