Tuesday, March 10, 2020


The United States is conducting a big experiment on how a pandemic responds to the lack of a modern health care system.  The issue isn't the quality of care available, but that there is a significant percentage of the population un- or under-insured, and thus without effective access to health care.  The worst cases aren't the indigent and homeless, who will at least may attend at an ER if the symptoms are bad enough.  The real problem are the millions of people who will put off being checked or screened just because they fear the cost, or even the cost of the co-pay or deductible.  It's a flu, and flu-like, so it is easy to shrug it off as not worth the money for a medical visit.  When you have millions of people outside of the system, you have millions of possible infectors moving through the rest of society.  It is a recipe for disaster.

Trump's baffling lack of any coherent response, and underplaying the danger, is probably just a reflection of the fact that he's been told there is nothing that can be done.  The only hope is to pray the virus doesn't turn into a pandemic, and in the meanwhile talk down the problem so as not to induce even more panic.

American 'I'm all right, Jack' libertarian policies are so prevalent that they also affect the provision of public health resources generally.  Americans are woefully behind on screening, or any sense of a larger plan, because everybody is supposed to deal with health care through their own insurance.  This works for the 1%, and even sort of works for the 10%, until there is a public health crisis involving a communicable disease, when the structural problems suddenly become apparent.

"Joe Biden suggests he could veto 'Medicare for All' bill if it got to his desk" (Sherfinski).
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