Health Care: Don't Be Evil

Google’s corporate motto – written in its original Code of Conduct -- was once “Don’t be evil.”  That softened over time; Alphabet changed it to “Do the right thing” in 2015, although Google itself retained the slogan until early 2018.  Some Alphabet employees think Google/Alphabet has drifted too far away from its original aims: they’ve formed a union in order to try to steer the company back to its more idealistic roots.

Parul Koul and Chewy Shaw, two Alphabet software engineers, announced the Alphabet Workers Union in a New York Times op-ed, vowing to live by the original motto, and to do what they can to ensure that Alphabet and its various companies do as well.  They assert: “We want Alphabet to be a company where workers have a meaningful say in decisions that affect us and the societies we live in.”

It’s past time that health care workers, including physicians and executives, stood up for the same thing.

Ms. Koul and Mr. Shaw cite several grievances, including payouts to executives accused of sexual harassment, the firing of a leading AI expert over her efforts to address bias in AI, and company efforts to “keep workers from speaking on sensitive and publicly important topics.”  Doing the work, even doing it well and being well paid for it, is not enough:

We care deeply about what we build and what it’s used for. We are responsible for the technology we bring into the world. And we recognize that its implications reach far beyond the walls of Alphabet.

Their goal is for Alphabet “to be a company where workers have a meaningful say in decisions that affect us and the societies we live in.”  Alphabet, they say, “has a responsibility to prioritize the public good. It has a responsibility to its thousands of workers and billions of users to make the world a better place.” 

Investors may not quite agree.

In an AWU statement, Nicki Anselmo, Program Manager, explained: “This union builds upon years of courageous organizing by Google workers…Our new union provides a sustainable structure to ensure that our shared values as Alphabet employees are respected even after the headlines fade.”

Google’s official response, released by Kara Silverstein, Google’s director of people operations, was predictably bland:

We've always worked hard to create a supportive and rewarding workplace for our workforce.  Of course our employees have protected labor rights that we support. But as we've always done, we'll continue engaging directly with all our employees.

So far, slightly over 200 Alphabet employees have signed on, out of some 120,000 employees (and roughly the same number of contractors or temps).  AWU is part of the Communication Workers of America (CWA) but has not had an employee election or ratification from the National Labor Relations Board, and so won’t have collective bargaining rights. 

Veena Dubal, law professor at the University of California, told NYT:

If it grows — which Google will do everything they can to prevent — it could have huge impacts not just for the workers but for the broader issues that we are all thinking about in terms of tech power in society,

I won’t try to predict how successful AWU will be, either in terms of building its membership or influencing Alphabet’s priorities, but I admire the goals.  But if there is an industry in which its employees need to speak up about their organizations’ need to prioritize the public good, it is health care.

Credit: Mario Tama/Getty Images

Right now, of course, we have healthcare workers putting themselves at risk fighting the pandemic, putting their own health and lives at risk.  It’s admirable, it’s heroic, and it must be commended.  But those efforts can’t mask actions that those same organizations are taking or allowing that aren’t so noble.

In no particular order:

• Even, or because, COVID-19 vaccines are scarce, we’re already seeing reports about rich or influential people “cutting in line” to get their vaccine early;
• We want people to get COVID tests, and they’re supposed to be free, but some health care organizations have found ways to include “surprise bills” for them;
• We’ve seen health care workers silenced, fired or forced to resign for speaking out about poor working conditions or lack of personal protective equipment (PPE) during the pandemic;
• Health care workers have had to walk off the job over wage and labor condition disputes during the pandemic;
• We still have hospitals suing patients for unpaid bills, even after promises not to during the pandemic;
• As bad as the racial disparities are in our health care system normally, they’re even worse with COVID-19, and may further worsen with the vaccine rollout;
• There are profound gender wage disparities among healthcare workers, and they may be getting worse;
• While pharma is getting plaudits for its rapid response to develop COVID-19 vaccines, it is also busy further raising prices;
• Already wealthy, nominally non-profit hospitals are raking in billions of disaster relief funds;
• Health insurers have done exceedingly well financially during the pandemic.

“Don’t be evil” would seem to apply.

What we need are the health care front line workers and leaders who will stand up and say, this is not good for our patients.  This is not good for our society.  This is when the needs or goals of our organization do not take precedence over the public good.

Credit:Marrian Zhou, Nikkei Asia

There are unions in healthcare already, even for physicians, but as a percent of all healthcare workers they have made about as many inroads as AWU has at Alphabet, and over a much longer period of time.  I have mixed feeling about unions generally; while they brought workers many important protections and benefits, they’ve often fallen ended up being more about workers’ insular interests than about broader social priorities.  But sometimes organizing is necessary.

Every health care organization should be, to quote Ms. Koul and Mr. Shaw about their goals for Alphabet, “a company where workers have a meaningful say in decisions that affect us and the societies we live in,” and which “has a responsibility to prioritize the public good.” 

If that is not true of your healthcare organization, if your healthcare organization isn’t committed to “don’t be evil,” then what are you prepared to do about it?