At his Feb. 27 press conference, President Trump said “… Johns Hopkins, I guess — is a highly respected, great place — they did a study, comprehensive: ‘The Countries Best and Worst Prepared for an Epidemic.’ And the United States is now — we’re rated number one. We’re rated number one for being prepared. …”
President Trump held up a map from The Global Health Security Index, issued in October by the Johns Hopkins Center for Health Security. This study rated 195 countries on their ability to cope with an epidemic or pandemic The good news was that the United States was No. 1. That would be more impressive if Johns Hopkins hadn’t reported “The US scored 83.5 and ranked No. 1 in five of six categories: prevention, early detection and reporting, rapid response and mitigation, sufficient and robust health system, and compliance with international norms. It ranks 19th in overall risk environment and vulnerability to biological threats, a category that assesses political and security risk, socioeconomic resilience, the adequacy of infrastructure, environmental risks, and public health vulnerabilities that may inhibit a country’s ability to prevent or respond to an epidemic or pandemic.” In other words, No. 1 is a B-minus.
In 2014, in response to the Ebola epidemic, President Obama appointed a former vice presidential staffer, Ronald Klain, as“epidemic czar,” with responsibility for organizing and coordinating a national response to an epidemic or pandemic. The epidemic task force was disbanded by Trump in 2018.
In addition to the national administrative preparation for an epidemic, which would include stockpiles of masks and gowns, and a formal communications system, there should be the resources for providing medical care – universal healthcare. This has been a goal of the Democratic Party, but has largely been blocked by Republicans.
According to the Commonwealth Fund Affordable Care Act (ACA) Tracking Survey the improvements in healthcare coverage created by the Obama administration are starting to decline, largely because of efforts by the current administration to dismantle the ACA. These include a shortening in the enrollment period, the repeal of the individual mandate penalty, and the approval of healthcare policies that don’t meet the standards of the ACA.
The Trump administration approved the sale of high-deducible policies. For 2020, the IRS defines a high-deductible health plan as any plan with a deductible of at least $1,400 for an individual or $2,800 for a family. High-deductible plans offer lower premiums, but higher prices for each medical visit, and many people with high deductible policies simply can’t afford to visit a physician. This is particularly true for a disease like Covid-19, which seems like nothing more than the common cold. From the transcript of Rush Limbaugh’s radio show (2/24/20): “Now, I want to tell you the truth about the coronavirus. (interruption) You think I’m wrong about this? You think I’m missing it by saying that’s … (interruption) Yeah, I’m dead right on this. The coronavirus is the common cold, folks.”
The Commonwealth Fund report showed that the number of uninsured adults between the ages of 19 and 64 rose to 15.5% in March 2018, up from 12.7% in 2016. The percentage of uninsured with lower incomes rose even more: 25.7% in March 2018 compared to 20.9% in 2016.
Health insurance is only part of the problem. To deal with an epidemic caused by an airborne infection or, like Covid-19 through respiratory droplets, we need hospitals where infected persons can be isolated– but hospitals are closing all over the United States. Most of the closed hospitals are in rural areas, which is a significant problem, but where, because of low population density, there is less risk of viral spread. High population density and public transportation are serious risks for contagion, and major cities have also been losing hospitals. Philadelphia’s Hahnemann University Hospital closed last autumn. Hahnemann was founded in 1848 and employed 2,500 people. It served some of the city’s sickest, poorest patients, the patients most at risk of infection.
New York City is home to a number of world-famous hospitals and six medical schools, but it too has lost hospitals – 174 hospitals, according to a 2015 tabulation by bestofhealthindia.com.
There’s also an ongoing need for healthcare professionals and technicians. According to a report in CNN Business, “The US will need to hire 2.3 million new health care workers by 2025 in order to take care of its aging population …” The Bureau of Labor Statistics estimates that growth of healthcare professions are “projected to grow 14% from 2018 to 2028, much faster than the average for all occupations, adding about 1.9 million new jobs.” Unfortunately, the greatest growth will be in the least-skilled occupations, such as home health aides, which offer the lowest salaries. Further, the projected growth is largely due to an aging population – the people who are at greatest risk from C-19.
Simply, a B-minus won’t be good enough this time.
Sam Uretsky is a writer and pharmacist living in Louisville, Ky. Email sdu01@outlook.com.
From The Progressive Populist, April 1, 2020
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