Health Care Disparities And The Virus

timesofindia.com

Hello Everyone:

Welcome to another episode of the socially distant blog. Blogger hopes you all are rigorously following protocol: wash your hands, keep more than three feet apart from each other, avoid crowds, cough and sneeze into your sleeve, and stay home if you are sick. Another important reminder, there is absolutely no need to hoard.  The food, water, and other necessary supplies are not running out. Finally, now that all the bars and restaurants are closed until further notice, Your Truly hopes that those of you out there, who flipped a double bird at the virus, will use the down time to rethink your carelessness. Onward

cdc.gov

One of the many issues that COVID-19 shined a bright spotlight on is the disparities in health care. A lot of the talk on the American campaign trail, regarding this subject, has been focused on the need for expanded access to quality care.  Blogger agrees with this policy item but right now the focus has to be on identifying, isolating, and treating patients. Debates on universal single payer healthcare and paid sick leave can take place once the pandemic is over and life returns to some version of normal. For now, let us talk about the disparities in obtaining treatment for this potentially deadly disease.

Here is a very real fact: in the weeks ahead, the American healthcare system will overwhelmed because it got a late start.  There is no point in re-hashing the reasons why, suffice it to say that the current state of the American health care system has been ailing for years.  Aaron Carroll wrote in The New York Times,

The ability of the American health care to absorb the shock--what experts call surge capacity--is much weaker than many believe.

Every hour of every day, the United States is becoming more conscious of this big problem.

No matter how many posts and tweets you read about "flattening the curve," the bottom line is COVID-19 prevention is more accessible to the rich than everyone else.  Case in point, jailed convicted sex offender Harvey Weinstein tested positive for the virus.  Mr. Weinstein is emblematic of how celebrities and other affluent members of society are able to gain access to the testing and treatment currently being parsed out to his fellow inmates and everyone else.  Being an affluent member of society also means you can take the necessary steps to self-isolate.  For example, abstaining from taking public transportation.

Los Angeles Metro bus
curbed.com

 Refraining from public transportation is far more feasible and already quite commonplace.  Simply put, working from is a more feasible option for people with higher-paying jobs.  The Bureau of Labor Statics conducted a survey in 2016 "found that a third of people who earn more than $1,441 per week have the option to work from home, compare to 9% of those who earn less than $581 per week" (qz.com; Mar. 16, 2020; date accessed Mar. 23, 2020).

Sick leave, or the lack of in the United States, is another factor in the healthcare disparity.  Sick leave is frequently not available to workers in the retail and service industries.  Although some employers, Walmart for example, have adjusted their policies, in the wake of the pandemic.  However, workers in companies with 500 or more employees are not eligible for paid sick leave mandated in the emergency legislation now pending before the U.S. Senate.  The COVID-19 did not create the disparities, just put them into sharp focus.  Jesse Bump, a lecturer on global health policy at the T.H. Chan School of Public Health at Harvard University, explained the disparities to Quartz,

The lack of benefits means it is very hard to access medical care and also less likely that people can afford to take time off to do so,... It is far less possible to take the day off when not feeling well if doing so means you can't eat that day or won't make rent that month.  The stark inequalities in American society threaten the health of everyone (qz.com; Mar. 16, 2020).

theorganicpepper.com

As cheerful and easy as the tweets and posts make a fourteen-day quarantine sound, the reality is quarantine is expensive.  "It can cost hundreds of dollars to buy food to last that long, and plenty of households would struggle to spend that money in one go" (Ibid).  A 2018 survey revealed that "40% of US households said they'd struggle to come up with an extra $400 in an emergency" (Ibid).  Anqi Chen, assistant director of savings research at the Center for Retirement Research at Boston College, spoke to Quartz,

A lot of households have really tight balance sheets and are short on liquidity,... Trying to stockpile could add stress to to household balances and budgets (Ibid)

COVID-19 also aggravates health inequalities that are already present along income levels.  University of York epidemiologist Kate Pickett told Quartz, in an email,

Those lower down the social ladder are much more likely to have underlying health conditions and multiple co-morbid conditions, making them more vulnerable to having a serious or fatal case when they are infected...Those with fewer resources are less able to absorb shocks and more likely to be tipped into poverty, debt and unemployment,... (qz.com; Mar. 16, 2020).

Prof. Pickett argues, "The solution is not simply for companies to provide more benefits, though of course they should,..." (Ibid).  She said "coronavirus should be a wakeup call to everyone about the value of public services to protect people's health (Ibid).  She wrote,

Just as in the global financial crisis, the taxpayer will be providing the social and economic security nets that we needs,... (Ibid).

spotlightnews.com

Public services meaning infrastructure as in sanitation, sewage, and potable water.

Historically, innovations in infrastructure, used to combat infectious diseases such as cholera and yellow fever, have shaped modern government.  Mr. Bump agreed with Prof. Pickett's argument that COVID-19 should be a wake up call about the value of infrastructure.  He said,

All the urban services such as sewerage, and sanitation, and filtered water were innovations to combat cholera (Ibid)

He added,

Over the recent decades many people in developed countries have become forgetful and lost the solidarity created by the shared experience of infectious disease,... Universal access to essential health services, environmental protections, equality in education, and equality of opportunity are the most fundamental element of preparedness... (Ibid).

Historically, disease and destruction, have led to greater equality for those who survive it.  Right now, it is far too soon to see if that will be the case when COVID-19 finally subsides, we can all go out and live life again.  One thing is certain, the virus' global impact is a powerful reminder of just how valuable social safety nets like paid sick leave and universal access to healthcare are for everyone.