Heeees baaaack! And the crowd goes mild. But the Hog here turns his hand to the role of theater critic; political theater, that is. With virus mania running amok full throttle, now is the time to consider an elemental question: what the hell is going on?
In just a few weeks, we have gone from “everything is under control” to “everything is getting better” to “hoax” to a declaration of a state of national emergency by a president who heads a breathtakingly incompetent administration. A president, who, in cahoots with state governments, has shut down, for at least six weeks, large sectors of the economy, which, until recently, had been his “trump” card for reelection. The likely result of this overreaction cannot be overstated. We are headed for what is euphemistically termed an “economic downturn,” more commonly known as either a recession or (Hog forbid) a depression. The dictatorial closing of so many businesses and activities will inevitably result in the ruin many small business owners, along with crushing job loss. (We know, this is uncharacteristically upbeat for ol’ BH).
Ironically, the economic ripple effect of this shutdown will spread just as exponentially as does a virus. Closed businesses and lost jobs will cause loan defaults, foreclosures, diminished consumer activity, and a general economic contraction. And all in the service of bad political theater. Hog, you say, where’s the evidence for that?
Before you can find the right answers, you must ask the right question. Up to now, we have not done so. The economic and social shutdown has been based on the (oxymoronic) premise that we must “flatten the curve,” meaning we want to prevent a large and sudden spike in cases that overwhelms our healthcare system. This seems valid; but the real question is: how close to capacity was the healthcare system before this outbreak? This is, after all, cold and flu season, and, as will be seen below, evidence indicates the flu virus may be more deadly than the coronavirus. The answer: a little research reveals that the system was close to capacity before anybody ever heard of this “novel” virus. (The Hog inconveniently points out that every virus began, by definition, as a novel virus).
Yes, the system touted by Republicans as the best healthcare system in the world was nearing overload as this new crisis began. So the fundamental problem is not that this virus is dangerous (it is), nor that it is so contagious. The real issue is that our healthcare system is inadequate to cope with this new outbreak.
As for the comparison with the flu virus, the CDC reports that in the current flu season, there have been at least 34 million cases of flu, 350,000 hospitalizations and 20,000 flu deaths in the United States. This, from a disease against which many of us are already vaccinated. By contrast, the worldwide figure of confirmed cases of the new virus is in the neighborhood of 1 million, of which about 200,000 are in the United States (population: about 330,000,000). The U.S. death toll is at about 4,000 as of April 1, 2020, according to data compiled by Johns Hopkins University.
Influenza, then, is a known, highly contagious dangerous and often lethal virus. The coronavirus is also highly contagious, and very dangerous for certain segments of the population, such as the elderly with pre-existing conditions. However, statistically, we do not have enough of a sample to determine exactly how its mortality figures compare with that of the flu. The data are simply insufficient, and thus, unreliable. Thus, the tremendous reaction to the outbreak is based largely on first, SWAGs (Scientific Wild-Assed Guesses, and secondly, more importantly, on the aforementioned lack of capacity in our healthcare system.
The danger is real, because if you get sick enough to need hospitalization, you may well run into a shortage of providers and beds. It’s probable that the flu is playing a large part in that shortage. But flu runs rampant through the world every year. So it would seem that our healthcare system is designed to cope with the problems of cold and flu season, so long as something new doesn’t come up simultaneously.
And now we get to the political theater. The rabid bipartisan response is designed to distract us from the awkward reality that if our healthcare system is the best in the world, the world is in trouble. The Democrats, under President Obama, embarked on healthcare reform via the Affordable Care Act, but, under pressure from various corners, that quickly became “health insurance reform,” thus guaranteeing that the insurance companies would continue to take their disproportionate share of the pie. It also perpetuated the fee-for-service, profit-based system. Then the Republicans launched a legislative and judicial attack on what they derisively called “Obamacare,” a decade-long effort that did nothing to strengthen the healthcare system, and most probably weakened it considerably.
The panic being spread by politicians, aided and abetted by the media, stems from the fear of their big donors in the health care industry that this will be the episode that finally wakes up America to the fatal flaw in a profit-driven, fee-for-service, insurance-based healthcare system: a profit-based system cannot afford to have much excess capacity sitting idle for long periods of time, in preparation for, say, a pandemic. Maximizing profits motivates the system to ensure that supply and demand are as closely matched as possible. Thus, during cold and flu season, the system approaches capacity, by design. A proper healthcare system would anticipate the need and provide adequate excess capacity. But that would be a healthcare system geared to actual healthcare, rather than profits.
None of this is to denigrate the efforts of the doctors, nurses, volunteers, and others on the front line. They’re doing the best they can, but they’re toiling in a broken system, one devoted to sick care and not health care.
The Hog fervently hopes that when the crisis has subsided, the public remembers that its world was turned upside down, solely because our healthcare system did not have adequate capacity. Perhaps it will come to understand that healthcare is not a commodity like widgets, and that this sort of disaster can be managed, if not averted completely, by a system that allows a generous amount of inefficient but necessary excess capacity. That would be a single payer system, like Medicare for all. (Ironically, we’ve heard how expensive that would be, and how we can’t afford it. Yet, look at how quickly the government came up with $2 trillion). But the public’s memory is short, and the power of the insurance companies, Big Pharma, and the corporate healthcare system, along with that of their minions in government, is great. Hope may spring eternal, but the likelihood is that the system must collapse (and it will) before we get fundamental change. And single payer will come only when the government has to pick up the pieces. In the meantime, enjoy the political theater from the comfort of your own home. The wild swings in policy, the rampant finger-pointing, the bogus statistics, the speculative predictions, the “now it’s open, now it’s closed” announcements, and the general fear mongering. It’s all so…. distracting… Excuse me, need to bring this to an end; the latest bad news beckons.