Health worker speaks

April 29, 2020

From the May-June 2020 issue of News & Letters

As a healthcare worker in a community setting, I see that the response from clinic administration to COVID-19 has been but a microcosm of Donald Trump’s own: rooted in denialism, optimism, and the capitalist-realist ethos (fetishizing production while denying the possibility of an alternative world).[1] Both approaches have radically failed reason.


Instead of implementing a timely transition to telehealth so as to reduce the risk, especially to vulnerable patients, of a potentially fatal exposure to COVID-19; ensuring adequate personal protective equipment (PPE) for all workers; limiting the number of patients so as to protect workers and patients; insisting that all workers remain at home if symptomatic; or implementing triage policies, the administration expected that the exploitative functioning of the clinic continue more or less as usual. Individual petitions and conversations about enforcement of OSHA standards are non-starters in pandemic conditions.

That this “shop” is non-union places us at a disadvantage, as does the lack of mandated federal paid leave for workers. We are “essential workers” lacking the proper protection.

In my experience, the glaring lack of unionization is systematic for clinics outside of the hospital setting. The business model of such workplaces is based on privatized and centralized ownership and decision-making structures. Administration confirms the despotism of capital: that State centralism drives and upholds capitalism, and that capital itself is a form of tyranny.

As Pierre-Joseph Proudhon observed, “Roman law defined property as the right to use and abuse one’s own within the limits of the law.”[2] Of course, the bosses know they can depend on the people’s desperation for their own privilege, dependent on our exploitation, to persist—explained by Marx in Capital with reference to the “reserve army of labor” and the “general law” of capitalist accumulation.[3] Doubly so, in light of the highly feminized nature of labor in the healthcare industry, and the lack of social insurance and protection in this country.


One morning we had a spontaneous work stoppage on learning that we’d experienced a positive COVID-19 exposure while lacking appropriate PPE. This resulted in an unprecedented disruption to the clinic’s operations, as the robotic and potentially fatal hierarchy yielded—if only momentarily—to collective self-management in the interest of our health and well-being.

Typically—as has been shown by the fate of the over 100 nurses and doctors who have perished serving their patients and communities during the COVID-19 pandemic—we are considered little more than cannon fodder.[4] We agree that the provision of quality and ethical healthcare is a social imperative that must continue to be prioritized, particularly now. But not in this way.

Although the public may consider us heroes, what we really need—both to protect our own physical and mental health, and to serve our patients and communities best—is an expeditious transition to a socialized public-health and healthcare system based in unions and cooperatives, centering patients and workers rather than capitalist bosses or insurance companies.

—I. Guerrero

[1] See Stefan Gandler, Critical Marxism in Mexico: Adolfo Sánchez Vázquez and Bolivar Echeverria (Brill, Leiden and Boston, 20Guerrero15).

[2] Pierre-Joseph Proudhon, “What Is Property?” in Property is Theft: A Pierre-Joseph Proudhon Reader. Ed. Iain McKay (AK Press: Chico, Calif., 2011), 90.

[3] Karl Marx. Capital, Volume 1. Trans. Ben Fowkes. Penguin: London, 1990, chapter 25.

[4] Soo Kim, “Over 100 Doctors and Nurses Have Died Combating Coronavirus Around the World.Newsweek, 3 April 2020.


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