America’s extreme neoliberal healthcare system is putting the country at risk

Single-payer healthcare can’t prevent a novel virus like Covid-19 but it could help us plan, coordinate and save lives * Coronavirus – latest updates * See all our coronavirus coverageAt the final debate of the Democratic presidential primary on Sunday, Senator Bernie Sanders and Joe Biden clashed on the coronavirus. Sanders contended the pandemic laid bare “the incredible weakness and dysfunctionality” of the US healthcare system, and called for single-payer reform. Biden countered that Italy’s universal system had failed to protect the Mediterranean nation, and asserted that Covid-19 “has nothing to do with Bernie’s Medicare for All”. At first glance, the ex-vice-president seems right: of course single-payer can’t close the door to a novel virus, any more than it can forestall a deadly earthquake or fend off a zombie apocalypse. Nonetheless, a national health program with unified financing and governance – basically the opposite of what we have in America today – is a powerful tool in a health crisis.The debate over Medicare for All in the age of Covid-19 is complicated by the fact that it is our public health agencies – and not the medical care system – that serve as our first line of defense against novel epidemics. In that regard, we’ve shot ourselves in the foot with a 12-gauge shotgun: year after year of underfunding of our federal, state and local public health agencies has left us ill-prepared for the Covid-19 challenge (as evidenced by the testing fiasco). How we finance medical care, however, is also critical. On the most basic level, containing the coronavirus will require those infected to seek medical care, so that they can be diagnosed and isolated. Fear of devastating ER or hospital bills, however, could keep some home – or at work. As a Taiwan government spokeswoman, lauding her country’s single-payer system for its successful containment of Covid-19, told NBC News, “Taiwan’s health insurance lets everyone not be afraid to go to the hospital. If you suspect you have coronavirus, you won’t have to worry that you can’t afford the hospital visit to get tested.”On Wednesday, Trump signed into law a bill that would make Covid-19 testing – but not treatment – free. It’s hence inadequate, given the predicted looming surge in hospitalizations from Covid-19 pneumonia. After all, 30 million Americans are uninsured – a number that will surely grow as the economy tanks and millions or tens of millions of Americans lose their jobs. Even more are underinsured, and for these individuals, co-pays and deductibles will only become more unaffordable as disposable income falls and savings dwindle. For both groups, medical bills for an intensive care unit (ICU) stay for Covid-19 could be devastating. People, of course, will also not stop having heart attacks, cancer or traffic accidents during this outbreak – on the contrary, medical needs are likely to rise in the face of a recession, as unemployment and misery takes its toll on the nation’s health. Financial ruin from medical costs – whether it stems from Covid-19 pneumonia or the looming Covid-19 recession – is financial ruin all the same, and will compound the harm of the epidemic.But there’s more to it than that. We need single-payer not only to protect us from healthcare costs, but to transform our healthcare infrastructure. In recent weeks, you may have heard that the US, despite our high healthcare spending, has fewer hospital beds per capita than many other wealthy nations. You may have also heard in recent years about an epidemic of hospital closures in poorly served rural areas, or the 2019 closure of a major academic safety-net hospital in Philadelphia. These hospitals closed not because they are unneeded, but because they are unprofitable. For the American hospital landscape is shaped by market forces, which largely determine where hospitals grow and where they wane.> Healthcare in America is uncoordinated – and ungovernedAt the same time, while our hospital bed supply is relatively low, our ICU bed supply per capita is among the highest in the world. Yet those beds aren’t necessarily where they need to be: a 2010 study in the Journal of American Medical Association, for instance, found large regional disparities in the distribution of ICU beds; the researchers concluded that in the face of a major epidemic, some areas might have empty beds, while others would have too few. Again, this distribution, far too often, is driven by market logic – not health needs.Finally, healthcare in America is uncoordinated – and ungoverned. Since the epidemic’s onset, hospital and city and state governments have waged “bidding wars” over crucial supplies and ventilators, the New York Times noted. It’s every hospital for itself: some are resorting to pleas to the community for donations of masks; presumably, others are well-stocked – but who knows? “Respirators, ventilators, all of the equipment – try getting it yourselves,” Trump suggested to state governors on Monday, quoted by the New York Times. This is not a healthcare system – it is atomized chaos. For again, in the American way of paying for healthcare, our hospitals (or increasingly, our multi-hospital systems) are silos, some rich and some poor, each fending for themselves, locked in market competition.This is neither necessary nor rational, leading both to excess and shortfalls, to generous overall health system funding yet care that remains unaffordable for many. A single-payer national health program would allow us to move past the market-driven status quo to remake this chaotic healthcare landscape of simultaneous healthcare plenty and poverty. It would, in short, allow us to begin to plan – not merely for this epidemic, but for the one that follows. * Adam Gaffney is an instructor in medicine at Harvard Medical School and a pulmonary and critical care doctor at the Cambridge Health Alliance. He is President of the advocacy organization Physicians for a National Health Program. He blogs at theprogressivephysician.org

Sen. Kelly Loeffler Dumped Millions in Stock After Coronavirus Briefing

The Senate’s newest member sold off seven figures’ worth of stock holdings in the days and weeks after a private, all-senators meeting on the novel coronavirus that subsequently hammered U.S. equities.Sen. Kelly Loeffler (R-GA) reported the first sale of stock jointly owned by her and her husband on Jan. 24, the very day that her committee, the Senate Health Committee, hosted a private, all-senators briefing from administration officials, including the CDC director and Anthony Fauci, the head of the National Institute of Allergy and Infectious Diseases, on the coronavirus. “Appreciate today’s briefing from the President’s top health officials on the novel coronavirus outbreak,” she tweeted about the briefing at the time.That first transaction was a sale of stock in the company Resideo Technologies valued at between $50,001 and $100,000. The company’s stock price has fallen by more than half since then, and the Dow Jones Industrial Average overall has shed approximately 10,000 points, dropping about a third of its value.It was the first of 29 stock transactions that Loeffler and her husband made through mid-February, all but two of which were sales. One of Loeffler’s two purchases was stock worth between $100,000 and $250,000 in Citrix, a technology company that offers teleworking software and which has seen a small bump in its stock price since Loeffler bought in as a result of coronavirus-induced market turmoil.Loeffler’s office did not respond to a request for comment from The Daily Beast on the transactions and whether they were prompted or informed by information shared at that late January briefing. It’s illegal for members of Congress to trade on non-public information gleaned through their official duties. Late Thursday night, she did offer a statement, tweeting: “This is a ridiculous and baseless attack. I do not make investment decisions for my portfolio. Investment decisions are made by multiple third-party advisors without my or my husband’s knowledge or involvement.“As confirmed in the periodic transaction report to Senate Ethics, I was informed of these purchases and sales on February 16, 2020—three weeks after they were made.”In the weeks after her spate of stock trades, Loeffler sought to downplay the public-health and financial threats posed by the coronavirus. “Democrats have dangerously and intentionally misled the American people on Coronavirus readiness,” she tweeted on Feb. 28. “Here’s the truth: @realDonaldTrump & his administration are doing a great job working to keep Americans healthy & safe.”“Concerned about coronavirus?” she tweeted on March 10. “Remember this: The consumer is strong, the economy is strong, & jobs are growing, which puts us in the best economic position to tackle COVID19 & keep Americans safe.”Loeffler is the second known senator to sell off large stock holdings between that Jan. 24 briefing and the dramatic drop in stock-market indices over the last week. The Center for Responsive Politics reported on Thursday that Sen. Richard Burr (R-NC), who chairs the Senate Intelligence Committee, sold between $500,000 and $1.5 million in stock in February, shortly before markets tanked—and before Burr privately warned of the havoc that coronavirus was poised to wreak.Burr lashed out at National Public Radio on Thursday over its report revealing those private comments in a series of tweets that did not mention his stock trades. Burr was one of just one of three senators who voted against legislation in 2012 banning so-called congressional insider trading.As it happens, Burr and Loeffler sat next to each other on the Senate floor during the chamber’s impeachment trial in January.Loeffler assumed office on Jan. 6 after having been appointed to the seat vacated by retiring Sen. Johnny Isakson. Between then and Jan. 23, she did not report a single stock transaction from accounts owned by her individually or by her and her husband jointly.Between Jan. 24 and Feb. 14, by contrast, Loeffler reported selling stock jointly owned with her husband worth between $1,275,000 and $3,100,000, according to transaction reports filed with Senate ethics officials. On Feb. 14, she also purchased the Citrix stock and another $100,000 to $250,000 in technology company Oracle, which has seen its share price decline by more than 18 percent since then.The 15 stocks that Loeffler reported selling have lost more than a third of their value, on average, since she reported offloading them. She initially reported many of the transactions as sales of stock owned by her husband. Last week she amended the filing to note that most of them were jointly owned.The full scope of Loeffler’s portfolio and its particular holdings is not yet known. Senators are required to regularly disclose that information, but in January she requested an extension from Senate ethics officials. A full accounting of her finances will not be public until May.When Loeffler assumed office, she immediately became the wealthiest member of Congress. The Atlanta businesswoman, whose husband is the chairman and CEO of the New York Stock Exchange, has a fortune estimated at $500 million.From the beginning of her tenure, she has faced scrutiny over potential conflicts of interest. Her position on a Senate subcommittee that oversees futures markets “gives Kelly Loeffler a direct position in overseeing her and her husband’s financial enterprises,” Craig Holman, lobbyist for the ethics group Public Citizen, told the Atlanta Journal Constitution in February. “I find it utterly irresponsible the Senate would choose to put Loeffler on that committee, given her conflicts of interest.” Unlike other senators, Loeffler’s finances are directly tied to her electoral fate. She has pledged to spend $20 million on her bid to hold on to her seat when she faces voters for the first time this November. For more exclusive stories, sharp analysis, and insider interviews, become a Beast Inside member here.Read more at The Daily Beast.Get our top stories in your inbox every day. Sign up now!Daily Beast Membership: Beast Inside goes deeper on the stories that matter to you. Learn more.

Iran in record virus deaths as calls mount for stricter curbs

Iran on Thursday announced 149 new deaths in 24 hours from the novel coronavirus — one every 10 minutes — as calls mounted for the government to take stricter measures against the disease. The latest toll was a daily record for Iran, where the overall toll of 1,284 dead makes it one of the countries worst hit by the pandemic. A total of 18,407 people have contracted the disease in Iran, with 1,046 new cases confirmed in the past 24 hours, he said.