Grassroots/Hank Kalet

Fix the Broken Health System

Grim milestone. That’s the phrase the press uses. A cliche. Melodramatic in a way that cheapens what’s been happening.

We are a year into a pandemic that has killed 400,000 Americans and counting as Joe Biden prepared to take office on Jan. 20. That’s about 100,000 deaths in the last month. By May 1, experts say, we could surpass 567,000 deaths — despite a Biden’s shift from Trump’s hands-off pandemic response disaster to a more aggressive effort to get everyone vaccinated.

This is the legacy not just of Donald J. Trump, but a Republican Party that decades ago abandoned any pretense of the common good. Decades of hospital closures and consolidations, shortages of personal protection equipment, respirators and ICU space marred the early response in the Northeast. And now, the same broken health infrastructure and lack of federal guidance has resulted in a botched vaccine roll out compounded by shortages.

New York City and other regions of New York State are reporting that they are running low on vaccines and may have to cease distribution. Other cities report similar issues.

The people hurt most by the failures of our health infrastructure live in low-income neighborhoods, often people of color who have been at the front lines during this pandemic.

Kaiser Health News reports that, among the initial doses distributed in “16 states that have released data by race, white residents are being vaccinated at significantly higher rates than Black residents, according to the analysis — in many cases two to three times higher.”

This is happening even as healthcare workers — a workforce that is more diverse than other occupations — are getting first dibs at the vaccine. The Kaiser report says that “in every state, Black Americans were significantly underrepresented among people vaccinated so far.”

“Access issues and mistrust rooted in structural racism appear to be the major factors leaving Black health care workers behind in the quest to vaccinate the nation,” the report says. “The unbalanced uptake among what might seem like a relatively easy-to-vaccinate workforce doesn’t bode well for the rest of the country’s dispersed population.”

These disparities are not unusual. Racism has played a central role in the provision of care in the United States throughout its history, in ways ranging from doctors dismissing the concerns of Black patients to doctors blaming Blacks for their health woes.

The lack of a real universal health system in the United States exacerbates the problem, limiting access for millions and denying access for millions of others.

And because our health system is profit based, it does not prioritize care. This is not a knock on doctors or nurses, who have done amazing work under the most difficult circumstances this year. They are just cogs in a larger system that rewards scarcity, and prioritizes expensive non-emergent, even cosmetic procedures over basic preventative and immediate care.

Health insurance companies regularly deny needed procedures and medications, which keeps profits in their pockets. They require doctors to see more and more patients, each getting less and less time. And they chew up an increasingly larger share of the health dollar every year, both by channeling the money into their coffers and by forcing medical practices to hire larger and larger in-house financial teams.

Drug companies focus their efforts on medication that will generate major profits — like drugs for erectile dysfunction and new “illnesses” like restless leg syndrome — at the expense of research and development on more effective drugs to treat deadly illnesses like AIDS and malaria, which are expensive to produce and often generate relatively little in revenue.

The Biden administration has promised billions toward vaccine manufacture, distribution, and provision, and billions more to retrofit schools to allow them to open. These efforts are coming late due to the inaction and ineptitude of the Trump administration. Biden will have a honeymoon period that he will need to use to repair the damage of the last four years, and to get our COVID response up to where it should have been during the last year. His $1.9 trillion budget proposal is far bigger and far reaching that I could have imagined and far more progressive than anything we saw during the Obama administration.

Sadly, Biden’s plan will not address the long term issues, and cannot, at least not yet. He’s playing catch up and he’ll be dealing with a Senate that is only nominally in Democratic control, one in which the West Virginia conservative Joe Manchin will wield great power, meaning there are no guarantees his plan will get through the Senate intact.

We can hope for the best, but we must demand that our senators act, put pressure on them, make it clear that their re-election will depend on what they do now with Biden’s emergency spending plan, and what they do going forward to fix the healthcare system, to break profit’s hold on the system.

COVID and Trump have exposed the major weaknesses in our healthcare system. We can’t wait to address them.

Hank Kalet is a writer based in New Jersey. Read his regular commentary by subscribing to hankkalet.Substack.com. Email, hankkalet@gmail.com; Twitter, @kaletjournalism; Instagram, @kaletwrites; Patreon, @newspoet41.

From The Progressive Populist, February 15, 2021

Populist.com