A Broken Economy and a Third World Healthcare System

Is it just a poor leadership response that led to the severity of this crisis or is the underlying economic system and a for -profit health system contributing factors?

Disclaimer:  I fully admit that I am not an expert in the fields of healthcare or economic systems. I also have to say that this has been one of the most difficult articles I’ve tried to write in my 25+ years of doing this.  It is easy to point fingers but it may take articles like this to lay the groundwork for the necessary changes we must face as a nation in the coming months and years.  I do feel, after listening to weeks of depressing news on the extent of spread of the COVID-19 virus throughout the world, that a discussion of this type has merit.  It probably is best to allow the focus at this time to be on limiting the devastation, both to our health and our economy, but at some point when the dust is cleared, there will be a need for scrutiny beyond compare as to what went wrong and what we can do to be better prepared next time, for there will be a next time.

I can’t get this nagging question out of my mind: “Would we as a nation have been better able to respond to this crisis if we had implemented a government-managed, single-payer health system during the Obama administration?”  There is evidence that indicates that much of what we have faced in the lack of supplies and equipment (beds, ventilators, etc.) was caused by a for-profit health system that is designed to provide for only those needs that are typical, frequent and profitable to process. In this article published by The Guardian entitled: "Coronavirus is revealing how broken America’s economy really is" it demonstrates in very clear terms how severely restricted the US health system is in its ability to respond to a pandemic of any kind.  Category after category of statistical data shows that we have one of the worst healthcare systems in the world, from the number of hospital beds and doctors per capita to maternal deaths, life expectancy, and income inequality.  In nearly every case, the U.S. is ranked in third-world like territory.  In addition, the cost in healthcare in 2018 in the U.S. was the most expensive in the world, representing 17.15% of our GDP ($3.6 trillion  - source www.CMS.gov).  Switzerland is second at 12.25%

We have the most expensive healthcare system in the world and are the least capable of handling a crisis.

“The facts are as exhaustive as they are exhausting. There’s one simple conclusion from all of this. We’ve been tricked. We’ve been told that America, like most other majority-white countries, deserves the title “developed economy”. It does not... You cannot constantly operate hospitals at close to capacity in order to maximize profits. The pursuit of private money in systems built for public good has not worked ethically or practically.”  (The Guardian)

A simple comparison of this healthcare model to the restaurant and hospitality industries will show you that empty hotel beds and empty tables at a restaurant are not a good thing for profits.  Everything possible is done in those industries to minimize these “empty” factors.  The same is true in a healthcare-for-profit industry.  A for-profit hospital cannot not maintain a large inventory of extra, unused equipment and supplies on hand and maintain profitability at the same time.  Maintaining a full capacity with a just-in-time supply chain leaves us a system that will never be able to respond to a national epidemic suchmas the one we are now experiencing

The main criticisms have been the manner in which we responded to this pandemic and that we did not have sufficient virus testing supplies, Personal Protective Equipment (PPE), ICU beds and ventilators available.  The one consistent comment was: “The supply chain is broken.”  It is a supply chain designed to handle the day-to-day with regularly scheduled, weekly deliveries of supplies that are relatively consistent from week to week.  In addition to not having supplies for this large of a surge of critical patients, there is no central authority managing the orders, prioritizing and guaranteeing prioritization and delivery to where the need was the highest.  Instead, everyone was competing for the same supplies.  John Doe ordering on Amazon was just as able to order the critically needed PPE equipment as was in demand at an ER in New York City.  States were unsuccessfully trying to outbid each other and the Federal government along with every other countries in the world for these supplies.  The only thing this achieved was to drive the prices through the roof so those who held them would profit immensely by having them.

In the meantime, patients and healthcare workers died.

Daily the Federal Government was asked to provide support to the growing crisis.  Regular messages from Trump and the White House said things such as:  “We are not to blame.”  “Relax, it’s going to disappear.” “The Federal Government is not designed to be an ordering system.”  “We won’t need 40,000 or 30,000 ventilators.”  “This is our inventory; it’s not for the States.” 

There was failure in leadership at the State level as well, indicated by the simple fact that at this writing, more than a month into the crisis there are governors who have yet to order Stay-at-Home requirements.  Everyone in the world knows by now that the only way to fight this disease is to keep people isolated from one another.  Countries such as Germany, South Korea and New Zealand are shining examples how separation procedures work.

Failure in leadership cost thousands of lives.  When a disaster strikes, people are completely reliant on the leadership of their community to make the right decisions to mitigate and eliminate unnecessary loss of life.

How does our economic system play a role?  Are the failures in the healthcare system and in leadership the root cause or is there something else at play?

A discussion about the impact of neoliberalism on our ability to respond to a pandemic of this magnitude can take us into an economic debate that is over one hundred years in the making.  Suffice it to say that there is strong evidence that the economy of Milton Friedman which is focused on generating wealth for the elite and depends on market mechanisms to respond to all societies’’ needs under a for-profit focus is clearly another contributing factor to the escalated crisis.  So much so that it can be referred to as The Plague of Liberlism, published by Truthout.org.  After reading this interview, I was inspired to write the following words:

“Economists have understood the failure of neoliberalism to afford succor to anyone but the ultra-elite ever since the Robber baron era. As Ayn Rand's books grew in popularity in the 1960’s I remember having long discussions with my mother, who was a fan. I kept saying it was an elitist philosophy that would leave us (the middle class) out in the cold. Now we see the full impact of the failure of neoliberalism in its inability to respond to worldwide disasters like Climate Change and COVID-19. Perhaps a pertinent question today would be "Who is John Galt and who the hell does he think he is?"

Who is John Galt and can he save us from the plagues of COVID-19, a third-world healthcare system, failed leadership, and from economic neoliberalism?   Can God?

I doubt it.