When it comes to our current healthcare system, the waste, cruelty and dysfunction was glaringly obvious even before the horrific pandemic we are now experiencing. Today, as millions of Americans lose their jobs and their healthcare benefits that come with them, it is now virtually impossible for any rational person to defend a system – unique among wealthy countries – that ties healthcare to employment, and is designed only to make huge profits for the insurance industry and drug companies, while ignoring the needs of ordinary Americans.
Before the pandemic, 87 million people were uninsured or underinsured in our country, and more than 30,000 people died every year because they couldn’t get to a doctor when they needed to see one. More than half a million families declared bankruptcy each year because of medically related debt. One out of five Americans could not afford the outrageously priced prescription drugs their doctors prescribed to them. And our healthcare outcomes, from maternal deaths to life expectancy to infant mortality, lagged behind most other industrialized nations.
That was before the pandemic. The situation is far more dire now.
Over just the last five weeks, more than 26 million Americans have lost their jobs and now face a crisis unique among advanced countries: for most of them, their healthcare was tied to their jobs. In America, unlike any other major country, when you lose your job, you lose your healthcare. As a result, up to 35 million Americans are estimated to see their health coverage disappear in the middle of this Covid-19 nightmare. And premiums for those who retain their health insurance in this crisis could increase by up to 40% . As horror stories circulate of $34,000 coronavirus medical bills, the uninsured remain terrified of going bankrupt just to get tested and treated for Covid-19. In many cases, they just cannot afford to go to a doctor or the hospital.
It is an incredibly byzantine and complicated collection of independent entities without a common purpose – except greed
But it’s not just the high cost and growing number of uninsured that expose the irrationality of the current system. It’s that the current “system” makes absolutely no sense to anyone. It is an incredibly byzantine and complicated collection of independent entities without a common purpose – except greed. Think about it: In the midst of the worst healthcare crisis in modern American history, with thousands of doctors and nurses and other medical personnel becoming infected and sometimes dying, hospitals and clinics have, for financial reasons, been forced to lay off thousands of medical workers at a time when they are needed most.
Further, our public health system is incredibly weak, in part because of consistent federal disinvestment and austerity that have decimated too many public health agencies. In most states, we lack the capability to significantly increase the level of coronavirus testing and contact tracing we need to begin to safely reopen the economy.
Price-gouging and profiteering has affected everything from hand sanitizer to respirator prices which, in some cases, have more than quintupled – virtually overnight. Cities, states and hospitals continue to fight over scarce gloves, gowns, masks and ventilators. Four out of five frontline nurses don’t have enough protective equipment. In the richest country in the history of the world, nurses caring for coronavirus patients have resorted to wearing trash bags as makeshift protective gear. That is an international embarrassment.
The current crisis has also exposed, to a horrific degree, how the massive level of income and wealth inequality in America magnifies healthcare inequities, and financially ravages our most vulnerable people. Rural hospitals and community health clinics, which often treat the poor, are on the verge of going bankrupt and shutting down. Major outbreaks are attacking our Black, Hispanic, Native American and undocumented communities, as well as the incarcerated and the homeless.
State and local data show that more than 30% of reported deaths have been African American, even though they only make up less than 15% of the population. The perverse irony of our broken for-profit healthcare system is that black, brown, rural and low-income people are most likely to be uninsured or underinsured, delaying or forgoing the costly necessary treatments or prescription drugs that could prevent the very conditions that make them most susceptible to the virus. It is no coincidence that the poor, the working class, the sick and the elderly disproportionately make up America’s 1m reported coronavirus infections and over 57,000 deaths – the largest figures of any country on Earth.
With tens of thousands of Americans dying and millions losing their jobs, how sad it would be if we learned nothing from all that we have done wrong
If there is any silver lining in this unprecedented moment that we find ourselves in, it is that we must use this time to reassess the foundational institutions of American society and determine how we go forward into a better future. With tens of thousands of Americans dying and millions losing their jobs, how sad it would be if we learned nothing from all that we have done wrong.
Do we really want to continue the current expensive and cruel system that ties healthcare to our jobs? Or do we need a simple, comprehensive and cost-effective system that understands that healthcare is a human right for all of our people – employed or unemployed, young or old, rich or poor?
Do we really want to continue being ripped off by the pharmaceutical industry that charges us, by far, the highest prices in the world for prescription drugs? Or do we want a system that negotiates drug prices like every other country on Earth?
Do we really want to continue the complicated, wasteful and bureaucratic system in which virtually every visit to a doctor or hospital requires the filling out of endless forms in order to determine how much of our deductible we have paid, what percentage of our procedure is covered, and whether we got sick in the appropriate “network”? Or do we want a simple system in which we go to any doctor we choose and never see a bill, because the system is publicly funded?
Do we really want to continue having a woefully inadequate primary healthcare system because medical and nursing school graduates, faced with huge student debt, often gravitate to communities where they can make big bucks? Or do we want to make sure we have an appropriate number of medical personnel in the locations where they are most needed?
The good news is that a growing number of Americans – especially in the face of this pandemic – believe that this dysfunctional and wasteful healthcare system must be replaced. A poll conducted this month, for example, indicated that 69% of all Americans – including 68% of independents and 88% of Democrats – support providing Medicare to every American.
The bad news is that the healthcare industry, which made more than $100bn in profits last year and provides their CEOs with huge compensation packages, will do everything possible to maintain the status quo. And don’t be fooled: they will lobby just as hard against any lesser proposal as they will against Medicare for All, buying politicians with campaign contributions and spending endless amounts of money on lobbying and advertising.
There is no question that this will be an enormous challenge – but we can win this struggle if we engage people in the political process in a way we have never done before. We are all in this together. In this unprecedented moment in American history, let us stand united and harness the solidarity and compassion that so many are now demonstrating. Let us, finally, guarantee healthcare to all our people as a human right.