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Issue #1911      April 20, 2020

COVID-19: THE VIRUS AND OUR HEALTHCARE SYSTEM

The following are some thoughts of a doctor, presently delivering services and watching the crisis unfold, about the possible future scenarios for his patients, the Australian people, and the health system as a whole.

For the past twenty years or so, we have witnessed the privatisation of public hospitals and defunding of Medicare – an inevitable result of the system’s drive to maximise profits. But now, with the arrival of COVID-19, the criminal consequences of these policies on the people are becoming apparent. If we didn’t already know it, it’s clear now: the public system is the only one that will look after everyone. It will take a superhuman effort to provide healthcare for all people at the risk of the lives of health and ancillary staff.

It will take years to build back up the public system: the staffing, the resources, and the infrastructure – we have to start now.

The dismantling of our public healthcare system is a result of our two-tier healthcare system (public and private) where healthcare workers find themselves left to face COVID-19 in an under-resourced public system and without sufficient protective equipment – including masks and PPE.

Meanwhile, the shutdown private hospital system has been shut down for elective surgery but has been given an extra $1.3 billion lease payment lifeline by health Minister Hunt. The private insurance funds continue to collect an annual $6 billion taxpayer subsidy, despite all elective surgery, dental, and physio being stopped. Meanwhile, cash-strapped citizens are forced to pay health insurance premiums for no benefit other than a windfall profit for the insurance companies!

No selfless sacrifices here! We must ask: why does the private system exist? The answer: private profit.

At press conferences, the health minister praises the frontline healthcare workers while at the same time not providing those same workers with the protection and safe workplaces they deserve and instead actively repositioning the parasitic, private health system.

CORONAVIRUS

COVID-19 is already changing the course of history, and it may be with us for a very long time. The highly infectious virus has created a pandemic where there is no treatment, where nobody has immunity, and that has proved deadly or can result in permanent scarring of the heart, lungs, liver, kidneys, and even the nervous system.

COVID-19 threatens to overwhelm not only the health system but also national and global economies, raising the spectre of depression and mass starvation. And it did not come as a total surprise; warnings were given on multiple occasions. So why didn’t our government act? Why were we left so unprepared?

The truth is our governments don’t want to spend money on preparing for people’s needs. Instead, they do everything to redirect public money into the private sector while cutting back on the public health system and research, by the Commonwealth Scientific and Industrial Research Organisation (CSIRO). As a result, there is no resilience left in the system, no preparation, no national stockpiles.

As with the bushfire emergency, we seem to be again left largely to our own devices, with only buckets and hoses on the front lines.

COVID-19 – CAPITALISM’S PERFECT STORM

More than just the catastrophic health consequences, COVID-19 has created the perfect storm for a government whose sole purpose has been to redirect monies into the private sector and maximise private profits over the needs of the people. After years of promoting the cult of the individual and rampant overconsumption and winding back government services, they have been caught out. As a result, the system is in chaos. As a result, systemic paralysis ensued with the Ruby Princess disaster, leaving schools open for too long without temperature checks or screening, the allowing of planes to keep coming in from the UK, Europe, and the US without checks or screening or quarantine, etc.

Even now, positive COVID-19 cases are admitted directly into our major teaching hospitals, thus putting large hospitals, and their large workforce, at risk rather than being isolated in special infectious diseases units.

The maths tells us a lot about how we will fare. We know that eighty per cent of cases will recover and may only experience at worst a flu-like syndrome that keeps them home in bed. Additionally: twenty-five per cent of cases can be subclinical, i.e. no symptom; twenty-five per cent can have a fever and cough, maybe a headache or conjunctivitis; twenty-five per cent will have flu-like symptoms that would keep you off work.

Around twenty per cent will have a severe illness – including viral pneumonia – and half of those will end up needing a ventilator, and about half of those may die. In severe cases, the lungs become wet and severely irritable, and even a speck of dust causes prolonged coughing. The distal tubules of the lungs pour out fluid, viral pneumonia follows, your lungs cannot get oxygen and therefore can’t get rid of the carbon dioxide that builds up in your blood.

There is no treatment. Coronavirus is especially deadly for older people or those with chronic conditions, including those with high blood pressure, a heart condition, lung disease, and diabetes.

But whether symptomatic or not, all cases are still highly infectious, including from five days before you exhibit any symptoms. Even now, where is the mass screening in hospitals, aged care, prisons, educational institutions residential facilities, as well as at airports and other places where people congregate? Morrison says we are “all in it together” and all playing on “Team Australia,” but clearly there are first class and second class members of the team and the coach is not leading properly and not equipping the team properly.

Realistically, despite the concocted optimism of the conservatives, we know, even now, there may never be a vaccine.

Recent studies have shown that even those who have had the disease, have low or no antibodies, i.e. develop little immunity. The concern is that if the disease itself does not cause antibodies or immunity, then what is the likelihood that an attenuated virus will?

We also know that even with current flu vaccines, the percentage of people protected by the vaccine can be fifty per cent or lower – particularly in older people.

All of this has serious implications for public policy and would negate the two popular narratives pushed by ultra-right conservatives, “Why don’t we just let the disease run its course until the community develops ‘herd immunity’?” i.e. let the health system be swamped, accept a high death rate, and get the economy back on track as quickly as possible. Or, “it will be OK because there are treatments.” e.g. chloroquine, Ivermectin, etc. – the promise of a quick fix or silver bullet or the rapid development of a vaccine.

However, we are yet to see the evidence that herd immunity will occur or that a vaccine will eventuate any time soon. If that’s the case, we may simply have to learn to live with COVID-19.

GETTING REAL FOR PEOPLE’S HEALTH

Thus, it is crucial we turn our minds to long-term plans and solutions.

What has been most remarkable is how quickly even the most conservative politicians have adopted socialist solutions in an attempt to control the crisis, including introducing a basic living wage, free childcare, stopping evictions, de facto nationalisation of the health system, income guarantees and protection of jobs, even free access to arts and culture! But we should not be fooled into thinking that they have dumped their neoliberal ideology like a cheap suit – far from it!

While these are meant to be temporary measures, it is the taxpayer that is paying for the government’s big spending. And instead of large corporations paying their fair share, it is the taxpayer who will be forced to pay it back, with a possible increase of twenty to twenty-five per cent increase to GST and/or a $20 copayment for Medicare.

The conservatives plan to get over this quickly (for the system to “snap back”), the question is: what if there is no quick fix, no vaccine, no herd immunity? And even if there were, do we really want to go back to a system of individualism, exploitation of the majority by a minority, rampant overconsumption, and exploitation of the limited resources of the planet? Isn’t nature telling us something here?

Obviously, the system wants to get back to business as soon as possible. This is especially so for big business (including the private health sector and private health insurance companies), where the current crisis represents an opportunity to reposition their businesses and strengthen their economic power in relation to their competitors.

The belief of the ruling elites that this will be only a brief dalliance with socialism is clearly exemplified by the decision noted above by the Health Minister to increase the bailout for private health insurance funds and the private hospital sector (which were going out of business before the pandemic).

WHEN REALITY STEPS IN …

For capitalism, the problem is that if the emergency goes on longer than three to six months, unless the monopolies and multinationals are forced to pay their back taxes, the state is quickly going to run out of money – resulting in the likelihood of the world economy falling off a cliff, causing depression and mass starvation.

We need a discussion about moving towards planned economies and equitable sharing of resources and wealth before it’s too late. We need to stay ahead of the curve. It’s time to stop the wasteful diversion of public monies into the private sector for private profit and the bloated military budget while ignoring the real needs of the people and their health.

NATIONALISE HEALTH RIGHT NOW

We need to nationalise health and essential services. We need to build a robust public economy based on people’s needs and not the vested interests of private finance and insurance companies whose sole aim is to maximise profits using public subsidies.

We need to build strong, collective, democratic structures. This includes strengthening unions and removing draconian anti-union legislation that is impeding workers’ ability to organise and defend not only their economic and industrial interests but also their social needs.

The terrible situation developing now in the US, the number one privatised society in the world, should sound a loud warning to all of the dangers of leaving our lives in the hands of the market. COVID-19 is placing serious questions of human survival in front of us, and we need to have this discussion. If not now then when?

THE PARADOX
The COVID-19 emergency is already being used as a reason to deny essential care for older or sicker general hospital patients – they’re rationing our healthcare system. All the while the failed private sector is receiving a miracle cash lifeline, rolling in taxpayer money. Why should the public system we all depend on struggle?

HYPOCRISY
We are in an economic crisis, the private hospitals are empty and NOT providing services. Yet, they continue to receive massive taxpayer handouts, and the private health insurance funds continue to charge a society without the certainty of jobs or income premiums. Private health premiums for a dodgy product which never provided the insurance in the first place? How can anyone believe Scott Morrison’s claims that “we are all in this together”?

Next article – This week …

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