There are a lot of different factors involved here- some of them structural, some specific to leadership- but it ultimately comes down to the fact that we as as a society despise capable government. If there's something that needs doing, it's only worth doing if people can make money off it. If there's no profit in it, then we just pile on unnecessary cost and difficulties until some company somewhere can extract enough money from the public and call themselves successful.
Our healthcare system is a prime example of this. There's really no need at all to make healthcare an industry with a profit motive. In fact, it makes it exponentially worse by cutting off access to those who need it but can't afford it. The crippling fear people have about going to doctor is a feature, not a bug, because, from a business stand point, it's better to make one big payout after people delay treatment then pay out lots of little piecemeal claims. It also, in the past, made it easier to deny claims when people needed treatment. It was a pretty good scam insurance companies had going- in order to get coverage, you had to divulge your entire medical history to them which they would later use against you to find any pretext to deny your claim so they could keep the money you paid them specifically so you would be covered in times of medical crisis.
Obamacare has made people forget that when it literally wasn't against the law to do so, it was standard practice for our entire insurance industry to leave thousands of people destitute, buried in debt, all for a bigger profit margin.
Another feature of our fragmented system is that it makes any coherent national response to pandemics and other health crises so much harder than it needs to be. Since there are millions of people who are covered by different insurers, HMO's, and government programs, it makes coordinating national testing efforts a convoluted mess of bureaucratic coordination of who will pay what costs for how long e.g. setting aside funds to cover the testing but not treatment.
There's also the problem of deciding who will administer the tests. Since we don't have a national health care system, the CDC can send out the tests but those are only administered by private institutions to people who self-select to get the test administered. We should have a massive testing effort like South Korea's where people just drive up to a testing station but we literally don't have the capability of doing so.
This essentially cripples our ability to accurately judge the spread and scale of the pandemic. The most crucial aspect of any pandemic is the basic knowledge of knowing how many people are infected. It's a hard thing to do in and of itself, but having a healthcare system that people avoid by design makes that problem exponentially harder.
It's the kind of problem any administration would have difficulty with; it's a nearly insurmountable challenge unless you go Spain's route and nationalize private hospitals- which we should, for the record- that requires a delicate, coordinated, and deftly executed plan of attack.
Unfortunately, all we have are these yahoos who would drown in a wet paper bag.
It's impossible to overstate how Donald Trump is the worst person in the world to handle this type of crisis. Disciplined, direct, and most importantly, honest communication is essential in times like these. People need to know what the government is going to do, how they're responding, and how they plan to handle the fallout.
But what we have instead is a man who whiffs the softest of softballs so he can complain again how the media is unfair to him. Trump disbanded the Pandemic Response Unit, refused to send doctors to China to get a head start on preparing or understanding how the virus operated, didn't prepare or stock up on Personal Protective Equipment (PPE) and denied the World Health Organization tests because he didn't want to scare the stock markets. His only concern this whole time is making sure the stock market and the economy don't crash and ruin his chance at reelection.
That's not to say the rest of the government has been doing any better. Senators using classified info for some good ol' insider trading, Republicans setting up a $500 billion slush fund to be doled out anonymously by Steve Mnuchin to whoever he sees fit, and Nancy Pelosi and Chuck Schumer balking at direct cash payments because it costs too much and isn't means tested. Biden flat out went MIA for almost an entire week and came back looking like a sad, confused grandpa who can't remember who he's talking to. The only one who looks like they have a clue as to what they're doing is Bernie, but why talk about him?
Not to say that any of this unexpected, of course. Republicans never waste an opportunity to funnel ever more billions into the hands of the already disgustingly rich. Liberals like Chuck and Nancy are pathologically afraid of handing out free money lest it end up in the hands of the undeserving poor. What did surprise me though, is how quickly the "let's go back to work and cull the herd" crowd popped up.
I figured we had to go into the tail end or very start of the second quarantine week before the "You know what? Maybe we just let people die" crowd reared its head. But nope. Instead we've got people from Trump to New York Governor Andrew Cuomo and Texas Lt. Governor Dan Patrick all talking about how they need to strike a balance between keeping people healthy and the economy going.
There's been a large contingent of people hammering them for this, thankfully, but one thing I keep seeing repeated is the charge that Trump et al. are willing to let 2% of the country die to save the economy for a few more months. This is based on early reporting that the coronavirus has a 2% mortality rate, so people are just running with that.
The thing is, mortality rates aren't inherent- they're the end result of a lot of different factors coming together. For one thing, a lot depends on how big you can make the denominator of total cases. South Korea, for example, has a mortality rate of .65%. A big reason for this is that the government did a huge testing blitz- as a result, they found and recorded thousands upon thousands of mild cases that didn't require hospitalization and were more effectively give treatment to those who needed it. So even though they have had 40 deaths as a result of the virus, taken against the 6,088 cases they've reported, you end up with a whisper of a mortality rate.
Another thing to take into consideration is the capacity of the healthcare system and the ability of that system to dedicate the resources it needs to deliver care. Italy, with its large elderly population, has been hit incredibly hard by the virus and is driving doctors to despondency over rationing care. A vulnerable population mixed with a government who took active steps just a little too late has led to a situation where people are dying by the hundreds every day. Things are looking up, however, in that it seems Italy has passed its peak with fewer new cases reported in the last few days.
We don't have any reason to expect that kind of news anytime soon, especially if Trump gets his way of getting people back out to work and regular public life in the next few weeks. We are no where near our peak, and, even though, as of this writing, there are54, 808 (edit: in the three days this sat on my computer, it jumped to 100,392) officially reported cases, the paucity of our testing regime means we are missing tens of thousands more. If we go back out like there's nothing wrong in a world where we aren't ramping up production of PPE's, of not buying respirators and ventilators, of no social distancing, no quarantines, then by the middle/end of April we'll have people dying by the thousands, every day. In that world, we'll be praying to work our way down to a 2% mortality rate.
I know it sounds a little hyperbolic, but it breaks down like this. We only have so many hospital beds and hospitals, period. Over half of rural counties have no hospital at all, so where are they supposed to go? To larger, urban areas with already overfilled hospitals? The lack of PPE's means that the doctors, nurses, and EMT's who are going to the front line of this crisis will have no reliable protection against the virus so when they get sick, it lowers the capacity of professionals who are able to direct and administer care to the infected. The lack of respirators and ventilators will compound this problem as there are fewer and fewer mechanical resources for depleted medical staff to dole out to an ever increasing number of patients.
What makes this all the more horrifying is this situation doesn't add any new complications, it just amplifies the built-in flaws of our system to their logical conclusions.
There are ways to mitigate what's happening and that we can dedicate our time to screaming the government make happen. First, just give everyone money; $2,000 for every adult and $1,000 for every child. Next, cancel/suspend all debt, rent, mortgage payments for everyone, period. Then, increase unemployment insurance so it provides 75%-90% of lost salaries. Increase SNAP benefits by at least 50% for anyone receiving them. Do all of this indefinitely.
There will be cries of "How do you pay for it?" and "But what if rich people get them too?" to which I say, who gives a shit. The U.S. is called a sovereign currency issuer, meaning that since the government has the sole authority to create money and does so on demand, the government doesn't actually have to "get" its money from taxes or other revenue streams. It literally can make money appear out of thin air. I know that idea makes people uncomfortable, so fine, you can tax the 1% a modest percentage after this whole thing is over so the government can "make" the money back.
Next, a federal shelter-in-place order for at least two weeks. All non-essential businesses are shut down, everyone stays home, start a curfew, anyone who breaks it is subject to legal penalty. Use the Defense Production Act to requisition and redirect manufacturing capabilities to increase the supply of PPE's, ventilators, and respirators around the country and supply around the globe. Also, nationalize every private hospital in the country and make treatment free at the point of care.
Release as many prisoners as possible to stop the spread of infection in prisons. Supply housing- in the form of empty hotel rooms or vacant housing- for every homeless person in the country. If any corporation requests a bailout, it must be under the terms that Elizabeth Warren outlined. If it's a company like a cruise line- which, why are we even talking about this?- they must additionally register their businesses so they sail under the U.S. flag to pay all appropriate taxes and comply with the labor laws of the U.S.
Sadly, the large majority of this won't happen. Congress is set to adjourn until at least April 20th after the massive corporate bail-out works its way through the House. It should tell you everything you need to know that, after giving away half a trillion dollars to the rich, our leaders consider their jobs done and are packing up to go home.
If it should come to pass that Trump orders the country to go back to work in the next two weeks, then we need a general strike to grind everything to halt. Refusing to go to work and possibly triggering an economic collapse is tragically one of the few ways we have of saving millions of lives.
I'm sure a lot of this sounds too radical to do. But consider the alternative. The vision of Trump and the Republicans means you get sent out to work in a time of literal plague to protect the profit of someone else. And what do you get in return? Sick, most likely. At best, you get a mild case of a high fever and terrible cough that puts you out of commission for a few weeks. More likely though, is that your symptoms progress and get worse because you don't have access to treatment. And whatever mild symptoms you start out with balloon into something worse that even if you survive will leave you with chronic lung issues probably for the rest of your life.
While all this is happening to you, your job, your employer who is demanding you put yourself at risk of all this, will abandon you to die without a second thought.
Fuck that. Fuck living on the edge, fuck a system that will literally kill us by the millions to protect its profits for a few more months. It's a barbaric way to live and for anything good to even have chance of happening after all this is done, we have to admit that the way we live now is a failure and we have to do something different. It's literally a matter of survival and if we ignore it, we die. It's just that simple.
Things are going to get bad, no matter what. Our government is incapable/refusing to do everything in its power to stop the spread of the virus and to mitigate the damage its already doing. It basically comes down to how good your governor is, at this point. So please, stay home, stay inside, treat the situation like you're already infected and just aren't showing. We're pretty much all we've got to get through this, so, let's not fuck it up.
But what we have instead is a man who whiffs the softest of softballs so he can complain again how the media is unfair to him. Trump disbanded the Pandemic Response Unit, refused to send doctors to China to get a head start on preparing or understanding how the virus operated, didn't prepare or stock up on Personal Protective Equipment (PPE) and denied the World Health Organization tests because he didn't want to scare the stock markets. His only concern this whole time is making sure the stock market and the economy don't crash and ruin his chance at reelection.
That's not to say the rest of the government has been doing any better. Senators using classified info for some good ol' insider trading, Republicans setting up a $500 billion slush fund to be doled out anonymously by Steve Mnuchin to whoever he sees fit, and Nancy Pelosi and Chuck Schumer balking at direct cash payments because it costs too much and isn't means tested. Biden flat out went MIA for almost an entire week and came back looking like a sad, confused grandpa who can't remember who he's talking to. The only one who looks like they have a clue as to what they're doing is Bernie, but why talk about him?
Not to say that any of this unexpected, of course. Republicans never waste an opportunity to funnel ever more billions into the hands of the already disgustingly rich. Liberals like Chuck and Nancy are pathologically afraid of handing out free money lest it end up in the hands of the undeserving poor. What did surprise me though, is how quickly the "let's go back to work and cull the herd" crowd popped up.
I figured we had to go into the tail end or very start of the second quarantine week before the "You know what? Maybe we just let people die" crowd reared its head. But nope. Instead we've got people from Trump to New York Governor Andrew Cuomo and Texas Lt. Governor Dan Patrick all talking about how they need to strike a balance between keeping people healthy and the economy going.
There's been a large contingent of people hammering them for this, thankfully, but one thing I keep seeing repeated is the charge that Trump et al. are willing to let 2% of the country die to save the economy for a few more months. This is based on early reporting that the coronavirus has a 2% mortality rate, so people are just running with that.
The thing is, mortality rates aren't inherent- they're the end result of a lot of different factors coming together. For one thing, a lot depends on how big you can make the denominator of total cases. South Korea, for example, has a mortality rate of .65%. A big reason for this is that the government did a huge testing blitz- as a result, they found and recorded thousands upon thousands of mild cases that didn't require hospitalization and were more effectively give treatment to those who needed it. So even though they have had 40 deaths as a result of the virus, taken against the 6,088 cases they've reported, you end up with a whisper of a mortality rate.
Another thing to take into consideration is the capacity of the healthcare system and the ability of that system to dedicate the resources it needs to deliver care. Italy, with its large elderly population, has been hit incredibly hard by the virus and is driving doctors to despondency over rationing care. A vulnerable population mixed with a government who took active steps just a little too late has led to a situation where people are dying by the hundreds every day. Things are looking up, however, in that it seems Italy has passed its peak with fewer new cases reported in the last few days.
We don't have any reason to expect that kind of news anytime soon, especially if Trump gets his way of getting people back out to work and regular public life in the next few weeks. We are no where near our peak, and, even though, as of this writing, there are
I know it sounds a little hyperbolic, but it breaks down like this. We only have so many hospital beds and hospitals, period. Over half of rural counties have no hospital at all, so where are they supposed to go? To larger, urban areas with already overfilled hospitals? The lack of PPE's means that the doctors, nurses, and EMT's who are going to the front line of this crisis will have no reliable protection against the virus so when they get sick, it lowers the capacity of professionals who are able to direct and administer care to the infected. The lack of respirators and ventilators will compound this problem as there are fewer and fewer mechanical resources for depleted medical staff to dole out to an ever increasing number of patients.
What makes this all the more horrifying is this situation doesn't add any new complications, it just amplifies the built-in flaws of our system to their logical conclusions.
There are ways to mitigate what's happening and that we can dedicate our time to screaming the government make happen. First, just give everyone money; $2,000 for every adult and $1,000 for every child. Next, cancel/suspend all debt, rent, mortgage payments for everyone, period. Then, increase unemployment insurance so it provides 75%-90% of lost salaries. Increase SNAP benefits by at least 50% for anyone receiving them. Do all of this indefinitely.
There will be cries of "How do you pay for it?" and "But what if rich people get them too?" to which I say, who gives a shit. The U.S. is called a sovereign currency issuer, meaning that since the government has the sole authority to create money and does so on demand, the government doesn't actually have to "get" its money from taxes or other revenue streams. It literally can make money appear out of thin air. I know that idea makes people uncomfortable, so fine, you can tax the 1% a modest percentage after this whole thing is over so the government can "make" the money back.
Next, a federal shelter-in-place order for at least two weeks. All non-essential businesses are shut down, everyone stays home, start a curfew, anyone who breaks it is subject to legal penalty. Use the Defense Production Act to requisition and redirect manufacturing capabilities to increase the supply of PPE's, ventilators, and respirators around the country and supply around the globe. Also, nationalize every private hospital in the country and make treatment free at the point of care.
Release as many prisoners as possible to stop the spread of infection in prisons. Supply housing- in the form of empty hotel rooms or vacant housing- for every homeless person in the country. If any corporation requests a bailout, it must be under the terms that Elizabeth Warren outlined. If it's a company like a cruise line- which, why are we even talking about this?- they must additionally register their businesses so they sail under the U.S. flag to pay all appropriate taxes and comply with the labor laws of the U.S.
Sadly, the large majority of this won't happen. Congress is set to adjourn until at least April 20th after the massive corporate bail-out works its way through the House. It should tell you everything you need to know that, after giving away half a trillion dollars to the rich, our leaders consider their jobs done and are packing up to go home.
If it should come to pass that Trump orders the country to go back to work in the next two weeks, then we need a general strike to grind everything to halt. Refusing to go to work and possibly triggering an economic collapse is tragically one of the few ways we have of saving millions of lives.
I'm sure a lot of this sounds too radical to do. But consider the alternative. The vision of Trump and the Republicans means you get sent out to work in a time of literal plague to protect the profit of someone else. And what do you get in return? Sick, most likely. At best, you get a mild case of a high fever and terrible cough that puts you out of commission for a few weeks. More likely though, is that your symptoms progress and get worse because you don't have access to treatment. And whatever mild symptoms you start out with balloon into something worse that even if you survive will leave you with chronic lung issues probably for the rest of your life.
While all this is happening to you, your job, your employer who is demanding you put yourself at risk of all this, will abandon you to die without a second thought.
Fuck that. Fuck living on the edge, fuck a system that will literally kill us by the millions to protect its profits for a few more months. It's a barbaric way to live and for anything good to even have chance of happening after all this is done, we have to admit that the way we live now is a failure and we have to do something different. It's literally a matter of survival and if we ignore it, we die. It's just that simple.
Things are going to get bad, no matter what. Our government is incapable/refusing to do everything in its power to stop the spread of the virus and to mitigate the damage its already doing. It basically comes down to how good your governor is, at this point. So please, stay home, stay inside, treat the situation like you're already infected and just aren't showing. We're pretty much all we've got to get through this, so, let's not fuck it up.
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