Health Care Crisis: Future Is Up To Us
Above photo: Mary Spoto, general manager of Madison Chop House Grille, prepares the restaurant to shift from takeout-only to dine-in service. Information that influenced Gov. Brian Kemp’s decision to reopen the state may have distorted perceptions of progress against the coronavirus. AP./
A society that is governed in such a way that it fails to protect its people from the catastrophic harm of the COVID 19 pandemic is a society ripe for revolutionary transformation. The pandemic crisis exposes capitalism’s inability to solve the problems it has created for humankind and the earth. The future depends on our class’ – the working class most impacted by the crisis – capacity to implement the visionary transformation necessary to literally save our lives and the planet.
From the outset, the U.S. response to the virus illuminated the chasm between the needs of the public’s health and safety and the core corporate character of the government. It isn’t just a case of botched lab tests, or ramping up dwindling supplies. For decades the public healthcare system has been sidelined and intentionally underfunded. Public health has been forced to take a back seat to the corporate medicine of commercial insurance companies, private hospitals, big pharmaceuticals, and proprietary research, – all of which sacrificed the public good for profitability.
Today, private laboratory corporations like Quest, Lab Corp, and Abbott are doing 85 percent of all the COVID 19 testing. Each of these corporations has its own proprietary testing supplies, reagents, and disrupted supply chains. It doesn’t take long to connect the dots about the current anarchy of coronavirus testing.
The failure of the federal government to coordinate or nationalize medical supply production and distribution defaulted everything to the laws of the market place. Governors, mayors, hospitals, and clinics were thrown into an international bidding war to obtain everything from ventilators to masks and testing kits. The price of Personal Protective Equipment (PPE) jumped more than 1000 percent. The essential N95 mask for the healthcare workforce went from 38 cents apiece to over $5.75 each.
The private ownership of the necessary tools required to fight the spread of the virus has functioned to strangle the urgent need for mass testing and the protection of hospital workers.
It’s not only the private ownership of life-saving supplies that’s putting us in jeopardy, but also the decisions about who gets PPE or tests, and who is deemed essential that have been handed over to the chaos of a fractured for-profit only market place.
Our best tools for slowing the spread of the novel coronavirus are our most primitive: physically distancing, face masks in public spaces, 20 second frequent hand washing, PPE where needed, and sheltering in place. Now, with Southern states leading the way, even those most basic protections are being stripped away as businesses are being encouraged to reopen.
“The Past is Never Dead. It’s Not Even the Past”
Governors of Georgia, Florida, and South Carolina are opening gyms, restaurants, barbershops, movie theaters, beaches, and more. Governor Brian Kemp of Georgia, having stolen the mid- term election through massive voter fraud, is serving up all the people of Georgia, especially Black, Latinx, indigenous and immigrant communities as an experiment to see how much illness and death will be tolerated to “save” businesses. This is not a new formula but rather an amplification of how Southern political structures have always worked and been dictated by Wall Street’s needs.
The stakes are higher now. The severe acute respiratory distress syndrome and multi-organ failure that COVID 19 can cause doesn’t limit itself to location, color, and nationality, international or state borders. It does have a special affinity for people with preexisting conditions like chronic lung and heart diseases, asthma, high blood pressure, diabetes, and kidney diseases. All of these, along with a high percentage of the elderly are conditions that disproportionately impact the South, especially the rural South. Southerners were experiencing dire health disparities long before the pandemic: Those inequities include the failure to expand Medicaid, a weak to non-existent public health infrastructure, the epicenter of rural hospital closures and home to over 20 percent uninsured.
Dougherty County, with a nearly 70 percent Black population in southwest Georgia’s Black Belt, has more deaths and sickness per capita than any other county in the State, despite having less than 1/10th the population of Atlanta’s Fulton County. A model shared by the CDC and created by a team at MIT projects the number of deaths in Georgia to more than double to 4700 deaths by early August as social distancing is relaxed.
Rise of Disruption and the Disruptors
It is not only the coronavirus that spreads exponentially. It is also the rise of the technology sector as the dominant force in the crisis of capitalism, especially in healthcare’s 18 percent of the GNP. Since the last decade’s introduction of electronic medical records capable of holding vast amounts of big data, technology companies and their private equity investors have been gobbling up mountains of healthcare resources and moving services away from hospitals to wearable apps and telemedicine. Once the Center for Medicare and Medicaid approved Medicare reimbursement for ‘telehealth’ services this March, the genie was out of the bottle. It will not go back if and when the pandemic subsides.
The impact of this further corporate consolidation of healthcare will be enormous. It is estimated that by this June, 60,000 primary care practices will close or shrink permanently with a ripple effect of another 800,000 lost jobs. Even now, at the height of the pandemic, upwards of 50,000 healthcare workers have been laid off, and thousands more are facing pay cuts as profitable elective surgeries and procedures have been suspended by hospitals.
At the very time when primary care is crucial to health, its future is insecure. More disturbing trends are also emerging. Touting a watch that alerts the wearer when in close proximity to a person who has tested positive for coronavirus is less about public health and more about surveillance. It’s likely that hundreds of hospitals will go bankrupt and close over the next months. Big university systems whose revenues depend more on corporate, proprietary research funds boosted by federal grants and loose guidelines will likely survive along with enhanced virtual medicine. But what way forward for public health?
The Future is up to Us
The COVID 19 pandemic has brought into laser focus the interconnectedness and interdependence of all life on the planet. This novel virus and others such as SARS, MERS, Ebola, Zika, and HIV have largely emerged from human assaults on environmentally sensitive areas and fossil fuel driven climate change. The fragmentation and assault on wild species’ habitats are causing microbes that were harmlessly harbored in other species to jump to a humanity that lacks immunity to these new pathogens.
There is no cure for the coronavirus. Vaccines are under development, but there is no guarantee that they will be globally, universally, and freely administered once science confirms their efficacy and safety. It is capitalist relations that will bear the major responsibility for the massive viral spread, with its deadliest impact on the most poverty-stricken and health insecure global working class.
The programmatic demands emerging from the working class for guaranteed livable income, safe jobs, and housing, hazard pay and PPE for essential workers, clean water, the end to mass incarceration and ICE detentions; and debt, rent, and mortgage forgiveness are not just necessary in a time of crisis but are integral to sustaining the public’s health all the time. The immediate expansion of Medicaid now and the passage of Improved Medicare for All are urgently needed in the face of 30 million newly unemployed and likely uninsured. Through work place organizing and community actions like mutual aid teams and massive digital pressure, some of these are being implemented now, but all must be made permanent.
The COVID 19 pandemic has accelerated a digital restructuring in society that’s been underway for years. What is needed is a trusted community rooted, scientifically robust and rapidly responsive public health infrastructure that is universal, comprehensive and capable of addressing the inequities that are not only built into the private commercial health system but into all of class society. It’s not about having a private health system for the shrinking few that can afford it and a public health system for everyone else.
We see the outlines of what’s needed through the lens of this crisis. The free distribution of goods and services, coordinated compassionately and cooperatively, and accountable to the demands of this new class of workers being created by this crisis: distribution according to need, not for profit. A new society is demanding to be born. It’s our collective obligation to make it happen!