The young man in Cleveland Clinic Akron General’s behavioral crisis intervention unit hadn’t communicated much during his hospitalization, but he showed no signs of violence until Brian Eckley tried to draw his blood early one morning.

The patient stood up, sat back down, rose again and then punched Eckley, a state-tested nurse aide and senior technician, in the left jaw.

Keeping his cool despite the pain, Eckley dodged more punches as he held the needle and tourniquet out of the patient’s reach, banged on the treatment room windows and called for help.

Attacks on health care workers have reached epidemic levels across the country, exacerbating turnover, turning caregivers into patients and further fraying systems of care already worn thin by COVID-19. The Workplace Violence Prevention for Health Care and Social Service Workers Act, twice passed by the House and just reintroduced in the Senate, would require employers to implement the safeguards needed to help keep Eckley and millions of his peers safe on the job.

The legislation—supported by numerous labor unions, trade groups and other stakeholders—would direct the U.S. Occupational Safety and Health Administration (OSHA) to develop a standard requiring health care providers to implement safety plans for clinics, hospitals, nursing homes, rehabilitation centers and other treatment facilities.

The bill calls for facilities to consider measures such as alarm systems, physical barriers and strategic staffing, including having workers in hazardous situations operate in teams. To ensure the plans are as comprehensive and effective as possible, facilities would have to devise them with the input of workers on the front lines and address the specific hazards in each work area or unit.

“Having a safety officer on the unit 24/7 would be a wonderful first step,” observed Eckley, a member of United Steelworkers (USW) Local 1014L, who had calmed down his combative patient by the time a security guard in another part of the hospital complex arrived at the behavioral health unit.

“They just don’t have what we need to do the job safely,” he said of health care employers around the country. “They do the bare minimum, and it’s more reactive than proactive.”

Even before COVID-19, health care workers faced five times more violence on the job than their counterparts in most other professions. Incidents skyrocketed during the pandemic as the crisis exacted a heavy toll on Americans’ emotional health and patients, relatives and community members grew frustrated with staffing shortages at medical facilities.

The violence is now so pervasive that many health care workers are victimized over and over again. Eckley, for example, has been punched repeatedly, stabbed with a pen, and bitten by an HIV-positive patient who disliked the meal he was served. He’s also witnessed numerous attacks on co-workers and once watched a patient batter a door to get to a jar of candy on the other side.

Early in the school year, a kindergartner on Joni Meyer’s school bus got motion sickness and threw up all over himself—and his brother, his cousin and his laptop.

Meyer pulled over, soothed the anguished child, cleaned everybody up as best she could and then drove the bus to school.

Over 34 years, Meyer has served as chauffeur, counselor, confidant, nurse and guardian angel to countless children like these in Bay City, Mich. She’s skillfully navigated a 35-foot, 14-ton bus over serpentine roads and through treacherous winter storms, safely delivering what she calls “our precious cargo” to schools and football games. Now, in gratitude for Meyer’s dedication, officials in the Bay City Public Schools intend to kick her to the curb.

The school district recently notified Meyer and her 25 co-workers, represented by United Steelworkers (USW) Local 7380, of plans to eliminate their jobs and outsource transportation to a for-profit company. By continuing down this road, they’ll join the ranks of short-sighted employers who auction off crucial services to the lowest bidders, potentially saving a few bucks but gambling on safety.

Out-of-town drivers will never know Bay City’s rural roads or care about the community’s 8,150 students like Meyer and her co-workers, some of whom log upwards of 150 miles during work days that—because of split shifts—begin at 5 a.m. and end 12 hours later.

“I really enjoy my job. I enjoy my children. They’re sort of like extended family to us,” said Meyer, Local 7380’s unit president and the district’s second-most-senior driver, who wonders where a private contractor would even find replacements.

In the wake of the COVID-19 pandemic, school districts around the country have struggled to recruit and retain drivers. Because of the shortage, some districts closed schools or cut service while others called in the National Guard for help, put teachers behind the wheel or paid parents to transport their own kids. So far this year, bus companies contracted by one Maryland school district missed more than 3,000 trips, leaving hundreds of students and parents in the lurch.

Bay City already has the dedicated, reliable work force that other school districts crave. Teachers, elected officials, other community leaders and parents are rallying around the drivers, demanding the school district keep them on the job and avert the potential nightmare contracting out would bring.

“It’s terribly sad and unfortunate and quite disappointing because it’s going to rock these kids’ boats. Some of these kids come from homes that aren’t really stable. This is one stable thing they have in their lives,” Kristin McDonell, a Bay City parent, said of district drivers. “I trust these drivers. They’re part of our backbone. It means a lot to them to be contributing to their community in this way.”

Montrell Steib recalls the young electrician rattling off his expertise in the latest technology and systems, hoping to make a good impression during his job interview at Atlantic Alumina in Gramercy, La.

But a supervisor took the wind out of the worker’s sails, saying he’d be working on old and temperamental equipment at the nation’s last remaining alumina refinery and that keeping the aging facility operating with Band-Aids would be a far cry from what he expected.

Steib, president of United Steelworkers (USW) Local 5702, relates that story to underscore the feeble state of U.S. supply chains and the need to equip America’s workers with the tools and resources needed to compete globally.

Although both the Senate and House each passed long-overdue legislation to overhaul the nation’s manufacturing base, only the House’s version, the America COMPETES Act, provides billions in direct investments essential to preserving critical industrial infrastructure like the Gramercy refinery.

“This is it. This is all we have,” said Steib, one of about 270 USW members who work there, noting that losing the facility would make America entirely dependent on other nations for the alumina essential to the automotive, health care, consumer goods and numerous other industries.

The long decline of American manufacturing constitutes a national security threat that recent shortages of face masks and semiconductors threw into sharp relief. America lags behind other countries not only in the production of these goods but in the manufacturing of aluminum and steel, commercial shipbuilding and the mining of essential minerals.

“Together, a U.S. business climate that has favored short-term shareholder earnings (versus long-term capital investment), deindustrialization, and an abstract, radical vision of ‘free trade,’ without fair trade enforcement, have severely damaged America’s ability to arm itself today and in the future,” the Defense Department warned in a report last year.

The America COMPETES Act would provide loans and grants for upgrading manufacturing facilities so that workers like Steib no longer have to scrounge parts or cannibalize some machines to keep others running. The investments also would enable employers to expand production, which Local 5702 members see an urgent need to do.

“Everything we can make is already sold,” Steib observed of current market conditions. “I wish we could open up more alumina facilities in the U.S.”

The single mom appeared at the church in Davenport, Iowa, where Vera Kelly volunteered and asked for some food to share with her children.

But not just any food, Kelly recalled, noting the woman only wanted items she could keep in the car where the family lived and cook on the charcoal grill that served as their kitchen.

Civic-minded activists like Kelly do all they can to assist the less fortunate and lift up their communities. But only fixing America’s broken tax system, as President Joe Biden has proposed, will force the super-rich to pay their fair share and curb the rampant economic inequality that’s turned the nation into a land of haves and have-nots.

“They have the money. We don’t have it,” Kelly, a member of Steelworkers Organization of Active Retirees (SOAR) Chapter 11-4 and the vice president of the Davenport NAACP, said of America’s billionaires. “Some of them got it by hook or by crook, and we worked honestly.”

“If you’re a billionaire, you’re never going to go broke,” added Kelly, who supports Biden’s plan calling for the wealthiest citizens to finally begin paying what they’ve long owed. “They can live off the interest on their money.”

The 77-year-old Kelly, who spends Saturday mornings distributing boxes of cereal, sugar, frozen chicken and other items at a local food pantry, worked 32 years at the former Alcoa plant, now operated by Arconic, near her home. Her husband, B.W. Kelly, who died in November 2020, worked at Deere & Co. for 33 years.

The two paid taxes on every dime they ever earned, considering it not only a duty but a privilege to support America’s social programs as well as essentials like infrastructure funding, medical research and the national defense.

But instead of holding up their end like the Kellys, America’s richest citizens let the rest of the country carry them. A rigged system lets billionaires exploit tax-avoidance tricks unavailable to the masses. The uber-rich shirk their obligations to society and freeload off of everyone else while squandering ever-growing sums on jets, mega-yachts, spaceships and even private islands.

“The rich get richer and the poor get poorer,” Kelly said, referring to the income inequality that’s been growing for decades. “That’s the way that happens.”

“They look down on people,” she said of billionaires. “They think they’re entitled.”