Health Care/Joan Retsinas

Lessons from the Twilight Zone

This just in: the federal government needs to back up state and local health departments in a pandemic.

Americans are living in the Twilight Zone. We saw the previews as the news tracked the virus’s devastation in China, in Iran, in Italy. Weeks of watching sports re-runs on television, ordering takeout from restaurants that eventually closed, and updates on the scarcity of ventilators have made the television show real. When social isolation melds into semi-quarantine, it is hard to focus beyond the daily reckoning of loss of contact, not just with friends and colleagues, but with the myriad others in daily life.

Still, it is time to ponder our future, post-Twilight Zone.

We need a strong federal government. The idiocy of axing the office that would plan for pandemics emerges no longer as cost-cutting efficiency, but as criminal. Did we expect that we would be forever immune from national health emergencies? Did we expect governors in Little Rock, Annapolis, and Salem to figure out what to do? The governors throughout this period have emerged as leaders: they have shut down the places where people gather, the petri dishes for this virus. They have closed schools, more petri dishes. They have set up testing stations, hospital beds, hot lines. But they need Washington to order and distribute masks, ventilators, tests.

We need a smart Washington, staffed with the best and the brightest. Our president exudes a folksy anti-intellectual bent. He has cavalierly dismissed the nerdy scientists throughout government. (Climate change? A hoax). The press conference where he shakes hands with the CEOs who have agreed to help (though being able to buy stuff curbside doesn’t rank as high as the need for tests) stands as more than idiotic … dangerous. It encourages Americans to ignore the admonitions of physicians to stay six feet away from one another. Ironically, months before the virus forced nursing homes into isolation units, the federal government had moved to loosen regulations on those homes.

We need our federal government to negotiate with other countries. Other parts of the world had tests for the virus. Could we have bought them from the World Health Organization? From Germany? The formula for the test exists. Could we months in advance have ordered our laboratories to spew forth these tests, along with the equipment for testing. “American exceptionalism” can be dangerously naive. Did we assume we would construct better tests than the rest of the world?

We need to bolster state and local health departments. In the backdrop of budget cuts, the health departments have been spurring vaccination clinics (the regular flu kills lots of us), inspecting restaurants, verifyiing nursing home standards, issuing all those stop-smoking directives that have made some of us stop smoking. They have gathered the data that underlie actions. In short, we need Small Government as well as Big Government.

We need to invest in education. The more that scientists know, the more likely they are to find a vaccine for this virus. But basic scientific knowledge underlies that endeavor. And once scientists have possible vaccines, they must test them. Our president can cavalierly order tax cuts; he cannot cavalierly order scientific wisdom. That means money for basic research, money for the National Institutes of Health, money for science education in high schools and colleges. Currently, we import a major swathe of our PhD scientists. We are not training the people who wll find the cures we need.

Finally, we need to reform our health insurance system. The government has waved co-pays for tests (when we get enough of them), for visits, for treatment for this virus — but only for this virus. Who will pay for the tests, the treatments for people who have no insurance? In a spirit of capitalist laissez-faire, we may not care whether those people have heart disease, diabetes, glaucoma or asthma. Those diseases are non-communicable. But we care that a swathe has something that can transmit (the reason we aggressively treat patients with tuberculosis, regardless of insurance status). Forget the grandiose Medicare for All. We simply need to bring everybody under a a basic insurance umbrella, including the immigrants, documented and not. who live and work among us. They have been making the take-out meals, delivering the medications, stocking the supermarket shelves that have sustained us in the Twilight Zone.

Joan Retsinas is a sociologist who writes about health care in Providence, R.I. Email retsinas@verizon.net.

From The Progressive Populist, April 15, 2020

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