By Richard Mellor in California
As the Covid-19 pandemic wreaks havoc around the world, the barbaric market-driven US health system stands out as the miserable and tragic failure it is. “The US has the greatest number of confirmed cases and deaths in the world.”, wrote John Tozzi in Business Week (June 11).
Tozzi points out much we already know and what many people live through in the real world. The US healthcare system is the costliest of all the advanced capitalist economies, consuming 18% of US GDP. We spend almost $4 trillion a year on health care. It is also the most inefficient. Even blockaded Cuba has a better infant mortality rate than the US and a similar life expectancy (CIA Factbook).
It is that way because in the US, health care is a business, a commodity. If you can pay for decent health care, you get it, if you can’t you don’t. Private sector spending on health care is triple that of comparable countries, according to studies.
Despite all this and the incredible profits in what I prefer to call the industrial sickness industry, the US response to the pandemic is that of an impoverished third world country. That is because when it comes to taking care of the public, we are impoverished.
Native Americans hit by pandemic
“Hospitals with billions of dollars in revenue couldn’t secure dollar masks to protect staff”, Tozzi wrote. And when we consider the conditions among Native Americans, we are talking catastrophe. In the Navajo Nation, the worst hit in the country, 30% have no running water and 40% no electricity. The issue of disease hits close to home with Native Americans, as millions of them died from diseases brought in by Europeans to which they had no immunity.
As an example of the refusal of US capitalism to fund public health (or pretty much any public services) Business Week gives an example of the Milwaukee Health Department, where prior to the pandemic the public health department’s budget serving 600,000 people amounted to $33 for “every city resident”.
Of course, it’s been this way for a long time for millions of people. We all know that health care is the leading cause of bankruptcy and that people buy health care (and food) with their credit cards. Millions of people put off necessary procedures because they don’t have the money. Thousands travel across the Mexican and Canadian borders to get life-saving drugs that are priced out of reach in the US.
“If you can’t pay you can’t play” warns a common US slogan. That your ancestors worked and paid taxes all their lives, (barring African Americans whose ancestors received no taxable wages for three hundred years), fought in wars and possibly died or were physically and mentally damaged in them, is not considered a sacrifice worth rewarding with something as basic as decent health care. Cannon fodder indeed.
Public health spending dwarfed by total health spend
The BusinessWeek article points out that the US spent $94 billion on public health in 2018, which amounts to less than three cents of every dollar spent on health care. Yet despite being in the middle of a pandemic of historic proportions, public agencies are citing shortages of funds, due to declining tax revenue, are cutting services and reducing staff. Recently, Trump proposed cutting the discretionary funding for the Centres For Disease Control and Prevention by 9% ($700 million).
Meanwhile, as BusinessWeek points out, “…..five for-profit health insurers together returned $13.9 billion to shareholders in dividends and stock buybacks—an amount greater than the entire CDC budget.”
We live in the belly of the beast here. All public policy, political debate, allocation of capital, which is the wealth workers create through the labour process, is determined on the basis of profits, not social need. Housing, education, health care, transportation, environmental protection: all these and other critical social needs are subordinated to profits. “Despite the trillions of dollars the U.S. devotes to health care…”, Business Week adds, “…the country lags behind many other developed economies on health measures such as life expectancy and infant mortality.”
Miserable failure of the system
So the pandemic has simply exposed the system for the miserable failure it is. The recent mass protests against police violence and the disproportionate murder of black people and other people of colour by the state security forces is centuries in the making. The pandemic has hit all poor people hard but black people more so because racism is an institutional aspect of capitalism that has affected every aspect of their lives in an extremely negative way.
Housing is worse in these communities, so is transportation, employment, health care, access to decent food and so on. The police are armed occupiers in these communities, to ensure that the anger that eventually breaks through the surface is suppressed or at least contained within them.
There is a famous speech by Martin Luther King on the Homestead Act in which he ridiculed the ideology that those who have, as opposed to those who don’t have, “pulled themselves up by their own bootstraps”. The ruling elite, or the 1%, as some refer to them, promote this ideology to defend their social position, which is a product of theft and violence.
White racist ruling class
As King explained, it is as one example of how the white racist ruling class in the US needed to create a solid economic base on which to rest and maintain its rule, the poverty-stricken European peasants, exploited as they were, were offered this carrot in the form of the white race identity. The white faces we see in powerful positions of government and business have no love for the white worker and this decision was simply a business decision. And in the long term and the wider sphere of things, it has been harmful to the material interests of the European/white working class.
(See The Invention of the White Race by Theodore Allen, two volumes covering Ireland and the Anglo-American colonies. For those without the time or the inclination to struggle through two volumes of US history here is a PDF that covers the issue and is considerably shorter. Class Struggle and the Origin of Racial Slavery.*)
BusinessWeek continues: “Beyond those specific failures, underlying inequities make some Americans more vulnerable than others. The virus spreads quickly in settings where people have little power to avoid it: nursing homes, homeless shelters, meatpacking plants, and prisons and jails that detain the world’s largest incarcerated population. Covid-19 kills more people who live in denser cities and crowded homes and work in lower-paying “essential” jobs. Black Americans, who have higher rates of chronic illnesses such as diabetes and asthma, are disproportionately harmed and killed by the virus.”
Reading the serious journals of capitalism, it is obvious there is a significant concern within the US ruling class over this disastrous failure of capitalism to deal with an emergency like Covid-19.“Once we come out of this pandemic, there is going to have to be some kind of an evaluation around, Do we need to be spending more on public health?”, Ashish Jha, director of the Harvard Global Health Institute tells BusinessWeek.
System kept in place by lobbyists
All the so-called experts have been shaken by the disastrous failure of US capitalism here. The health care situation has been pretty bleak in the US for a long time, a poor system kept in place by the powerful lobbyists in the hospital and pharmaceutical industries and the doctors that get rich off sick people. It has been made easier for them through the collaboration of the heads of organized labour, who have refused to lead a movement against this madness. How do we get to a point where the physical health of 31% of young adults make them ineligible for military service?
Naturally, Business Week, owned by the billionaire Michael Bloomberg, points to the American character for being so individualistic, anti-government and selfish. The implication is that we are opposed to the government providing health care for all. “The idea that the government should invest in the health and well-being of its citizens has always been in tension with America’s predilection for individual liberty.”
What does it mean to say America has a predilection for individual liberty? The individual liberty of Carnegie, Jay Gould, their successors Bill Gates and Warren Buffet is what Business Week means by individual liberty. But US history is full of examples that prove workingclass and all oppressed people have achieved any “liberty” at all through collective action; through recognizing that there is such a thing as class interests.
“A deep flaw in our system”
The right to join unions was not won from the most brutal ruling class on the planet by people obsessed with individualistic Rambo tactics. They realized individual liberty was linked with collective liberty and class solidarity. This solidarity and class consciousness has been successfully weakened with tragic consequences for people of colour and to the detriment of all workers through conscious racist policies and the introduction of “white” as a racial definition and the white supremacy ideology, that arose in the mid to late 17th centuries.
Another expert, David Blumenthal, President of the Commonwealth Fund adds his two cents, “Our failure to deal with the pandemic reflects a deep flaw in our system of governance and our political culture,”
We can see how concerned some of the more astute sections of the US capitalist class are, in the wake of the pandemic and the huge widespread response to the George Floyd murder and racism and racial violence in particular.
The quote above doesn’t explain what “our system of governance” is. Is it a feudal system? A slave system? Of course not; we live in a capitalist system of production where the means of producing the necessities of life are in private hands and these means are set in motion on the basis of profits. Capitalism is constantly championed in the media as the most productive, fairest and “only” system of production that works. The media and its apologists conveniently forget this important fact when reporting on catastrophic failures of this system which is responsible not only for the virus itself as a by-product of industrial food production, but the failure of the US government to deal with it. The destruction of the environment is market-driven.
Blacks and whites fought together as a class
The “flaw” according to Blumenthal, is to be found in the collective US character. We hold “continuing hostility and distrust toward government” in addition to this Rambo-like obsession with individual liberty. From the first time European capitalism set foot on this continent, there was class tension between the labour they brought with them and the merchants who were seeking wealth. There is much evidence that blacks and whites joined together in order to improve their conditions, conditions that were so appalling and the death rate so high that many fled to the safety of the local native communities.
Lerone Bennett: “ …the available evidence, slight though it is, suggests that there were widening bonds of solidarity between the first generation of blacks and whites. And the same evidence indicates that it proved very difficult indeed to teach white people to worship their skin.” (The Shaping of Black America, p62)
The degenerate racist in the White House
Nothing will be the same after this. We’ve seen massive protests against police violence and against lack of resources and money to fight the pandemic. The US working class has stepped on to the world stage in a big way and has sparked off similar movements globally given fuel by the degenerate misogynist and racist in the White House. It has generated concern and divisions in the US ruling class that they are trying to rectify.
Money is being thrown at the movement by corporations and racist images are being removed from brands and public places, but we must beware of Greeks bringing gifts as the old saying goes. As I have pointed out in other blogs, we are witnessing the US working class in motion. It is not the industrial working class or the organized working class at this point, but the working class nevertheless. If the organized working class were to overcome the obstacle of their own pro-capitalist leadership and join this movement, something that is inevitable at some point, this will open up great opportunities for working people and our families.
From the US socialist website, Facts for Working People. The original can be found here.