Where, When, Who? Workplace Activism & Healthcare Access --THE LEFTIST ETHICIST

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November 11, 2013

The Leftist Ethicist is an advice column for Zeek readers who envision a more just world and act to create it. With a commitment to justice and progressive Jewish teaching (and a loving nod to the Bintel Brief), the Leftist Ethicist provides a space to raise questions, without judgment, and receive sensible solutions.

I have seen the same primary care doctor for about five years, and she gives me good care. Unfortunately, I just saw her, and she told me — not without a guilty look in her eye — that expenses and regulations were just too much, and she had decided to close up her current shop and open a concierge practice. I looked up what these practices are like, and my blood ran cold: I mean, sure, I could afford it (I make a good living), but what about all the people who can’t? Is my doctor making an unethical decision? Should I stick with her? Finding a new doctor is such a pain.

In concierge medicine, patients pay an annual or monthly fee on top of services. The models vary, but concierge practices are significantly smaller and provide more access to the doctor, and often don’t accept health insurance. They’re basically the artisan cheese and bespoke suit of doctors.

If you believe healthcare is a human right and that doctors should make reasonable steps toward providing care based on need, not class, this model isn’t ethical. The American Medical Association has a Declaration of Professional Responsibility. It compels doctors to use “their skills and knowledge competently, selflessly and at times heroically” for the “well being of humankind.”

Your doctor will serve fewer clients, who are wealthier, while her middle- and lower-income patients get the boot. Everyone will be pushed to search for new primary-care physicians, which are in short supply.

Dr. Zachary Sholem Berger, author of “Talking to Your Doctor: A Patient’s Guide to Communication in the Exam Room and Beyond,” assistant professor at Johns Hopkins School of Medicine (not to mention Yiddish poet and translator), explained that doctors who specialize, like surgeons and gynecologists, have higher incomes — and this is one reason there’s a primary-care physician shortage. But, he says, we shouldn’t feel too badly for primary care physicians, “Even with admin time and paperwork, doctors in the United States still have it pretty good. Yes, many have medical school loans, but they pay off their loans and make much more than doctors in other countries.” Bureaucracy is a pain, but many professions have it.

Unless you have a medical condition that only this doctor can treat, jump ship and make sure you tell your doctor why. As Dr. Berger said, “people don’t usually talk to doctors because of the hierarchy. The doctor talks, and the patients listen.” Well, not this time. With the Affordable Care Act’s changes for doctors and patients, patients must take this opportunity to speak up for their needs and rights.

For more info on changing the medical system, check out Health Care Now, an organization fighting for single-payer healthcare nationally.

I am in my first year of teaching. My new coworkers, the other first-grade teachers, have a tradition of going to Wendy’s on Wednesday’s for lunch. They want to make me part of their club. They are the most hardworking in my grade and write the best lesson plans. They like me, so I need to take advantage. I don’t want to go to Wendy’s because I am a longtime supporter and ally to the Coalition of Immokalee Workers (CIW), a farmworker organization that has a campaign against them. I haven’t talked to my coworkers about CIW, but I don’t think they’d get it. What should I do?

Your solidarity with the innovative, Florida-based, farmworker-led organization — one I’ve been personally involved with — will make you the coolest kid at the playground in social justice oriented workplaces. Too bad at 99% of jobs, people want to keep their heads down and blow off steam with like-minded colleagues by, say, going for lunch at Wendy’s. They’re not super-interested in your activist propaganda.

Fortunately, according to Rabbi Toba Spitzer of Congregation Dorshei Tzedekone of many rabbis who have rallied their congregants to support the farmworkers — it “isn’t that radical” to support the Coalition of Immokalee Workers. This is actually a good opportunity to engage your colleagues, one that wouldn’t have arisen otherwise.

“Nobody is saying you shouldn’t be eating there,” she says. “There is no boycott against Wendy’s. In fact, it is actually more powerful for Wendy’s to hear the message from customers.”

The Coalition of Immokalee Workers has spent 12 years campaigning to secure Fair Food Agreements. So far, they have agreements with 11 multibillion-dollar corporations (including McDonald’s and Whole Foods) that raise wages for workers and provide regulation mechanisms to minimize rampant abuses as extreme as slavery and as basic as access to shade in the tropical fields of Florida. The five biggest fast-food chains have all signed agreements with the farmworkers. Wendy’s has refused.

Your stomach turns stepping into a Wendy’s, but the CIW only wins when people like your coworkers begin to distrust the Wendy’s brand. Go to lunch, talk shop for a bit and then take the leap to talk about this great organization that has inspired you so much. Start with something that would interest teachers, such as the abuse of migrant children working in the fields. Mention the lesson plan you are writing about farmworkers’ rights for your students (start writing!). Offer to share the lesson plan or make it a grade-wide activity. Of course, it may be jarring for the first-grade teachers to hear that Wendy’s is knowingly complicit in perpetuating abuse. But, as Rabbi Spitzer says, “People want to do the right thing. And in this case, it isn’t that complicated.” Just make sure to stay away from these menu items on your next visit to Wendy’s.

Shout out to T’ruah, working tirelessly to raise awareness in the Jewish community about the CIW in the fight for slavery-free tomatoes.

The Leftist Ethicist is not intended as a replacement or substitute for financial, medical, legal or other professional advice. It’s just my opinion! What’s yours? Talk back in the comments! Send questions about ethical dilemmas to LeftistEthicist@Zeek.net.

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