This racially disproportionate rate of death
Another way the US is not a developed country:
Across the city of New Orleans and throughout the state of Louisiana, in America’s deep south, similar scenes of mourning have played out among hundreds of African American families. Louisiana is among the states hardest-hit by Covid-19, with 755 deaths marking one of the highest per-capita death rates in the country. Seventy per cent of those who have died here are black, despite African Americans making up only 32% of the state population.
This racially disproportionate rate of death has begun to emerge among other states in the deep south, America’s poorest region, where a nexus of intergenerational poverty, a greater prevalence of underlying health conditions, and less access to healthcare are certain to have more pronounced consequences for the black community as the virus proliferates.
Black people in the South and in the rest of the country have been systematically and deliberately kept in that intergenerational poverty since their ancestors were dragged here in chains. Poor people are treated like shit in this country. That’s not “developed.”
“The south has the perfect storm of characteristics to just be a tragic region in terms of the Covid outbreak,” said Thomas LaVeist, dean of public health and tropical medicine at Tulane University.
… The “perfect storm” LaVeist refers to, brews over a region that has almost unanimously – bar Louisiana – declined to expand Medicaid benefits offered by Barack Obama’s signature healthcare legislation, the Affordable Care Act, which would enable millions of low-income southerners access to health insurance.
We treat poor people like shit here.
That lack of healthcare is why you can readily envision a second peak forming. This thing could just be getting started in the US.
I recently saw a tweet which said, in essence, Breaking Bad would be a completely non-starter in Germany as a realistic premise for a TV show, because teaching here is a decently middle-class profession and nobody has any medical bills and essentially no university debt. (There are certain cases where people have to take out loans for living expenses during full-time school, but tuition ranges between zero and a few hundred euros per semester here, depending on the state.)
I think that is indicative of something deeper.
Indeed it is.
What I miss from this account is whether religion has played any role in this appalling death toll. As we’ve seen, the media was recently full of stories about (I assume) mostly white US evangelicals “cursing” the virus, obstinately continuing to hold crowded services, and so on.
I wonder if similar things have occurred among black congregations in the South, and whether this is now contributing to these distressing results.
Of course other religions have shown similar blindness. In the US you had that Jewish group in New Rochelle.
In Southeast Asia, Islamic leaders have a shameful record. In one example, Malaysia and its neighbouring countries registered many Covid cases arising from a single Muslim “tabligh”meeting of 15,000 held near Kuala Lumpur. Participants then went home to Indonesia, Vietnam, Pakistan etc, spreading the virus around. In another “tabligh” case, an Indonesian participant said he was more afraid of Allah than of a virus.
Indonesia is especially worrying, being the largest country in Southeast Asia, with a government which has been far too respectful of conservative and even radical Islam, and has been hesitant to do anything practical about the current crisis. The fasting month is approaching, after which the Idulfitri celebration traditionally involves millions of city workers going home to their villages, mostly by public transport. The virus could hardly hope for a better scenario.
Will the government actually ban Idulfitri? Observers doubt they’d have the courage to do so, and whether the public would follow such an order.
Yes I think religion probably has played a role. The Guardian article I quoted from included a section on church gatherings.
This is something I could write a thesis on but I’m typing on a tablet so I’ll be short and sweet. Well, not that sweet really.
Most of my research is in health disparities. As a genetic epidemiologist, I’m primarily interested in genetics but you can’t do this kind of work without an understanding of the other pieces of the puzzle. In my US-based research, social determinants of health are the elephant that’s not so much in the room as having crushed the entire building. We are seeing the tragic consequences of those injustices in the bodies of dead black and brown people.
I can’t speak for the whole of the south. But here in the Mid-South, in a majority-minority city, black churches have risen to the challenges. Easter Services held online, on Facebook etc. Encouragement and education on social distancing and dissemination of accurate health information. Mosques and synagogues have also stepped up. It’s the white churches that are being assholes.
Just to note that there have been racially disproportionate death rates in the UK as well. I don’t know the racial breakdown of Covid deaths here, but I do know that all (or at least all of the first dozen or so) doctors that have died of Covid here have been men of colour.
One of the most disgusting responses to the virus I saw was – The View accusing Bernie Sanders of politicizing the crisis by pushing medicare for all.
Joe Biden sounding very much like he’d veto medicare for all if it ever actually passed the lower houses.
https://www.cnbc.com/2020/03/10/biden-says-he-wouldd-veto-medicare-for-all-as-coronavirus-focuses-attention-on-health.html
Biden had previously said medicare for all wouldn’t help – just look at how Italy’s healthcare service was over-run.
https://www.bloomberg.com/opinion/articles/2020-03-17/coronavirus-italy-shows-medicare-for-all-is-no-cure
Well, if you go to Vox and look at their story from two days ago that included charts of infection rates, what you can see from their linear graph is that Italy has handled the virus significantly better than the US, despite both countries having failed to lock down early enough.
https://www.vox.com/policy-and-politics/2020/3/13/21178289/confirmed-coronavirus-cases-us-countries-italy-iran-singapore-hong-kong
The US is handling this crisis uniquely badly, and a big chunk of that is that the US’ healthcare policy is highly fragmented. Because the US is entirely reliant on private healthcare, some insurers are waiving costs for treatment, others are not.
https://www.nytimes.com/2020/03/19/health/coronavirus-tests-bills.html
And it required bringing in new legislation to make the tests free, which meant delays on getting sufficient testing done.
So you’ve got a crisis which requires federal action to deal with. Leaving it up to the states, means you get stupid shit like giving religious exemption to lockdowns despite the fact that religious gatherings are pretty good at spreading the disease.
https://abcnews.go.com/Health/states-crack-gatherings-due-coronavirus-exemptions-religious-groups/story?id=69847021
It also means that you have big gaps in where has adequate and inadequate medical infrastructure.
https://www.npr.org/2020/04/09/829753752/small-town-hospitals-are-closing-just-as-coronavirus-arrives-in-rural-america
And yes, the virus is in rural America.
https://www.nytimes.com/interactive/2020/04/08/us/coronavirus-rural-america-cases.html
There is a real risk of creating reservoirs of the virus that reinfect places that took sensible measures, because the handling of it is so fragmented.
So essentially it is fine to politicize the pandemic in order to prevent any action that might conceivably help solve the crisis and mitigate future pandemics, that’s exactly what Joe Biden did with regards to Italy.
But to suggest letting people get free-at-the-point-of-service healthcare under a unified federal system is bad form. There is a disgusting and frankly odious hypocrisy in that.
Now you’ll note I’m hitting the Democratic Party in this. This is because right now the Democrats need to start showing some spine.
If they cannot argue for a more unified approach on public healthcare now, then when can they?
The argument from high costs is identical to the argument against dealing with climate change, and suffers the same problems. The fact is that you’re already paying for the status quo, and you’ve got no guarantees of treatment under the status quo.
Much like climate change, the cost of doing nothing may well be more than the cost of action.
What medicare for all does is essentially migrate how you pay for healthcare to doing it through your taxes. If healthcare costs are destined to balloon over the next decade, they’ll still do that if you’re doing it through the private sector. Doctors will still need to be paid, medicines will still need to be made, if you get sick, you will still need treatment.
Where the savings predicted in medicare for all come in are through economies of scale, you need less administration for one healthcare system versus a whole load of insurance companies, and through savings on drugs due to the fact that a single payer has more negotiation power.
You also have better preventative care, and earlier detection of health problems, reducing the costs of dealing with those problems as a whole.
The US pays more for medication than any other country in the world, and that medication is developed into a commercial product by drug companies, but are actually often discovered by publicly funded universities.
https://www.latimes.com/health/la-xpm-2011-feb-10-la-heb-drug-development-taxpayers-20110210-story.html
So the argument that the private sector is the driver for new drug discoveries is in fact dodgy.
This is the case that should be being made by what is supposed to be the leftist party in America, yet they are too timid to make it even as the current sitting president is confiscating medical supplies from hospitals.
https://www.gq.com/story/trump-admin-confiscating-coronavirus-supplies
When Zimbabwe suffered through its economic collapse, one of the things Zanu-PF did was ensure that their supporters got food aid, while the opposition did not.
https://www.bbc.com/news/world-africa-37306514
The fact that you cannot trust the current president not to do the same thing in this crisis means now is not the time to be nice.
There comes a time in which a party has to be able to fight. To stand up and suggest solutions and not back down for fear of getting criticized.
A politician’s job is to politicize things, to suggest political solutions to problems, to debate what action the body politic should be taking, and for far too long and on far too many issues, this has become taboo because that taboo supports the kind of people who buy patents for diabetic medications and hike the prices.
If you’re hiring somebody for a job, you don’t want somebody who is too cowardly to do the job. The Democratic Party needs to do better here, or risk losing to a man who belongs in jail, not the Oval Office.
Bruce Gorton, while I can agree with MOST of that, I have to dispute this push toward Medicare for all. As someone who is dealing with the situation of a spouse that is now on Medicare, I can say that it is categorically NOT a good insurance. It was much better many years ago when I was on it for a disability (and much more affordable – there are very high premiums for Medicare), but it had no drug plan. On the current drug plan, we pay large amounts for it, and the drugs are higher than on my insurance.
This has become a slogan – Medicare for all. It should stop being a slogan. We need to say “Single-payer healthcare”, and shoot for a system that will actually insure the poor (no way could I have afforded Medicare premiums like they are now when I was on it in the 90s), and pay decent coverage. The current Medicare system will leave people in the same boat as the ACA or as nothing – unable to afford the care. The premiums will be impossible, the co-payments will be impossible, the poor will continue getting no treatment, and the situation will not change.
I wish someone…anyone…in higher places would bring that up, but they all seem to be living under the illusion that Medicare is something you get that is wonderful, magical, fairy dust type coverage. It is not., It sucks. My BC/BS provided by my employer is orders of magnitude better, but is costing my employer thousands, and the deductible is high, the co-payments are high, and they are free to refuse to pay for needed services if they decide on a whim that they are not needed (usually because they are expensive). My drugs are tied to a formulary, which appears to be tied to kickbacks given by drug companies to insurance companies, and none of my crucial, life-saving asthma drugs are on the formulary, leaving me with high co-pays even for generic medication. So for me to say my insurance is better than Medicare is saying something, indeed. In fact, from what I see, my insurance may be better than almost any other insurance plan out there…
Yes, we need everyone covered. But not by Medicare.
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