The trick with Maslow's Hierarchy is that it's not a serial process. Problems can happen in parallel, and different combinations of problems can happen to different kinds of people. All of society is not carried up and down the pyramid in lockstep, as we can clearly see. This means it's really hard to define any objective "significance" to a problem. "Fundamental", sure; you can't worry about the cost of emotional labor if you're dead from hunger, or a workplace fatality as you suggest. But it's much harder to assert that that provides a complete ordering over "kinds of problems people have".

So, in short, I guess instead of defining the whole picture as a (probably) false dilemma, why not do both? All of these issues need addressing, and all of these issues need voices. To paraphrase the Horowitz story, there's no silver bullet here, so we need lots of lead ones.