A New Economy for a post-Covid world May 3, 2020
Dr. Roger Ray, pastor
This is my friend, Dr. William Jimenez, suited up to go into an exam room to treat a Covid-19 patient in New York. William and I had planned to meet this past week in Puerto Rico for his kids to enjoy their Spring Break on the beach and for us to sit on the balcony and solve the problems of the world.
But the problems of the world got to New York and most of the rest of the world before we got to take our long-awaited vacation. But we talk most days now about what it is like for him to be on the front lines of a battle where 62,000 Americans have died in the past two months and where no real cure, treatment, or vaccine is realistically in sight.
I fear that William is too big hearted for this virus. When one of his long time patients contracts the virus and dies, William suffers so dramatically from each loss that I am sincerely worried for him as well as for all of the people in New York and New Jersey and New Orleans, and Washington. But he tells me, “This is my calling, this is what I was born to do.”
It is that kind of courage and devotion that makes New Yorkers go outside every night at 7 and applaud, blow their car horns, and bang on pans on their balconies, showing appreciation and respect for our nation’s healthcare workers.
sadness of it all and took her own life. Dr. Lorna M. Breen’s father is also a physician. He told reporters that she was a casualty of the pandemic as much as anyone who died on a respirator at the hospital and he asked only that she be remembered as a hero.
I know that you all get this. You have all heard most of this in the news. I know that even if no one you know personally is on the front lines or is a patient, I know that your heart has been filled with grief just as mine has. But here is what you may not know, in the middle of all of this drama, and grief, and strain, William and the other doctors in his group were told this week that they would not be getting paid this month.
You see, the measures taken to deal with the pandemic: cutting patient load, video conferencing, canceling surgeries, and reserving space in hospitals and clinics for an unknown surge of coronavirus patients has meant that physicians are not billing for medical services at even a third of the normal rate . . . so while they are working harder, and risking their lives every time they go to work, and most will have some level of PTSD when it is over, they are also being asked to do it without getting paid . . . no rent money, no grocery money. How crazy is that?
And locally, while our hospitals ramped up to prepare for pandemic patients, emptying offices and rooms for a surge of patients we have not seen here in Missouri, the hospitals are laying off, firing, or furloughing thousands of employees.
Just when people in Italy, Germany, England, and all over America, are standing up to give tribute to healthcare workers for taking care of us in the midst of a medical crisis, our hospitals are giving out pink slips to these same heroic healers.
This not happening, of course, in Canada or Great Britain where their national healthcare services employ doctors, nurses, therapists, cooks, and cleaners to serve the healthcare interests of their citizens. In the United States, our healthcare system is still based on the profit derived from the illness of others. The individual doctor or nurse may have the highest and most noble motivation to be of service to the sick, but the system is all about the spread sheet and the bottom line. And as little sympathy as I typically have for our hospitals and health insurance companies, right now, in our state, when they are losing more than $30 million a day, even I have to acknowledge that they can’t just bear that loss.
But what is wrong here is the system. We have not designed our healthcare system to deliver healthcare, we have designed it to make money and profit is not the issue with illness. It never should have been, I’ve been saying this for 40 years, but now, the coronavirus is making it painfully clear. We need to get healthcare out of the marketplace and make it a human service as it should have always been.
The capitalism that may work well in the competition among fast food restaurants, coffee shops, retail clothing outlets, and lawn services absolutely does not work in the universe of healthcare. We spend twice as much per citizen as most western nations, yet we fail to care for nearly 10% of our population, and the people who do receive care have worse outcomes than in other western nations.
The only category in which we were rated as #1 at the beginning of this year was, we were considered to be the best prepared to deal with a pandemic. I don’t know who was in charge of making that estimation and I don’t know where he is selling used cars now; but real life experience shows that we were the worst in preparation for the arrival of covid-19!
I am, of course, very worried about the nearly 30 million people who have lost their jobs in the past two months. . . but I am forced to wonder how many of those 30 million have historically opposed the idea of giving Medicare to everyone because they liked their employer provided healthcare? How do they like it now that they don’t have an employer? It is amazing how clear this issue becomes when the comfortably insured suddenly find themselves among the ranks of the uninsured.
Honestly, I don’t have much sympathy for people who are crying wolf now who refused to find some compassion for their uninsured neighbors but maybe now they realize how wrong they have been since the efforts of Roosevelt, Eisenhour, Nixon, Kennedy, Johnson, Carter, Clinton, and Obama to give healthcare to everyone has been thwarted for 80 years. Isn’t it time for that battle to be won?
Healthcare is just a prime example of why our economic system is broken and demands to be changed to something that is less tied to the feudal lords who enslaved the peasants of medieval Europe to make them rich. We were not prepared for a pandemic, not with PPE, masks, hand sanitizer, or ventilators. And we were not morally or ideologically prepared for the economic implications of this pandemic.
We seem to think that the economy has to work the way it has worked for the past two centuries, where the only way to have money is to either be born rich or go work for a salary. But, look at how we divide up our public and private work: Teachers are trying to teach on-line. . . I’ve taught online courses, it can be a lot of work but you have to know that there is not as much education going on in that way. But, they are still being paid the same.
Doctors are being confined to video conferences and exams, but they get paid little or nothing for that unless they can order an MRI, a blood panel, or some treatment that they can bill for. Why, since the pandemic is forcing both teachers and physicians into online work, wouldn’t we pay physicians for complying with the pandemic regulations just like always?
If you had 9 Taco Bell restaurants and none of them had sold a Taco in 20 years, how long would you keep paying people to keep them open? People act like this can’t be done when, in fact, it would be as easy and stumbling and falling down these stairs, and you already know that I can do that (we’ve destroyed that video, right?).
So, now that we have closed down the retail and service economy almost everywhere except for Sweden which is taking a very risky herd immunity approach to the virus, many American governors are determined to lift the mandatory closing. Our governor says that restaurants, bars, hair salons, and retail shops can open on Monday. And, of course, people are not going to rush back into those places because people know that it still isn’t safe.
And shop owners who have to restrict the number of people who can come in and try to get them to stay several feet apart, will not be able to have enough volume of business to be able to turn a profit. But what lifting the ban does is it keeps them from applying for business stoppage insurance. It keeps their staff from drawing unemployment. This means that they have to go back to paying their landlord and their utility bill and it cuts them out of applying for special assistance from either the state or the federal government.
The one thing that should be obvious to everyone is that all of these billionaires crying out to send people back to work are realizing that they don’t make money, their employees are the ones making money, and without the people they have refused health care, a living wage, and available education to, they will go broke.
But here is what you can bank on, Missouri’s Gov. Parsons won’t be going to a bowling alley and renting shoes and using one of the bowling alley’s balls. His family will not be crowded into a booth at TGI Fridays and they won’t be getting their haircut at Hudson Hawk Barber shop. They want you to risk your life, but they are not going to be joining you in this very risky behavior!
I am a southern boy, I don’t want to run out of country ham for my biscuits or pulled pork, but if I have to pay more for it and have it less often so that these guys can have a safe work environment . . . and what kind of moral monster would object. . . other than the Republican elected officials in Iowa? We always hope that electing women to high office will give us better government but, in a word, Kim Reynolds was obviously the wrong woman.
Last year, Frank Snowden published the frighteningly prophetic book, Epidemics and Society. He is a Yale history professor, so this is not a prediction that a pandemic was around the corner, but Snowden painstakingly describes the way that epidemics have shaped how the world works in the past. And often, Snowden points out, a pandemic holds a mirror up to society to reveal its weakest moral points.
It is not an accident that people of color are dying in numbers way out of proportion to the white population because, as in the Plague, and other epidemics, the people who live in the most crowded conditions, the people with the poorest diets, the people with the least access to health care, are much more likely to die. And, as we are seeing the Trump administration’s insistence that meat packing employees go back to their dangerous and low paying jobs, we cannot feign surprise that the majority of those employees are people of color.
Again, it is the system we have, it is not a necessary matter of nature. Our system doles out the best healthcare to the top of the income ladder and the whole employer-based health insurance system, keeps the unemployed from having reasonable access to healthcare at all. That is not nature. That is not human need. That is an economic system designed to serve the rich, and though the doctors’ lounges at Mercy and Cox hospitals have been full of Trump enthusiastic aspiring millionaire physicians for the past three years, I suspect that things have fallen rather quiet lately. I bet I could walk into a physicians’ lounge today and casually make the observation that doctors in England’s National Healthcare System typically have shorter work weeks and a much better standard of living than American doctors and still walk out without a scalpel in my back.
How we react to an epidemic depends greatly on who is the most likely to die. Gov. Kim Reynolds will send laborers back into meat packing plants, but members of congress are refusing to cram over 400 people into a room that is actually a lot smaller than it looks on TV. In the 1980’s you remember how the married and straight reacted to the AIDS epidemic which was perceived as being an almost exclusively gay liability. The news media even blithely used the term “innocent victim” to reference someone who was exposed to HIV through a blood transfusion or an accidental needle stick. . . as if gay people were not innocent since they got the virus through sex . . . sex is, of course, something the rest of us have never done, right? Or is this not the church of perpetual virginity? Is there something you guys aren’t telling me?
Compare that to how people reacted to things like tuberculosis or polio, which affects the rich and the poor, the young and the old, equally. A pandemic can teach us a moral lesson.
When we hear about an Ebola outbreak, we need to stop thinking about that as an African problem or thinking of poverty as someone else’s problem. We are all connected. We not only need to have universal healthcare, but we need a universal basic income, a guarantee of employment, retirement, housing and education.
This pandemic brings us to the threshold of change . . . what kind of future do you want to live in?
I fear that our system is much more like the Hunger Games, in which the poor are pitted into mortal competition against one another, for the entertainment and security of the wealthy. And that system, I submit. Must stop. It can stop peacefully at the ballot box through better government, or it can stop through revolution. But it has to stop.
As Gandhi famously said, “We have more than enough to meet the world’s needs, we just don’t have enough to satisfy the world’s greed.” I don’t know about you, but I’m done trying to sacrifice to satisfy the greed of the 1%. We can provide safe housing, a healthy diet, meaningful work, a living wage, universal healthcare and education to everyone…. We have the resources to do it, and if that means we have to go from 800 foreign military bases to just three or four hundred, then, somehow, we’ll get by.
I am not equipped to hazard a guess how many lives will be lost this year in this pandemic. Many experts say that we are only in the second inning and we have a lot yet to endure this fall and winter but whether the number is 60,000 or 600,000 let’s not let them die in vain. We have seen our society’s weaknesses and we know that we can fix them and there is no excuse short of damnation if we fail to do it.
