Since 1975, while the U.S. population has risen from 216 million people to 331 million, the total number of hospital beds has declined from 1.5 million to 925,000. 



The United States currently has only 2.8 hospital beds per 1,000 residents, just a little over half the average of 5.4 beds per 1,000 residents in other wealthy countries.



In 2018, the American Hospital Association estimated that 30 hospitals will close each year and the number is expected to rise over time.



Rural hospitals are closing the fastest. Over 120 have closed down since 2010. A report by the Chartis Center for Rural Health found another 453 of the 1,844 that remain are at risk of closing. Failing rural hospitals are preyed upon by large corporations that take them over, extract their revenues and then allow them to lapse into bankruptcy and the land sold as valuable real estate. The highest number of rural hospital closures, 19, occurred in 2019. Six rural hospitals have already been shut down this year. Roughly 20 percent of the U.S. population lives in a rural area. Residents of rural areas tend to be older, sicker and poorer than in other areas. They require more care and often can’t pay for it, placing a greater financial burden on local hospitals than populations that are healthier and wealthier.  In general, the Pew Research Center found people living in rural areas travel twice as far as people living in urban and suburban areas to get to the hospital. According to a study by the National Bureau of Economic Research, mortality rates rise by 5.9 percent when hospitals disappear, especially for people with emergencies such as strokes and heart attacks that require immediate attention. 



Hospital closures in cities also tend to occur in areas that serve poor communities and often populations of color. Like rural hospitals, they may be bought by a large corporate hospital system when they are failing and then allowed to go bankrupt. It is often more profitable to redevelop them in a gentrifying area than to keep them open.



When hospitals are located in communities with high numbers of uninsured residents, they are particularly vulnerable to closures. According to the University of North Carolina’s Rural Health Research Program, the 17 states that did not expand Medicaid under the Affordable Care Act had the highest number of hospital closures. Texas lost the most hospitals, followed by Tennessee, Georgia, Alabama, Mississippi and North Carolina. Over half of the remaining rural hospitals in Texas and Tennessee and more than a third of hospitals in Oklahoma and Georgia are at risk of closing due to their weak financial position.



In other cities, hospitals may stay open but close down essential services to make way for more lucrative fields such as orthopedics and cardiovascular disease. MedStar, a Washington, D.C.-based corporation that owns 10 hospitals in Maryland as well as physician practices, laboratories, long-term care centers and other health facilities, abruptly closed whole departments that provided obstetric, pediatric and psychiatric care in recent years.



Epidemiologist David Fisman of Toronto, Canada, says, “having a healthcare system that’s a public strategic asset rather than a business run for profit allows for a degree of coordination and optimal use of resources.”

https://truthout.org/articles/the-uss-wave-of-hospital-closures-left-us-ill-equipped-for-covid-19/

https://www.theguardian.com/money/2020/mar/31/uk-minimum-wage-rise-of-6-to-go-ahead-despite-coronavirus-pay-freeze-call

The Guardian columnist George Monbiot is always makes for interesting reading even if sometime we may differ with him. In this article of his we find a lot to agree with, although not everything.

In South Africa, communities in Johannesburg have made survival packs for people in informal settlements: hand sanitiser, toilet paper, bottled water and food. In Cape Town, a local group has GIS mapped all the district’s households, surveyed the occupants, and assembled local people with medical expertise, ready to step in if the hospitals are overwhelmed. Another community in the city has built washstands in the train station and is working to turn a pottery studio into a factory making sanitiser.



In the US, HospitalHero connects healthcare workers who don’t have time to meet their own needs with people who can offer meals and accommodation. A group called WePals, created by an eight-year-old, sets up virtual play dates for children. A new website, schoolclosures.org, finds teaching, meals and emergency childcare for overstretched parents. A network called Money During Corona texts news of job opportunities to people looking for work.

Around the world, self-organised groups of doctors, technicians, engineers and hackers are crowdsourcing missing equipment and expertise. In Latvia, programmers organised a 48-hour hackathon to design the lightest face shield components that could be produced with a 3D printer. A number of UK groups are encouraging companies with protective equipment in their storerooms to give it to frontline health workers. In the Philippines, fashion designers have repurposed their workshops to produce protective suits. Sharing techniques through the website PatternReview, home sewers have been mass-producing masks and scrubs.



In just one week, a group of doctors, technicians and other experts organised themselves to design a crowdsourced ventilator, the OxVent, which can be produced from widely available parts for under £1,000. Another design, VentilatorPAL, can be manufactured for $370, according to the community of technicians that created it. The Coronavirus Tech Handbook is an open-source library pooling technologies and new organisational models for beating the pandemic. In the US, self-organised expert groups are filling some of the catastrophic gaps in public health provision, carrying out testing and tracking projects, creating directories of vulnerable people and speed-matching medical specialists with the hospitals that need them.



I have the sense that something is taking root now, something we have been missing: the unexpectedly thrilling and transformative force of mutual aid. “

“We assess that the United States and the world will remain vulnerable to the next flu pandemic or large-scale outbreak of a contagious disease that could lead to massive rates of death and disability, severely affect the world economy, strain international resources, and increase calls on the United States for support.” – The US intelligence community, in its January 2019 Worldwide Threat Assessment

Private interests, many of whom have been making lucrative profits in the recent past, have been busy lobbying for government bailouts while tens of millions of working people are losing their livelihoods. Businesses are in receipt of financial hand-outs in amounts that have not been seen since the Second World War, often with little oversight. It is a transfer of wealth and power to the super rich unprecedented in peacetime. 



Meanwhile, there is no critical reporting in ‘mainstream’ media about the destructive nature of the global system of profit maximisation and endless ‘economic growth’. 

As Chomsky says: “What our leaders are good at, and have been very good at for the last 40 years, is pouring money into the pockets of the rich and the corporate executives while everything else crashes.”



The core problem for society is that we have been subjected to a system of fairy-tale propaganda that tells us repeatedly that capitalism, despite a few ‘failures’ or ‘flaws’, has been primarily responsible for huge progress in the human condition since the Industrial Revolution. In reality, it has been people at the bottom of the social order – working for centuries to extend the voting franchise, setting up trade unions, improving healthcare and education – who have been primarily responsible for advancements in living standards.



Working people feel powerless. We are ignored by politicians. Our future is uncertain.



Capitalism assumes people are fundamentally selfish. Socialists understands people are primarily collectively-creative. This is demonstrated when workers are given the opportunity to operate cooperatives, create workers councils in revolutionary situations or even during natural disasters. Selfishness is a product of capitalism and not the primary way human beings operate. Capitalist divide-and-conquer strategies create racism on the job by giving privileges to white workers to keep them from uniting with minorities for better pay. Capitalists expect loyalty to sports teams even when the owners sell the players to the highest bidder. Capitalists expect working-class loyalty to a nation and for them to fight wars, while capitalists exercise no loyalty to workers when they relocate in another nation where the costs of labour and land are cheaper.



But the brighter, safer, saner future can still be attained, if we remember that together we have more power than the destructive forces of capitalism. Mankind has the capacity to abandon the disaster path of capitalism, and instead embark upon a journey of solidarity and compassion. A whole new ball–game may emerge.

Imagine being told that all schools will be closed, all public gatherings will be cancelled. Hundreds of millions of people around the world will be put out of work, billions told not to leave their homes  and governments launching some of the largest bail-outs in history while landlords are stopped from collecting rent and banks letting mortgage payments to fall into arrears while the homeless are housed in hotels free of charge. Governments are helicoptering cash payments to households, writing out checks,  and some on the Right are even adopting the left-wing idea of the universal basic income. Would you have believed what you were hearing?



There is a pessimistic view is that the pandemic crisis inflames xenophobia and racist scape–goating.



Mike Davis, author of the 2005 book, “The Monster at Our Door. The Global Threat of Avian Flu” explains that “In a totally rational world, you might assume that an international pandemic would lead to greater internationalism. In a rational world, we would be ramping up production of basic essential supplies – test kits, masks, respirators – not only for our own use, but for poorer countries, too. Because it’s all one battle. But it’s not necessarily a rational world. So there could be a lot of demonisation and calls for isolation. Which will mean more deaths and more suffering worldwide.”

Some populist and demagogue politicians have blamed foreigners for COVIS-19 and have embarked upon unilateral nationalist policies rather than coordinated with neighbouring nations. In a 2008 report on the legal aspects of pandemic response, prompted by the increase in pandemic flu outbreaks, a team of historians and medical ethicists assembled by the American Civil Liberties Union suggested that  “People, rather than the disease, become the enemy.”



However there is another way of responding to a global pandemic.



Long before COVID-19, people died of diseases we knew how to prevent and treat. People lived precarious lives in societies awash with wealth. Experts told us about catastrophic threats on the horizon, such as climate change, and we did next to nothing to prepare for them. We are now aware of the extent of that can be accomplished (and quickly!) when we understand the urgency of the threat and risk. We have learned that the market cannot provide solutions to protect the public good. 



The task today is not to fight the pandemic in order to return to business as usual, because business as usual was already a disaster. The goal, instead, is to fight the virus – and in doing so transform business as usual into something more humane. 



“We’ve been trying for years to get people out of normal mode and into emergency mode,” said Margaret Klein Salamon, a former psychologist who now heads the advocacy group The Climate Mobilization. “What is possible politically is fundamentally different when lots of people get into emergency mode – when they fundamentally accept that there’s danger, and that if we want to be safe we need to do everything we can. And it’s been interesting to see that theory validated by the response to the coronavirus. Now the challenge is to keep emergency mode activated about climate, where the dangers are orders of magnitude greater. We can’t think we’re going to go ‘back to normal’, because things weren’t normal.” Salamon believes that one lesson of the coronavirus crisis is the power of shared emotion, which has helped make possible radical action to slow the pandemic. “I’m not talking about people giving each other medical expertise. I’m talking about people calling each other up and saying: ‘How are you doing? Are you scared? I’m scared. I want you to be OK, I want us to be OK.’ And that’s what we want for climate, too. We need to learn to be scared together, to agree on what we’re terrified about. It’s good that we’re entering emergency mode about the pandemic,” she said.



“The political outcome of the epidemic,” said Mike Davis, “will, like all political outcomes, be decided by struggle, by battles over interpretation, by pointing out what causes problems and what solves them. And we need to get that analysis out in the world any way we can.”



Rebecca Solnit, author of  “A Paradise Built in Hell”, a study of disaters, said she was taking heart from all the new ways people were finding to connect and help each other around the world, ranging from the neighbourhood delivery networks that had sprung up to bring groceries to people who couldn’t get out, to more symbolic interventions, such as kids playing music on an older neighbour’s porch.



 The Italian political scientist Alessandro Delfanti said he was finding hope from a post-outbreak wave of strikes roiling Amazon warehouses in the US and Europe, and also the steps that workers across different sectors of the Italian economy were taking to help each other secure equipment they needed to stay safe.



The world feels strange right now because –it is changing so fast and any one of us could fall ill at any time, or could already be carrying the virus and not know it. It feels strange because the past few weeks have exposed the fact that one of the biggest things which can change is ourselves.



The pandemic reveals that people are not selfish and self-centred but possess the capacity to share and act in solidarity with one another, even in the midst of a disaster.



Adapted from here

https://www.theguardian.com/world/2020/mar/31/how-will-the-world-emerge-from-the-coronavirus-crisis

 

Socialist Standard April 2020

Socialist Standard Apr 2020 PDF

Editorial: Capitalism struggles to cope

Pathfinders: Under Siege

The trade in footballers

Coronavirus: The Italian experience

Market Panic : Capitalist Hysteria

Cooking the Books I: Capitalism catches a cold

Wood for the Trees: A ‘Man of his Time’

Material World: Proxy warring in Syria

Arbroath 1320-1820: A History of Them and US

Irish Capitalism: Who Cares Who Runs it

Inequality: Labour’s Straw Men

Socialism, Communism, Association—A rose by another name

Transport : Future Travel

Plastic: Container Crisis

Cooking the Books II: Iron asteroids and golden meteorites

Proper Gander

Reviews

Atheism: Transcending superstition

50 Years Ago: French “Communists” support wages system

Letter: A good question

Rear View

Free Lunch

In 2009, Dr. Margaret Chan, Director-General of the World Health Organization stated in, “All countries should immediately activate their pandemic preparedness plans and must remain on high alert for unusual outbreaks of influenza-like illness and severe pneumonia.”

In the richest country on the face of the earth, doctors and nurses have no guarantees about having enough two dollar masks or other personal protective equipment (PPE) when they care for patients. The inadequate supply of PPE has already killed patients and providers. It is shameful. Covid19 provide ample reasons for anger—towards the  healthcare corporations and the media purposefully oblivious to exploitation. As usual in times of crisis, those most affected are generally those with the least economic resources. Millions of employees worldwide have been left without work given the widespread cessation of all kinds of activities, except the essential ones. As a result, those workers who depend exclusively on their wages and savings are unable to meet their needs and those of their families. Some governments have promised financial aid to those most in need but that aid is insufficient or it will take time to arrive, making it less effective. What workers need right now is not good-will, but will-power.

We’re living in a different world now. Schools, workplaces, and restaurants are shut down, adding to that already desperate situation of workers living pay-check to pay-check. The COVID-19 pandemic exposes the huge cracks in capitalist society. The longer the coronavirus emergency goes on, however, the clearer it is that people require to start rethinking our whole society. Is a “return to normalcy” possible when we may never see normal again. It is time for a revolution in our politics, pushing the idea of a more sane, more humane type of system.  Squeezing a few concessions from the government is hardly revolutionary and no amount hyping it up as a revolution will make it one. We need to back radical change in the fundamentals of this economic system. The COVID-19 pandemic is leading to major changes in people’s behaviour. It will also bring a new way of thinking. The majority of people are acting with a great sense of responsibility and expressing a great amount of generosity, offer their assistance at the risk of their lives. The pandemic, economic collapse will define the future. What we need to do is to develop solidarity and reciprocity between people around the world, to cooperate and collaborate and to provide mutual aid. To create change, people must demand it. Technology allows us to educate and organise online. People are showing they can be innovative to get our message across to our brothers and sisters. COVID-19 has shown that essential workers are among the lowest-paid workers and that it is they who make our society function.  Understanding this gives a new understanding of the power of the people. We are all connected and share a common humanity. If we act in solidarity during this time of crisis we can create the future we want to see for ourselves. We are all in this together.

  POWER TO THE PEOPLE

Some countries are hoarding food items to ensure supplies for their population as the virus crisis deepens. The export curbs could prove especially harmful for poorer nations that survive on imports.

In biological terms, pandemics are a leveller, attacking prince, prime minister and pauper without favour. In economic terms, they are much more hierarchical. 



In the United States COVID-19 is likely to widen the country’s alarming racial wealth and income gap.  Black Americans are on average much poorer than whites, a divide that has widened in recent years. They more commonly occupy insecure jobs at risk from the forced shutdowns, and have less financial flexibility. A Fed study found almost 30% of college-educated black households couldn’t pay all their bills if confronted with an unexpected $400 expense – a proportion that doubles where the household lacks a bachelor’s degree. People tend to believe it has got much better in the past 50 years. It hasn’t. 



While the wealth gap is large, it’s income that counts most during a public health crisis.  White households make roughly double the income of black households, a reality that hasn’t improved since 1962. 

That’s aside from the direct health risk. The same people often do jobs that cannot be performed from home and pose serious risk of infection such as retail, home help and nursing, according to the Center for American Progress. Moreover, if they get sick, the 16 states that are home to 65% of black Americans rank well below average on healthcare access, according to consultancy McKinsey. Death rates among African Americans are already higher than average for heart disease, asthma, cancer and pneumonia. 



Covid-19 could therefore leave black Americans a disproportionate legacy of death as well as financial disarray.



https://www.reuters.com/article/us-health-coronavirus-breakingviews/breakingviews-racial-wealth-gap-weakens-u-s-virus-defenses-idUSKBN21H384