The COVID-19 pandemic forces us to think broadly about where this event fits in a much larger picture.
How is it that our government can produce such a massive financial bailout, but we have not properly funded our acute and chronic health care services, which have been starved since the 1990s when transfer payments from the feds to the provinces were dramatically cut, as were the number of physicians trained? Clearly the current crisis demonstrates that we can indeed afford to fix our neglected health care system and should have done so. We can afford it; not to have done so is a values-based political choice.
Failing to keep operating rooms open before this event has allowed the growth of private solutions, which undermined the public space and equity, the basis of our medicare.
The link between the current COVID-19 crisis and climate change, the development of zoonoses (diseases that jump from wild animals to humans) and a parallel diminished support for the public health system, and even the way that the office-based curative system operates – all need a rethink. While it is wonderful how in this crisis physicians in the private office-based system of medical care have stepped forward to provide leadership, it also illuminates that in normal times, private office-based fee-for-service care is divorced from the overall community-based needs of the public.
In fact, we do not have a health care system at all. We have an underfunded system for paying for hospitalizations and physician services, while public health needs are largely invisible. It is important to realize, however, that even a real health care system like the U.K.’s can be corrupted, neglected and destroyed if not protected. In the U.K., the public system has been hollowed out and undermined by progressive privatization of its components.
The current crisis can force us to re-evaluate the totality of how we deliver care and protect the public or, under the shock of the pandemic, give in to more privatization. Recent catastrophic nursing home deaths, with most nursing homes owned by private interests, point out how, by skimping on care, death in large numbers among the most vulnerable is an inevitable by-product.
Dr. Michael C. Klein, author of Dissident Doctor: Catching Babies and Challenging the Medical Status Quo (Douglas and McIntyre, 2018), lives in Roberts Creek.
