By Kimberly J. Soenen
I grew up amongst the Shock Doctrine generation, Generation X.
We were raised in between the sentences of the book by Naomi Klein that has been referenced frequently as of late. The book supports the theory that exploitation of national crises such as perpetual warfare, mass shootings, climate disasters, environmental distress, domestic terrorism, income inequality, barriers to healthcare and other incessant upheaval enables business practices and policies that impose harm to Public Health.
Occasionally, a catastrophe can motivate humans to rid themselves of—or at least mitigate— unbridled discrimination and greed, and instead, view that working toward the common good is salient. As Americans file for unemployment and stand in line for food assistance in the weeks ahead, will they come to believe this virus could be the catastrophic catalyst for a profound shift in the way we view healthcare?
Yet again, the modern-day economic expansion-in-perpetuity house of cards has crashed. Businesses from the Atlantic to the Pacific are boarded up while riding out the public catastrophe that is COVID-19, allowing space for capitalist institutions to profit and establish policies that not only benefit an “elite” small portion of the population, but also endanger the masses while they, the masses, are distracted by the ongoing catastrophe.
A record-breaking number of people are now unemployed. Despite that, the Affordable Care Act marketplace remains closed in all but a handful of states. COBRA, the temporary health insurance hustle, is cost-prohibitive. Commercial health insurance companies in states where attorney generals haven’t issued an executive order to end billing, continue to bill patients for COVID-19 testing and treatment while trumpeting the “health insurance choice” talking point. What is the argument for tethering employment to healthcare access now? Where is the “choice” now?
Through shared pain and collective strife, this is our chance to wake up and create a new definition of responsible healthcare—one that emphasizes empathy over judgment, equity over discrimination, human potential and human capital over obscene record-breaking profit at any cost. This virus is asking us: Will we one day see one another as equal? Equally fragile? Equally vulnerable?
The time has come to enact a Single Payer National Health Program / Universal Healthcare and protect it as settled law.
From Columbine to Corona
Ongoing failed United States Public Health policy is at the heart of all this endless disruption and economic distress. Healthcare should not be a political football or a bloody free market combat sport that Wall Street plays to profit from illness, injury, disability and death.
Let’s take a closer look at the three major man-made public health crises in the United States over the last 20 years:
In 1999, it was Columbine. That horror triggered an ongoing mass shooting virus, a vicarious trauma virus, a man-made public health crisis. Just last week, new data from the Centers for Disease Control and Prevention (CDC) revealed that between 1999-2018—the year of the mass shooting at Columbine to the COVID-19 pandemic—the rate of suicides in the United States rose by 35%.
In 2001, it was the mass murder at the World Trade Center on September 11. Afterward, we watched as the U.S. Congress refuse to allocate tax dollars to pay for the healthcare of first responders and aftermath healthcare workers. Congress continued to periodically delay support until 2019, when figures such as journalists and celebrity voices with global platforms, shamed them into acting. Not only did the lack of support impact the physical health of those individuals, it also fractured their hope, their spirt and their belief in good. That was a health inequity and wealth disparity virus: members of Congress deserve health insurance and health workers do not.
In 2007, private insurance companies, hedge funds and banks created the subprime mortgage scandal. Some called that an “economic crisis,” but in actuality, it was a man-made public health crisis caused by greed; a lack of business ethics virus that had been slowly spreading in the U.S since the 1980’s. When people lose their life savings, their homes and their businesses, their health can be irreversibly impacted by suicide, heart conditions, cardiac issues, hypertension and depression, to name a few.
Commercial Health Insurance Hustle
The statistics and research illustrate the widespread harm our current approach to healthcare imposes, and why we need a Single Payer National Health Program.
The University of North Carolina last week published a study confirming 170 rural hospitals have closed in the U.S. between January 2005 and April 2019. 128 have closed since 2010. Also last week, a new Annals of Internal Medicine study estimated that far more than 7.3 million Americans will lose their commercial health insurance coverage by June 30, 2020, due to the COVID-19 pandemic. In 2009, Harvard University linked illness, commercial health insurance costs and medical bills to nearly two-thirds of bankruptcies in the U.S; a 50 percent increase from 2001. That was 10 years ago.
But, we don’t need more data or statistics.
One needs only to walk out their door in the city, suburbs or rural America to observe the gravity of disparity, chronic illness and wealth inequity. As I type, the addicted throw-away people that live on the streets of Lower Randolph, Lower Columbus and Lower Wacker Drives beneath my home in Chicago languish, as their daily rush hour supply of food and money handouts has been cut off by the “Stay at Home” mandate. Hungry opioid-addicted persons are emerging into the sunlight—literally—and floating like walking corpses around the 42nd Ward of the city with endocarditis and bleeding limbs. Do they deserve healthcare?
In the meantime, emergency medicine physicians are using band-aids and bandanas as Personal Protective Equipment (PPE); Northwestern Memorial Hospital in Chicago and Mt. Sinai Hospital on the Upper Eastside of New York City are actively soliciting donations for equipment and money, patients are reporting bills of more than $10,000 from their health insurance companies for testing and treatment, and physicians are reporting how barriers to healthcare are making COVID-19 deadlier for minority and low-income communities due to lack of health insurance and medical facility deserts. But, professional athletes, CEOs, Senators and Hollywood actors—modern day deities and throne sitters—are accessing tests and treatment ahead of persons who are paid $8.25 per hour to clean our hospitals.
The Good News
The last thing Americans need is more incremental tourniquet-style healthcare policy.
Last year, 150 CEOs signed on to endorsing Common Sense Gun Laws in the United States. 181 business roundtable CEOs signed on to prioritizing stakeholders rather than shareholders. Nurses and physicians continued to strike across the country standing up for patients’ rights and quality of care. We witnessed the largest global outcry in history for environmental health. Are these merely PR declarations or truly a shift in the American business philosophy? In January of 2020, international biotech and pharmaceutical industry CEOs even published a “Commitment to Patients” stating their intention to begin considering the “common good” over greed.
That greed has motivated physicians and nurses to be very vocal about the stress unaffordable healthcare, budget cuts and lack of resources creates for them and their patients. Long before the COVID-19 crisis, they began talking directly to the press and testifying before Congress about how understaffed, undersupplied and overworked they were.
The time has come for more business owners, elected officials and executive boards to change their tact and prioritize health and healthcare—the very cornerstones of economic dignity—as essential to manifesting human potential to its fullest. This opportunity for a business ethics revolution is not solely about implementing a new “system.” This is about a new way of thinking by the individuals who propel systems forward.
A New Philosophy of Health
Seismologists have stated that with the worldwide “stay at home” order, they can now hear the Earth’s tectonic plates shifting like never before. Perhaps, too, in the wake of the Coronavirus, we may witness a profound shift in the American philosophy of, and approach to, healthcare. Americans may begin to assign social, economic, cultural and ethical value to healthcare access as a fiscal priority, like they do highways or mass transit, clean water and clean air. We might soon wake to a society that makes no distinction between lives that are or are not, worthy or worth-while. We may enter a new era led by business owners who prioritize health rather than the hustle, the make and the take.
The mood in the United States is currently mournful, empathic and suspect. The streets are mostly empty. But long before this invisible Coronavirus began to infect people indiscriminately, you could possibly not see the millions of letters from commercial health insurance companies arriving to the homes of patients nationwide denying them needed healthcare. Possibly, you could not feel the weight of worry from the mother in rural Kentucky who has to drive four hours to access a hospital. Possibly, before the pandemic, you could not understand the distress the business owner feels when they cannot afford to pay for their staff’s health insurance or the distress the disabled person feels who routinely receives seven-digit medical bills in the mail.
And just maybe, in decades past, you could not hear the voices of American nurses and physicians reporting about how pre-authorizations, pre-approvals and methodical denial of care by commercial health insurers harm their patients.
But now, over the incessant sirens in Queens and Williamsburg, over the crouched shoulders of undocumented underpaid workers in the Central California Valley, over the overcrowded prisons of Mississippi and Chicago, and above people hauling water in the Navajo nation of New Mexico, over the churches of Birmingham, the fast food restaurants of Detroit and the billion dollar technology companies in Seattle, you can hear exhausted physicians and nurses—along with those of us, like me, who have been bankrupted by denial of care and unaffordable medical bills—all shouting loudly through their N95 masks next to the haunting hum of ventilators: National Improved Medicare For All now. Single Payer now. Universal Healthcare now.