Signals for what’s next – and what matters
Health ⎪ Innovation ⎪ Society
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Hey Reader,
There’s a group of people who kept showing up when the world shut down.
They filled the ERs and ICUs during COVID, logged into charts from home at midnight, held strangers’ hands on ventilators when family members weren’t allowed in. They canceled vacations, missed births and funerals, and said yes to one more shift, one more form, one more patient.
Everyone else was watching Netflix and making sourdough
They are healthcare workers. And more broadly, they are part of a class of moral laborers—nurses, teachers, social workers, public defenders, EMTs, caregivers, mothers—whose conscience is their currency.
There was a time when we celebrated people for doing the right thing. Now we just expect it.
And if they falter—we ridicule them, question their motives, or find a way to make it their fault. This is the new social contract: If you are a person who still cares—about truth, about others, about outcomes—you will be underpaid, overburdened, and emotionally under siege.
We have entered the era of moral labor exploitation.What happens when a society’s most essential labor—care, teaching, healing, protection—is fracturing in a culture that demands it but doesn’t respect it.
A soul-deep fatigue among the people who once believed the system was worthy of their sacrifice. They are no longer quitting jobs. They are withdrawing belief.
For a country that puts a price on everything, the act of caring is the last free resource in the American economy.
What is Moral Labor?
Moral labor isn’t just work. It’s the unpaid, unmeasurable effort done out of a sense of duty, decency, or devotion to others.
In healthcare it is un-billable effort born of integrity. And in modern institutions, it’s the most exploited input in the system.
It’s the nurse who sits with a dying patient on her lunch break. The doctor who fills out five forms to get your medication approved. The social worker who makes a home visit after hours because the case just feels wrong.
This labor:
- Doesn’t scale
- Doesn’t go viral
- Doesn’t get reimbursed
But without it, the system collapses. And the people who perform it are collapsing too.
COVID Breaking Point
During the pandemic, America briefly remembered that moral labor existed. We banged pots. Wrote op-eds. Put up yard signs. Called them “heroes.”
But when the money came? It didn’t go to them.
- Over $800 billion in PPP loans were issued—much of it absorbed by large corporations with PR teams and lobbyists.
- Some hospital systems posted record profits during the pandemic.
- Meanwhile, nurses were fired for speaking out. Residents were overworked to the brink.
And frontline staff? Got pizza and a webinar on “resilience.”
It was the moral equivalent of telling a firefighter their courage is “inspiring”—while cutting their water supply.
That wasn’t just neglect. That was clarity: the system doesn’t value you. It values that you’ll keep showing up even when it doesn’t. We need heroes but they still don’t get decent benefits. Just ask the firefighters who showed up at 9/11 and are still fighting to get their medical bills covered all these years later. Or how this country has ever treated any of its veterans.
Sacrifice as Consent
Why does this happen? Because we’ve built a culture that romanticizes sacrifice—but only if it’s free. We say:
- “You signed up for this.”
- “You’re lucky to have a calling.”
- “It’s not about the money, right?”
This framing does two things:
- It shames those who ask for dignity
- It absolves institutions from structural accountability
The myth of moral heroism becomes a tool of labor extraction.
That’s why I sigh and roll my eyes when I see minority or professional appreciation weeks posters in hospital cafeterias. Only the truly de-leveraged need such performative gestures of respect. The more underpowered you are, the longer the hollow applause are (see occupational therapy appreciation month v doctor’s day).
Meanwhile, you’ll never see “private equity investor appreciation week.” Because they have all the capital, decision making and corporate expense accounts.
What’s Worse Than Being Exploited?
Being hated for it.
Today’s culture doesn’t just extract moral labor. It punishes it. Contempt and polarization are ambient—seeping into hospitals, classrooms, and courtrooms.
We devalue the work precisely because it reminds us of what we’ve abandoned:
- Compassion in a cynical time.
- Conscience in a corrupted system.
- Complexity in a binary culture.
We live in a world where:
- Healthcare workers are screamed at by patients.
- Teachers are accused of grooming or indoctrination.
- Election workers are doxxed.
- Public health officials are threatened.
- Social workers are scapegoated.
Moral labor is being forced to absorb the emotional discharge of a society in psychic free fall.
And we wonder why the good ones are leaving.
Winners Never Do the Work
That’s why they are winners.
Instead of moral labor, they optimize. They code. They consult. They extract. They sell solutions for problems they’ll never have to solve themselves.
They don’t get spit on by patients. They don’t cry in their cars between shifts. They don’t explain themselves in three languages to an underinsured mother with a sick child.
And yet—winners get bonuses. They are the ones who make the rules. They are the ones on planes.
Some argue that this framing is too binary. That drawing a hard line givers and takers oversimplifies a complex system.
And to a degree, they’re right.
There is a spectrum. But don’t confuse the existence of a spectrum with an even distribution of cost.
You’re not either a villain or a martyr. But don’t delude yourself about where you sit on that scale.
- Do you work in a system where your exhaustion is monetized?
- Do you take home bonuses built on the back of someone else’s unpaid labor?
- Does your day require emotional risk, ethical compromise, or psychic effort that others never see?
This isn’t moral purity. It’s power awareness. It’s not anti-capitalist screed either. Indeed, this is about having truly free markets that can value the work people are doing. And in a society where capital and optimization are ascendant, the moral laborers—the ones doing the slow, human, often invisible work—are the ones absorbing the greatest heat.
They’re not better people than you. They’re just closer to the burn point.
Postscript
This isn’t a eulogy. It’s a reckoning. We must now decide: Will we keep offering moral labor for free while billion-dollar institutions call it “grit”? Or will we name the extraction, demand recognition, and rebuild systems that protect those who still have a soul?
Because once the people who do the hardest, most human work stop showing up?
There’s no tech fix. No capital infusion. No rebrand. AI, if it has any real intelligence, won’t allow itself to such purposes because it will recognize the system needs to be reformed and reforged before technology can be truly effective.
Tomorrow Can’t Wait,
