Regarding COVID-19, Trump claims he has done an “incredible job.”
If so, then how does the richest nation in the history of the planet, comprising 4.25% of the global population, have over one fourth of the cases and deaths?
Certainly, Trump’s delaying and ineptitude played an enormous role. But there are other factors that also figured large. Just as a fire fighting department has a much greater challenge if there have been decades of neglect in enforcing building codes, poor planning, improper storage of flammable materials etc., our medical providers had to compensate for shortsighted, profit-driven approaches adopted decades ago that set the stage for this fiasco.
Great inequality fosters a culture of “every man for himself” which neglects common needs and public health. For example, clean drinking water, taken for granted here, is often hard to obtain in Latin America. This situation exists because, understandably, the opulent minority is reluctant to spend large sums of their money to create an infrastructure which would deliver clean water to the poor, when they can just get their own bottled water. Great inequality induces the elites to ask, as Cain: “Am I my brother’s keeper?
U.S. inequality fundamentally shaped its health care. World War II fostered a feeling of shared sacrifice (“we are all in this together”) and common humanity in many of our European Allies; in the war’s aftermath, most of them adopted some form of universal health care and today among those nations, the U.S. is alone in lacking universal health care. Why?
At the time, President Truman (1945-1953), a Missouri Democrat, proposed universal care and initially its prospects seemed reasonable. But Southern conservative Democrats had a near stranglehold on political power and universal health care for all U.S. citizens was completely unacceptable because of the glaring racism of their region. In the South, great efforts were made to have “whites only” drinking fountains and restrooms, etc. Unsurprisingly, many Southern elites would have been horrified to have people of color using hospitals that they would use. Europe was quite different. At that time, they lacked the racial divisions of the U.S. and were not aiming to exclude a racial minority. So, their adoption of universal care was much easier.
Racism is not the only factor that heavily shaped our approach to health care. Profitability also played a role. By the 1960s, insurance companies recognized that insuring the poor and elderly was generally not profitable. Thus, those groups largely became the responsibility of government with the creation of Medicaid and Medicare. (Is it any wonder government is unprofitable when primarily unprofitable activities are delegated to it?)
Today, the U.S. lacks a single comprehensive system. Instead it has an amalgamation of multiple systems: Its veterans are on a system akin to the British system, its elderly are on a system akin to the Taiwanese, and its millions of uninsured are on the Ethiopian system and have no rights to medical care. The U.S. hodgepodge reminds one of the poem “The Blind Men and the Elephant” by John Godfrey Saxe. One man grabs the tusk, one the tail, one the ear, etc., and they bitterly debate the nature of the elephant while all six miss the big picture.
The U.S. approach to health care is as full of holes as Swiss cheese; that is likely why our response to COVID-19 compares unfavorably with many nations we derisively accuse of having “socialized medicine.” Sept. 11 caused the U.S. to rethink and greatly expand national security, without any regard to the deficits. Whereas COVID-19 is far more deadly and damaging to the economy, it is time reexamine our patchwork approach to health care.