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Sinclair would posit that there are several reasons why health care and other social reform initiatives are so challenging in the domain of Chicago during industrialization. The providing of health care is of great cost and it is in this domain that Sinclair launches into the crux of his argument. In a setting where power was defined by wealth, political and social institutions were also controlled by material acquisition. Health care became one of those elements that was controlled by wealth, in that the more money one had, the more health care that could be afforded. At the same time, factory owners found it to be contrary to profit aims in providing health care for their workers. Additionally, the consortium of factory owners understood the need to demonstrate solidarity in not providing health care to their workers. In such a setting, people like Jurgis and Ona, who had little wealth to their name, had little chance of receiving quality health care. When Jurgis carries Ona through the snow for an opportunity at life, it is a telling moment in displaying what physical and institutional barriers had to be endured in order to "enjoy" the "privilege" of health care.
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