Global Pressures and Individual Choices Theme Analysis

It’s easy to blame farm management for exploitative working conditions, patients’ poor health choices for their chronic pain, and migrant workers’ greed and impatience for their decision to illegally cross the U.S.-Mexico border. However, when author and physician-anthropologist Seth Holmes actually studies these issues, he realizes that global economic pressures—not individual choices—are actually responsible for them. Because most public conversations about agriculture, medicine, and immigration view individual decisions in a vacuum, without considering these structural factors, public policy consistently tries to change individual behavior rather than global economic conditions. This is usually ineffective. Instead, Holmes shows that, in order to institute more humane and effective public policy, government officials, scholars, and activists must understand the economic pressures that globalization places on individuals and communities.

Global economic forces—not poor individual choices—have caused the interconnected problems that Holmes studies in agriculture, public health, and immigration. Most importantly, the Triqui migrant workers whom Holmes studies don’t go to the U.S. because they want to strike it rich: rather, they literally have no other option. They used to farm corn, but when the North American Free Trade Deal (NAFTA) went into effect, their crop suddenly became uncompetitive with cheap, industrially produced, government subsidized corn from the U.S. Unable to keep farming or find work in Oaxaca, many Triqui people can’t afford to feed themselves or send their children to school. As a result, they have no viable economic option except migrating elsewhere for work. While conventional immigration narratives suggest that people like the Triquis are responsible for the consequences of crossing the border because they’ve freely chosen to do so, Holmes shows that their decisions are not truly free. Rather, because of the globalizing agriculture industry, they have no choice but to migrate.

The effects of globalization are also clear at the other end of the spectrum, in the decisions of the managers and healthcare workers who mistreat the Triqui migrants once they arrive in the U.S. The Tanaka Brothers Farm exploits its workers, forcing them to live in tiny metal shacks and suffer chronic health problems, but its owners are actually charitable, well-intentioned, and generous people. The Tanakas don’t improve these conditions or pay their workers more because they can’t afford to: facing competition from farms overseas, they constantly need to cut corners if they want to avoid bankruptcy. In other words, the Tanaka brothers don’t neglect their workers out of greed and cruelty. Rather, they have no choice because of global market forces in agriculture—the same economic pressures that forced their Triqui workers to leave Oaxaca in the first place. Similar pressures also explain why doctors and nurses provide substandard medical care to migrants. In the for-profit U.S. healthcare system, practitioners have no incentive to treat poor, uninsured immigrants like the Triqui farm workers. When they try to serve such communities out of goodwill, practitioners lack the resources they need to provide effective treatment (like medicine, language interpreters, and administrative support staff). Like the farm owners who can’t afford to treat their workers better because of economic pressures in the globalizing agriculture industry, healthcare workers can’t afford to adequately treat migrant workers’ illnesses because of economic pressures in the profit-seeking healthcare industry. The globalization that causes these problems isn’t an abstract, invisible, or unstoppable market force: rather, it’s a deliberate policy decision that governments have the power and obligation to overturn. Holmes isn’t trying to say that migrant workers’ suffering is inevitable because it’s the result of global forces—rather, he’s saying that it’s impossible to alleviate this suffering simply by changing individual decisions, as systematic policy change is what’s necessary.

To effectively address exploitation and human suffering in agriculture, medicine, and immigration, public policy must target broad economic change, rather than just trying to influence individuals’ decisions. First, limiting undocumented immigration and healing migrants’ suffering at the border requires changing economic conditions in those migrants’ home countries. While many Americans assume that giving more resources, weapons, and political power to the border patrol will dissuade migrants from crossing the border, this assumption is based on a misunderstanding. For most undocumented migrants, crossing the border will nearly always be worth it, as they face worse violence and abject poverty at home. But through policy change, the U.S. government could dissuade people like the Triquis from migrating illegally. By modifying its agricultural export policies, the government could make it possible for them to stay in Mexico, and by giving them protected status as temporary guest workers, the government would make it possible for them to cross the border legally and safely. But improving migrants’ lives and regulating immigration requires this kind of policy change, which targets structural conditions rather than individual decisions. Similarly, whereas the Tanaka brothers can take incremental steps to improve working conditions, they can’t meaningfully improve their workers’ lives unless the government implements new policies to protect workers and farms like theirs. Finally, to solve the problems with migrant healthcare, Holmes argues that it’s necessary but insufficient for individual doctors to unlearn their prejudices and listen better to their immigrant patients. Rather, the U.S. needs to overhaul its healthcare system and address the systemic lack of funding where it’s needed most—in the poorest and sickest communities. Again, Holmes underscores that the solution is public policy, not individual decision-making.

By emphasizing how the global economy impacts individual lives, Holmes hopes to recenter conversations about immigration, healthcare, and agriculture on the structural forces that shape people’s personal decisions. As a result of these forces, the people who actually perpetuate violence and inequality on the ground—like Rob and John Tanaka, who exploit their workers, or the coyotes and Border Patrol agents who duel at the border—have little choice in the matter. As long as the public continues to view these individual decisions in a vacuum, isolated from the global economic context that causes them, the real policy changes needed to aid widespread suffering will never come about.