A Turning Point Part V: Healthcare

For a number of reasons—none of them good for us—it’s been safe, profitable, and self-satisfying for certain public figures to demean science and experts. When we finally limit the damage and scope of this novel virus, it will be the public health experts—researchers, statisticians, doctors, infectious disease specialists like virologists and epidemiologists—not the pols and pundits, who save us.

It should, and hopefully will, return schooled experts to their proper place of respectability in society, but our top political leadership, conspiracy theorists like QAnon, and the Rush Limbaugh/Sean Hannity continuum of bloviators, will move on from their assaults on science and medicine to generate outrage about whatever they see as the next big contrarian attention-getter. It’s important to remember that they are interested only in audience and ad sales. Scientific reason does not sell magic hair-growers, prostate-shrinkers, and get-rich-quick schemes.

They won’t be interested in the economic healthcare crisis Covid 19 has visited upon us, except to denigrate any response aimed at helping those most in need.

A recent Washington Post page-one headline read: Jobless Scramble for Healthcare. The pandemic has exposed the cruel inequities in our broken system. It is bizarre, perverted even, that in the ensuing Covid-19 economic collapse, 40 million Americans have lost their jobs, and according to Kaiser Family Foundation estimates, a total of 27 million are at risk of losing coverage at the precise moment they need it most.

Ever since FDR’s New Deal, conservatives have held that government has no role in providing a social safety net. They continue to rail today against Social Security. In 1964, a central tenet of Republican presidential candidate Barry Goldwater’s platform was to kill the then brand new initiative called Medicare. The notion that government shouldn’t be in healthcare will seem even smaller and sillier in the aftermath of this economically devastating pandemic.

In a reset, adequate healthcare must be regarded as a right, just as it is in every other developed country. I highlight “adequate” because so-called “catastrophic” insurance plans cover only the really big emergencies, and then, not all that well. They don’t provide for preventative care, or cover pre-existing conditions, well-visits, imaging, vaccinations, or routine testing. Still, even these limited policies remain out of reach for many people.

If you’re unmoved by human rights, perhaps the coming fiscal toll of tens of millions of uninsured will convince you. You’ll recall from childhood allegories that an ounce of prevention is worth a pound of cure. Economically speaking, curing is exponentially more expensive than preventing, but preventative medicine is the sole province of adequate health insurance plans.

In the early going, back when the lie, “anyone who wants a test can get a test” was being foisted on us, only the privileged and powerful could get tested. NBA teams got immediate testing while hospitals in Orlando had no access to tests. President Trump dismissed the privilege of wealth as “the way it’s always been,” and he was correct, but I submit that we will have to change “the way it’s always been,” if only because we won’t be able to afford the status quo. I know this doesn’t play into the heroic image of a “woke” social consciousness, but I’m betting this crisis, unlike any other in our living memory, will put us on the path to some kind of universal health insurance, because, in addition to having killed over 180,000 Americans as I write this, the virus will also kill the debate over whether health insurance is a human right or a consumer choice. The cost of late-stage emergency care for tens of millions will simply be too high to ignore.

Any way you look at it, our healthcare cost far too much for the return we get in efficacy and outcomes. The US is an outlier where costs are concerned:

Jeneen Interlandi underscored the pre-Covid costs of our current patchwork system in a recent New York Times article: “If American health care were its own country, it would be the fourth largest in the world by gross domestic product. The nation spends an average of $3.5 trillion per year on health care—more than Japan, Germany, France, China, the United Kingdom, Italy, Canada, Brazil, Spain and Australia combined—and still loses more people to preventable and treatable medical conditions than any of those countries do.”

The pandemic of 2020 is the trigger, the straw that breaks the camel’s back, but a healthcare reset that truly lowers costs and raises outcomes has been on the horizon for some time. Public health experts and economists will come back into vogue as this post-truth time of tribal divisions wanes. Our petty differences require exactly this kind of existential crisis to start the pendulum swinging back toward a set of shared facts.

We are tired of politicians and pundits who are so intent on fixing the blame, that they never get around to fixing the problem.