01 Apr Roxanne D. BrownDavid McCall – This Union Paramedic Treats an Epidemic of Inequality
Dominick Sapien and a fellow paramedic arrived at the home in Central Wyoming to find the victim of a fall lying helpless on the floor, one knee split in half, part of the mangled mass of flesh and bone jiggling up and down.
Sapien, president of United Steelworkers (USW) Local 9012, prepared to transport the person to the hospital for emergency surgery. But the patient, writhing in pain and unable to move without help, balked at going.
“I can’t,” the patient said, describing the cost of an ambulance ride and hospital care as simply unaffordable. “I’ll just rest.”
Tragic, isn’t it? Rest alone was never going to help Sapien’s patient walk again.
Yet this is the kind of story we hear more and more often in a nation where a handful of billionaires possess obscene wealth while growing numbers of ordinary people go without food, health care and other essentials.
It’s an epidemic of inequality.Getty Images
Sapien’s experiences throw the scope of the crisis into sharp relief. He and his colleagues care for some of Wyoming’s poorest people in little-known towns like Lander and Riverton.
These places sit about 160 miles and a world away from Jackson Hole, the posh resort town that’s one of America’s wealthiest enclaves.
The richest 10 percent of Americans control nearly 70 percent of the nation’s wealth, and life in Jackson Hole revolves around—delights in—this rigged system.
While Sapien’s patients ration the basics, the uber-rich in Jackson Hole amass ever more of everything thanks to the tax cuts Donald Trump enacted just for them. These members of the coddled class drop millions for “cabins” in the mountains, treat themselves to extravagant spa days and squander thousands on excesses like the diamond-studded cowboy hats sold in town.
The disparity fuels Sapien’s desire to provide excellent care to the people he encounters on the job. It’s also made him a vocal advocate for unions, the only force powerful enough to counteract billionaire greed and ensure working people their fair share.
Sapien got into emergency medicine believing he’d spend his days saving people injured in car accidents and other tragedies.
But he found that he’s much more likely to answer 911 calls from people having flare-ups of chronic diseases that are either undiagnosed or go untreated because poverty restricts access to care. Think of a single parent, unable to afford diabetes medication, who wakes up disoriented one morning with out-of-control blood sugar and dials 911 for help.
“It isn’t what I thought I was signing up for,” Sapien explained. “But I’ve come to realize it’s a vital part of our health care system.”
Sapien regularly encounters residents who work multiple jobs in Fremont County’s retail and tourism industries, without ever getting ahead.
Their erratic, demanding work schedules leave little time to prepare decent meals at home, so they fall back on convenient but unhealthy food options that take a toll on their bodies over time. They fail to exercise as well, lacking the time to work out or the means to afford something as simple as a pair of track shoes.
Because many employers fail to provide medical insurance with part-time jobs, many of these same folks also forgo regular check-ups and preventive care.
When a problem forces them to call an ambulance, Sapien said, they get as much help as they can from paramedics while turning down a ride to the hospital or other services that would generate a bill. All they want, Sapien said, is to be stabilized enough to “get through another work day.”
The data back him up on that.
Among Wyoming’s 23 counties, Fremont ranked dead last in health outcomes, such as length and quality of life, in a 2022 report issued by the University of Wisconsin Population Health Institute. Fremont also ranked last in the “health factors”—such as diet, exercise and access to care—driving the health outcomes.
Then there’s Teton County, home to Jackson Hole, which ranked first in both measures of well-being. No surprise there.
“The things you have when you are wealthy are time and money,” Sapien pointed out. “These are also two of the requirements for living a healthy life.”
In the end, the patient with the pulverized knee agreed to go to the hospital after Sapien stressed the potential for permanent damage and warned, “I’m not leaving you here.”
There’s a lesson there for all of us.
It’s impossible to wish away the crisis facing this country. If working people fail to act—fail to stand together and fight for better lives—inequality will continue to grow until America is divided entirely into haves and have-nots.
This is exactly why Sapien led a union drive at the ambulance service a few years ago, a victory that helped his co-workers achieve not only fair wages and benefits but a voice on the job and the equipment needed to do their jobs.
It was the first new union in Wyoming in decades, and that milestone inspired a group of workers at a long-term facility in Cheyenne to join the USW as well. Baristas in Cheyenne, rangers at Yellowstone National Park and workers at a cement plant in Laramie also unionized at about the same time.
The USW welcomes other workers, in Wyoming and around the country, who want to avail themselves of the union difference.
Union members harness the power of collective action to move all ahead. We lift each other up and draw strength from one another.
As Sapien demonstrated, we leave no one behind.