Book excerpt: The most dangerous work in North America at the turn of the century may have been extracting metal-bearing ore from mountains of hard rock. Beginning in the 1890s miners in the West worked through local unions both to prevent occupational hazards and to assure themselves of adequate health care. Among other projects, they planned, built, and governed more than twenty general hospitals throughout the Western United States and Canada. Workers' Health, Workers' Democracy is an engaging and richly documented account of this first attempt to create a democratically controlled health care system in North America. Focusing on the efforts of local unions, Derickson illuminates the broader history of the Western labor movement, the self-help traditions of rank-and-file workers, and the evolution of health care on the industrial frontier.