In this third blog in the series I offer a characterisation of another key set of players in the substantive area of health inequalities, those who stand up against or resist the ‘greedy bastards’. The greedy bastards here comprise a cabal at the core of the capitalist executive class (CCE) supported by the state’s power elite (PE), whereby CCE + PE = OLIGARCHY). I call these resisters dedicated meta-reflexives. The primary references for this series of blogs are appended to the first blog.
It is now more anachronism than platitude within sociological circles that people have beliefs, values and attitudes that owe more to their natal or involuntary placement in society than to the exercise of agency. Bhaskar and Archer acknowledge as much but yet allow for the transformative power of agency. As far as the CCE/PE dyad is concerned, they are without doubt prime peddlers, via mass media and heavily sponsored think tanks, of the prevailing neo-liberal ideology. The ideology of sociological salience, in other words, is that of the capitalists, the bourgeoisie, the ‘neo-cons’, the CCE/PE and so on. It is one matter to inherit interests that go ‘with’ the structural/ideological flow, another to inherit interests that come up ‘against’ them. This was once a commonplace in sociology. To re-introduce the concept of ideology is necessarily to re-introduce that of ‘false consciousness’. Any discomfort at doing so is arguably itself a function of a degree of (ideological) taming of the discipline.
Resistance necessarily involves countering, subverting and ultimately undermining the global/national/local potency of ideology, in the present the ideology of neo-liberalism. And the accumulated evidence of the post-welfare-statist decades leads ineluctably to the conclusion that health inequalities in the UK and elsewhere cannot be addressed effectively by Popperian ‘piecemeal social engineering’: meaningful resistance necessarily reaches deep down into generative social mechanisms, be they of structure or agency. The class/command dynamic that characterizes the present represents the key and overriding structural input into health inequalities/inequities. But what of the potentially transformative power of agency?
For Archer, meta-reflexives, oriented by values, are characterized by ‘contextual incongruity’, which denotes an incongruity between dreams and aspirations and contextual factors that obstruct their realization. But not all dreams and hopes fade away, and those organizers and leaders of resistance to neo-liberal ideology might be said to represent a sub-set of meta-reflexives whose value-driven commitments become central to identity for self and others and transmute into life-long advocacy on behalf of the ‘community as a whole’. I cal them dedicated meta-reflexives.
These putative activists might superficially appear to resemble the CCE/PE contingent of focused autonomous reflexives; but Archer separates them unambiguously. While the focused autonomous reflexives are almost entirely instrumental, strategically, single-mindedly and ruthlessly oriented to the pursuit of their own interests, the dedicated meta-reflexives are value, other- and community or ‘third sector’-oriented. As Archer shows, the:
‘ … meta-reflexive concern for ‘community’, despite its varied meanings, is light years removed from both the communicative reflexives’ preoccupation with their own micro-life worlds and the autonomous reflexives’ use of the locality as a place for out-sourcing and paid access to selected facilities … what unites (meta-reflexives) is not a burgeoning communitarianism, but rather a common belief that social problems will not yield to individualistic incentives or to centralized political interventions’.
Michael Marmot, a key public health practitioner and leader in World Health Organization and UK health inequalities research and policy, often cites Neruda’s injunction to ‘rise up with me against the organization of misery’, a plea he regards as an international rather than national or local call to arms. There is a question here of the degree of commitment to ‘making a difference’. Terry Eagleton writes:
‘reform is vital; but sooner or later you will hit a point where the system refuses to give way, and for Marxism this is known as the social relations of production. Or, in less polite technical language, a dominant class which controls the material resources and is markedly reluctant to hand them over. It is only then that a decisive choice between reform and revolution looms up’.
In a neo-liberal era Marmot has fought nobly but unavailingly. If he and sociologists of health inequalities are (in a Hegelian sense) ‘serious’, then there will have to be a sociological reckoning with the contradictions of capitalism and the likes of transnational and national relations of class and command, a step far beyond an abstruse, academic fascination with socio-economic group/status and health. The SEG/S and association with health cannot be explained sociologically in the absence of a more comprehensive theory of social class and class struggle.
Key protagonists in such a struggle are presented here as dedicated meta-reflexives. Given the low visibility of class politics in the neo-liberal era, dedicated meta-reflexives are unlikely to see themselves, or be seen by others, as class warriors engaged in an ongoing struggle. They are more likely to be the issue of a heterogeneous array of ‘mobilizing potentials’. Some of their number, whether campaigning against the hike in student fees, the abolition of the Education Maintenance Allowance or the Health and Social Care Bill, might be paid up members of an anti-capitalist ‘movement of movements’, but others are manifestly not. The characteristics of this sub-type of meta-reflexive are as follows:
AN IMPULSE TO SOLIDARITY
Picking up on Archer’s narrative, dedicated meta-reflexives are oriented to community. In Habermasian terms their natural mode of relating is communicative rather than strategic. Their actions are informed by values of sociality, favouring norms of reciprocity.
SYSTEM IMMUNITY
Activists falling within the category of dedicated meta-reflexive have strong ego-defences, allowing them to have enduring lifeworld rather than system ambition. Their aspirations are unlikely to be easily undone by, Habermas again, the ‘steering media’ of the economy or state, that is, money or power.
A PREDELICTION TO OPTIMISM
Optimism of the will subduing pessimism of the intellect is likely to be on the calling cards of dedicated meta-reflexives. These are disciples of Gramsci, refusing not to act against the odds. They do not just have ‘system immunity’ but are committed to better futures.
VISIONARY INSIGHT
However embryonic, the dedicated meta-reflexive envisages a future that improves on past and present, and does so for the ‘community as a whole’ rather than a discrete (wealthy, powerful) segment (like the CCE/PE). Their vision belongs within Giddens’ category of ‘utopian realism’.
THERAPEUTIC ORIENTATION
Dedicated meta-reflexives ‘care’ in ways often antipathetic to instrumental or strategic action. Their challenge is Lenin’s and is around Hegel’s notion of ‘seriousness’. If they are ‘serious’ about their activism, however, are they not ceding crucial territory to the focused autonomous reflexives of the CCE/PE by their therapeutic orientation?
ACTION COMMITMENT
It is in their predisposition to act, to intervene, to make a difference, that the dedicated meta-reflexives’ therapeutic orientation is leavened by engagement.
There may be a tension here, however, between actions aimed at consensus and actions aimed at outcome. Which do dedicated meta-reflexives privilege, representing the communities in which they participate or securing utopian realist benefits on their behalf? Or is it necessary to choose? Castells suggests that contemporary movements are more consensual than their predecessors (see my blog on ‘Habermas, Civil Society and the Public Sphere’).
These blogs on Archer’s work are cumulative: it is best, even necessary, to read them in order. The first offers an exposition of Archer’s stance. The second and third have ventured ideal types of those primarily responsible for producing and reproducing health inequalities (number two) and those most likely to resist them (number three).