Everything is Politics (1)

By:  Robert Bryson

Recent allegations are being thrown around by both Republicans and Democrats that the side-opposite is “politicizing” COVID-19 and using it to push through “their” agenda. However, politics isn’t a bad word. Politics is another word to describe the process by which a group of people make a decision. HOAs, unions, book clubs, local governments, and business management all engage in politics in some way. Everything is politics. Everything has been politics.

During normal times, the process is slow, deliberate, exhausting, confusing, and distasteful. During crises, it is fast, incompetent, corrupt, and, sometimes, groundbreaking. Politics doesn’t halt for a crisis, politics is accelerated by the crisis.

Indeed, a crisis can highlight vulnerabilities that the country was previously able to ignore. The Great Depressions exposed America’s vulnerable populations—single mothers, children, the blind and physical impaired. While the country was reeling, it also passed one of the most consequential bills in its history, the Social Security Act of 1935 which established a system of old-age benefits for workers, unemployment insurance, aid for dependent mothers and children, for the blind, and physically handicapped, and benefits for victims of industrial accidents.[1]

So too here, COVID-19 is exposing the catastrophic failure that is the American healthcare system. What many do not consider is that a “private” (as opposed to public) institution is operated to generate a profit, even hospitals which may be nominally non-profit, earn billions in revenue, granting preferential treatment for those who can pay. The U.S. healthcare system (excepting Medicare, Medicaid, and similar programs) is operated for profit. Hospitals are looking to increase their margins, insurance companies want to increase their margins, drug companies would like to develop drugs which they can sell at a high markup (like for hair loss).

When the economy is strong, and unemployment is low, this system can operate just fine. However, the instant that any of these careful pillars is undermined, the system is an unforgiving place for those who are no longer granted access because they lost their job. Before this pandemic, it probably did not occur to many people that you could lose your job due to a pandemic, and that by losing your job, you could lose your healthcare … in the middle of a pandemic.

Hospitals are big business, so big that private equity groups are buying up medical groups. Blackstone Group owns TeamHealth, an agency that staffs emergency rooms for hospitals. Dr. Ming Lin spoke to the press and on social media pleading for more supplies. Blackstone Group fired him for doing his job, saving lives[2][3]. Doctors and nurses are being fired in the middle of a pandemic because it is more important to safeguard the images of the various businesses, rather than engage in the messy work of providing healthcare, adequate equipment, and saving lives. Undoubtedly, this travesty is being repeated all over the country, too many times for the media to report on it.

Finally, for this article, but not for this debate, the market demands efficiency. Greater efficiency leads to increased profits. Modern hospitals are ruthlessly efficient, maintaining just enough beds to maximize use.[4] However, an efficiently run hospital is also one that is incapable of dealing with an unexpected surge in cases.[5] Hospital won’t maintain surplus stockpiles of beds and equipment while they are driven by profit, but a government-run system can.

COVID-19 is underscoring the tragedy of the American healthcare system. A system run for profit cannot adapt to address public health crises. Business can come up with clever solutions, but the government must implement them. Businesses cannot absorb months of losses, the government can. Businesses cannot provide healthcare for free in the middle of an economic freefall, the government can. Businesses cannot spend millions researching and developing tests, cures, and treatment protocols for potential outbreaks, the government can.

Politicians aren’t using COVID-19, they are responding to the vulnerabilities it exposed. Now is the time to engage in the hard work of politics.

 

[1] https://www.ourdocuments.gov/doc.php?flash=false&doc=68

[2] The Seattle Times, “Bellingham physician who decried lack of coronavirus protections is removed, sparking protest,” Patrick Malone, 29 March 2020

[3] Blackstone (via TeamHealth) did release a statement saying he wasn’t technically “fired,” he simply no longer works at the hospital. However, a spokesperson backtracked and said he was indeed fired.

[4] Vox, “The US needs a lot more hospital beds to prepare for a spike in coronavirus cases,” Zeeshan Aleem, 14 March 2020; Bloomberg, “Why the U.S. Doesn’t Have Enough Hospital Beds,” Stephen Mihm, 13 March 2020

[5] Drs Cavallo, Donoho, and Forman, “Hospital Capacity and Operations in the Coronavirus Disease 2019 (COVID-19) Pandemic—Planning for the Nth Patient,” published 17 March 2020

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