Informed Comment - March 30, 2020
Southwest Harbor, Maine (Special to Informed Comment) – The escalating total Covid 19 deaths in New York City and the frantic quest to obtain life saving medical gear has rightly captured media attention. New York governor Andrew Cuomo’s impassioned plea for more federal assistance and a need-based system for allocating aid among the states was covered by CNN and other major corporate media. Nonetheless, they omitted the backstory, the grave decline in NYC hospital capacity over the last two decades, continued and endorsed by leadership of both political parties.
Though much attention was focused on how short of ventilators, masks, and beds the hospitals were there was almost no attention to how the city fell ino this crisis. It was as though only the virus was to blame. Over many years now Medicaid and healthcare activists have made hospital closures an intensely contested issue. In the last two decades NYC hospital beds have gone from 73,000 to 53,000. Democracy Now co-host Juan Gonzales and guest Sean Petty, an emergency room nurse in the Bronx, point to the role that a market mentality creeping into private and even many nonprofit hospitals has played in this decline. “During the years Cuomo has been in office, the number of beds available per patient in the United States in many states has declined dramatically, mostly because hospital managers see empty beds as not money-making, so they want to reduce the number of empty beds as much as possible, so they staff fewer and fewer beds.” Beds in short are subject to the same just in time principles that govern any other supply chain in the modern market economy. Applying just in time metrics to all key resources purportedly maximizes efficiency.
Efficiency, however, is a concept that deserves more critical scrutiny. Writing in the Atlantic Helen Lewis argued: “The tech sector’s overarching philosophy remains bent towards treating the human brain and body like a machine that can be tweaked and perfected until it is running at peak efficiency,” the journalist Lux Alptraum wrote forQuartzin 2017. This is, however, a fundamentally inhuman philosophy. People aren’t machines. We are inherently inefficient, with our elderly parents and sick children, our mental-health problems, our chronic diseases, and our need to sleep and eat. And, as the past few months have demonstrated, our susceptibility to novel viruses.…
Humans and the ecosystems of which they are a part are volatile and not always predictable. The decision to forego back- up systems and ample inventories is analogous to a homeowner’s choosing not to insure his/her house because a fire is unlikely and insurance premiums consume after- tax income. Fortunately most homeowners don’t or are not allowed to think that way. In the public arena, however, things are different.
Governor Cuomo has been generally supportive of the neoliberal development model that includes tax cuts for business and fiscal austerity for the public sector to fund those cuts. He shares the centrist faith in markets as perfect information processing systems and strives to remove the public from active participation in such decisions. When the state budget mandated multi billion dollar cuts in spending for hospitals he attempted to deflect attention to his role by creating a commission comprised disproportionately of health industry insiders.
Those industry insiders seem to object even to discussion of this backstory. “Focusing on closed and consolidated hospitals does nothing to help the task at hand,” said Brian Conway, spokesman for the Greater New York Hospital Association. “All that matters is rising to the current challenge, and the hospital community is deeply committed to doing exactly that.
This is the familiar line of an institution in crisis. When the crisis is in full force now is not the time to explore its history. That would be fine except for two facts. Knowing how we arrived at this potentially catastrophic point is one key to a more humane resolution of it. Major media, including NPR, sadly have done little to explore the deeper background of the NYC shortages. Activists and alternative media must fill the void. Secondly even in the face of corporate healthcare’s many tragedies and inequities, its proponents and beneficiaries continue to push for its preservation and extension of a market dominated health system from which they profit.
Recent sociological studies aimed at locating and finding the backgrounds of the most influential leaders in both private and nonprofit healthcare indicate that MBAs are replacing those who primary focus is in health delivery, public health, and biomedical research. Thus if these players get their way, potential vaccines to prevent a future Covid19 pandemic will be patented and thus limited to those who can afford their inflated prices. The politics of healthcare and Covid19 provide ample reasons for anger—toward corporate healthcare and the corporate media so oblivious to their exploitation.