Name: Stop Blaming Trump—the U.S. Coronavirus Health Care Crisis Runs So Much Deeper
Brand: foreignpolicy.com
SKU: foreignpolicy-com-46
Availability: OnlineOnly

critic

Stop Blaming Trump—the U.S. Coronavirus Health Care Crisis Runs So Much Deeper

preview

An expert's point of view on a current event.One of the emblematic images left behind by the coronavirus in the United States will be that of the mass graves dug for many of the victims of COVID-19 in New York City. The visual shock of stacked low-cost coffins in the city that people the world over see as symbolic of the United States rippled across the global media.One of the emblematic images left behind by the coronavirus will be that of the mass graves dug for COVID-19 victims in New York City.Much of the on the handling of the coronavirus pandemic in the United States and the hitting the U.S. economy over the months to come focuses on U.S. President Donald Trump, personally, and his handling of the crisis. But this focus on Trump is too limiting and ignores the fact that Trump’s policies play out within the U.S. institutional and cultural context—one that would be there under any other president as well. This is not to excuse Trump or his administration. Rather, the point is to recognize that if Trump were to lose in the November election, it would not at solve the most critical flaw in American’s : its health care system.The basic problem all governments face is how to enable their health care systems to cope with a prolonged pandemic without crushing all economic activity. But the nature of the U.S. health care system makes this problem much more pernicious than in other advanced economies.One of the emblematic images left behind by the coronavirus in the United States will be that of the mass graves dug for many of the victims of COVID-19 in New York City. The visual shock of stacked low-cost coffins in the city that people the world over see as symbolic of the United States rippled across the global media.Much of the on the handling of the coronavirus pandemic in the United States and the hitting the U.S. economy over the months to come focuses on U.S. President Donald Trump, personally, and his handling of the crisis. But this focus on Trump is too limiting and ignores the fact that Trump’s policies play out within the U.S. institutional and cultural context—one that would be there under any other president as well. This is not to excuse Trump or his administration. Rather, the point is to recognize that if Trump were to lose in the November election, it would not at solve the most critical flaw in American’s : its health care system.The basic problem all governments face is how to enable their health care systems to cope with a prolonged pandemic without crushing all economic activity. But the nature of the U.S. health care system makes this problem much more pernicious than in other advanced economies.Unlike other rich countries, the United States went into this crisis with adults. Across the labor market——health coverage is tied to employment, but even within this pool some 34 million people have . Now consider those who have lost, and are in the process of losing, their health insurance because of coronavirus-related unemployment, and you can easily get up to of the country losing insurance by midsummer, a figure that would be compensated only partially by other programs such as Medicaid or by people going on a working spouse’s insurance plan.[ Get daily updates on the pandemic.]Compounding this is that U.S. hospitals find themselves in the bizarre position of in the middle of a pandemic. The U.S. hospital system as a whole faces a liquidity crisis of epic proportions; Boston Consulting Group that almost two-thirds of all hospitals and health systems&nbsp;face material financial risk. Even with bailout money, many hospitals seem to be , financially speaking, due to the cancellation of profitable elective procedures to prevent the spread of the coronavirus and prioritize medical resources. Other advanced economies also have private hospitals, but because their share of privately owned hospitals is and labor laws often make it much more difficult to fire staff, they have not experienced such layoffs.Furthermore, a mainly private health insurance system like the United States’ is premised upon insurers while they receive from employers and employees. But if insurers go bust, who will fund hospitals when possible of the virus hit and intensive testing is required? Meanwhile, the doctors and nurses who treated the first wave of COVID-19 patients are not just exhausted and often ill from their experiences. Many will also face long-term traumatic effects such as post-traumatic stress disorder, reducing the capacity of the system still further. And on top of all of this, a majority of U.S. states, which fund local health care, are . So with falling tax revenue, they are also while trying to respond to a pandemic.Within such a system, the lifting of lockdowns can only last until hospitals once again fill up with cases until their intensive care units are full, testing operations face drastic shortages, and there is no more cash for health facilities to operate. To get out of this mess, the United States needs to address three distinct challenges. If it does not, any return to normal will be fleeting, dangerous, and ultimately abandoned.The first is for the federal government to commission a permanent expansion of intensive care and infectious disease treatment capacities on a scale resembling planning. To reach Germany’s capacity to deal with the pandemic, for example, the United States should triple the number of , with federal funding covering the costs. Rather than relying on pre-coronavirus just-in-time supply chains, hospitals need to construct large storage facilities to prepare to deal with situations such as the current one. COVID-19 is not going to be a one-off event. All of this means a federally funded effort.America needs a medical microgrid focused on treating patients where they are. Without locally focused care, doctors will continue to fail those who need them most.As it improvises its way through a public health crisis, the United States has never been less prepared for a pandemic.The second problem is how to come up with a vaccine and supply expanded hospitals with a ratio of ventilators per million people that, for example, was able to marshal in order to contain mortality rates. This requires large volumes of low-tech and medium-tech supplies. The United States can and should do better.Contrary to the free market legend, the United States has developed one of the world’s most capable which needs to be retooled to substitute imported medical equipment while innovating a vaccine in a matter of months, not years. It’s a matter of political will, not a lack of skill. Doing so means forcing U.S.-based manufacturers of ventilators, drugs, and tracing apps to forget about technology profits, share their templates with downstream companies, and mass-manufacture these devices in the numbers needed.It is a damning indictment of what U.S. capitalism has become when the same economy that was able to quickly convert its manufacturing sector to both and Japan during World War II can’t make enough ventilators, testing swabs, reagents, and personal protective equipment for the medical staff on its front lines in the fight against the coronavirus. These should be the supply problems of a developing country, not of the world’s economic and military superpower.The third problem is of course the big one: getting back to work. Given how little we know about infection and reinfection rates, getting the economy moving again . It is the prerequisite for lifting lockdowns and returning to some semblance of normal life. Here, the problems are not just supply-related. They expose how the capacity of the U.S. government to manage a crisis over the long term has been hollowed out over the past 40 years by successive administrations.Even with the entire U.S. pharmaceuticals, biotech, and medical sectors in emergency mode, still hasn’t caught up to the German level. Critically, this being a public health issue, the funding needs must be addressed by the government on a much larger scale. The Nobel Prize-winning economist Paul Romer estimated that the real cost of restarting the economy will be . In a worst-case scenario of poorly targeted testing, Harvard’s Edmond J. Safra Center for Ethics estimates the total cost of mass testing to reach . That is expensive—but so is the from lockdowns and social distancing. It would require for testing run by a federal agency, a program that could fight future pandemics as well. In short, effective mass testing will require fast decentralization, more competence at the federal level, and a “bazooka” option for funding the whole endeavor.Finally, to generate usable results, mass testing by systematic contact tracing. This would entail Americans agreeing to use tracing apps of the type being developed by Google and Apple to geotrack all movements and warn Americans of exposure to infected individuals. While this approach has proved highly effective in and is being embraced by , in the United States and elsewhere this is considered by many to be an invasion of privacy and a violation of rights. of those surveyed in an April poll, 70 percent of self-identified Republicans and 46 percent of Democrats, are firmly against it. The mandatory use of tracing apps may also not be constitutional. A way around both popular distrust and legal limits could be sunset clauses. That is, the apps could collect after a set period, as demonstrated by Germany’s development of a contact-tracing app designed to avoid both privacy breaches and the risk of having data used after the end of the pandemic. Other European countries , and the European Commission has provided . But given the lack of trust in experts and technology surrounding COVID-19, such safeguards are likely to be insufficient.Given the peculiar structure of the U.S. health care system, the coronavirus is on track to and economic capacity in the United States than all the major economic crises of the 20th century. If Americans disagree over the details of health care reform, they should at least shore up what they already have so that it fits the purpose of fighting a pandemic. Neglecting to do that will ensure that any attempt to get back to work fails and fails again. Blaming it all on Trump might make some people feel better, but it will do nothing to fundamentally help the nation’s economy and public health.Mark Blyth is professor of international&nbsp;economics at Brown University and co-author of Angrynomics , to be published in June by Agenda/Columbia University Press. Follow him on Twitter: @MkBlyth.America needs a medical microgrid focused on treating patients where they are. Without locally focused care, doctors will continue to fail those who need them most.As it improvises its way through a public health crisis, the United States has never been less prepared for a pandemic.Latest12345Latest AnalysisAccording to IR textbooks, the United States, Russia, and China are on a collision course.Six months into Russia’s war, seven thinkers outline its impact on foreign policy.Misperception, sunk costs, escalation, and internationalization all make conflicts last longer than planned.Russian diplomats were once viewed with begrudging respect in the West. Now they’re seen as irrelevant mouthpieces for Putin’s war in Ukraine.LatestSign up for Morning BriefEnter your emailBy signing up, I agree to the Privacy Policy and Terms of Use and to occasionally receive special offers from Foreign Policy.By signing up, I agree to the and and to occasionally receive special offers from Foreign Policy.Expand your perspective with unlimited access.Loading graphicsComplete your profileShow moreAug 15, 2022 |In her role as administrator of the U.S. Agency for International Development, Samantha Power is often thrust into the forefront of some of the world’s biggest crises. From working to ensuAug 11, 2022 |Last summer, the United States decided to end its longest war. But just days after the U.S. military withdrew from Afghanistan, Kabul fell—and the Taliban took control of the country. Aug.Aug 09, 2022 |Want the inside scoop on Russian arms sales to Africa? Care to learn more about how Ukraine is arming itself and how Beijing views Washington’s support for Taiwan?FP subscribers are alreaRight-wing nationalists are spreading a dangerous “stab-in-the-back” myth to explain Russia’s crushing defeats.The late queen incarnated and ably helped sell her nation and its system while never criticizing or apologizing for its past.Pyongyang has abandoned any rapprochement with Washington.An old ideology rears its head but offers little for the present age.Next: NewslettersRemind me later

An expert's point of view on a current event.One of the emblematic images left behind by the coronavirus in the United States will be that of the mass graves dug for many of the victims of COVID-19 in New York City. The visual shock of stacked low-cost coffins in the city that people the world over see as symbolic of the United States rippled across the global media.One of the emblematic images left behind by the coronavirus will be that of the mass graves dug for COVID-19 victims in New York City.Much of the on the handling of the coronavirus pandemic in the United States and the hitting...

public

Cornel Ban

Mark Blyth

The magazine for global politics, economics, and ideas 🌎 || Sign up for our newsletters: http://foreignpolicy.com/newsletters/

Stop Blaming Trump—the U.S. Coronavirus Health Care Crisis Runs So Much Deeper

No article scores yet.

CRITIC REVIEWS

PUBLIC REVIEWS