A look at some of the systemic failures of the U.S. that demonstrated our ineptitude in the face of a pandemic.
I was reading an article about why pets act so weird while we are all in lockdown, and I noticed a little side-note widely overlooked: during the Spanish Flu of 1918, people were putting masks on their pets to protect them (and themselves, perhaps). How sobering of a contrast is that with today, where we have such a shitty system that front line healthcare workers are frequently unable to get the protective gear they need, much less the public, who was actually deterred by the CDC recommending no one needs masks despite the fact this is a respiratory virus? The CDC would go on to reverse and encourage the use of masks (costing much needed credibility in the process), and so it seems their motivation was not so much scientific advice about the efficacy of masks as much as an effort to prevent a run on masks by the public and create a bigger supply problem. Yet less masks for the public means more infections. Think about that for a moment. The public was lied to, willfully put in danger because our precious supply of masks and other PPE was so utterly neglected.
It’s worth asking how American society 100 years ago at the height of a pandemic worse than this, was swimming with so many masks that pets were getting them without controversy, while today they are objects of battles between every stakeholder desperate to get some supplies just to maintain a few more days’ worth just for those who need it most.
Back in 1918, some places went so far as to mandate the wearing of masks on penalty of a fine, with California’s governor arguing it was the “patriotic duty of every American” to wear a mask. What a far cry from today’s messaging, where the patriots are the ones leaving the masks for the front lines. Instead we are using cloths to cover our faces at the same time nurses protest wearing them as outrageously ineffective. Does it really protect front line workers — much less the people and the country that’s been shutdown — if you’re letting the infection spread through the public?
So the question is, why would our healthcare system place such a low priority on stocking masks, when we can and have done a far better job with it even 100 years ago? Well, for one, our government has long ignored the issue. We have long known in pandemic simulations that shortages of PPE and critical supply chains are a major vulnerability, but the government has simply ignored this.
Another factor in our failure is the intra-fighting between governments, organizations and regions. I’m not even talking about internationally, I’m talking about states, cities, and organizations having to conceal movements and orders to avoid hostile takeovers by the federal government, who proceeds to store it in some government warehouse with no known plan for distribution.
This is horrifyingly revealing for two reasons. First, it shows there is no grand plan for this, everyone is doing their own thing, which shows an abject failure of national leadership. Second, this makes our dollars less effective and costs more expensive, meaning we get less bang for our buck, which translates to lives at some point. If a city or hospital sets aside a million dollars for masks, and they are outbid by the state government two-fold, who is then out-bid by the federal government 5-fold, well we not only wasted 5x the money, but we also wasted all that time too. Moreover, even when a hospital finally manages to order the supplies, they are likely to be intercepted by the feds, meaning we are seizing needed supplies in order to distribute them to where they are needed. That is also called a bureaucratic cluster-f**k.
The next factor though may be decisive on its own terms. As private equity firms have bought numerous hospitals and healthcare operators, they have had to return to them with profits in hand, make the necessary cuts, or else shut down. Emergency stockpiling isn’t profitable, needless to say. Indeed, stockpiling for the public’s benefit is what has been legally scorned explicitly. A legal case decided in 1919 established and demonstrates this principle well in Dodge v. Ford Motor Co., and goes some way to explain the differences between now and then, as well as the absurdity of the current laws.
Ford was being sued by Dodge for its unholy desire to shift stock dividends and instead reinvest in the company in order to lower the price of cars more. Predictably, Dodge didn’t want to have to compete against lower priced cars, and sued to stop this, arguing this goal of Ford’s to be “semi-humanitarian” and illegal, as semi-humanitarian acts aren’t in Ford’s charter. The Michigan Supreme Court held that “a business corporation is organized and carried on primarily for the profit of the stockholders…it is not within the lawful powers of a board of directors to shape and conduct the affairs of a corporation for the merely incidental benefit of shareholders and for the primary purpose of benefiting others.” Translation of that legalese: it is goddamned illegal for a corporation to make decisions with the primary aim of benefiting others rather than primarily benefiting shareholders. The Court promptly forced Ford to release those dividend yields and scrap the plans even to reinvest in itself.
The implication was that profit supremacy can not only defeat any attempt by a corporation to primarily help others (they are legally required to have ulterior motives…explains a lot about their PR designs and community sponsorships doesn’t it?) but it can defeat even attempts to reinvest in the company itself if those goals are merely “semi-humanitarian”. So it is that a hospital doesn’t stockpile needed goods for emergencies, because that’s something for the public good and not for shareholders. Think of it this way: is it profitable for you to pack an earthquake emergency kit? No, that’s not the point, it’s for the good of you and your family. Yet a for-profit hospital can’t do the same unless perhaps it would harm their reputation and thus harm shareholders.
This changes the entire focus of corporate law from helping the public’s problems and changes it to helping the shareholder’s problems. While shareholders are people too, the public’s and shareholder’s goals are very different. The emphasis on serving the shareholder’s problems also goes a long a way to explain why wealth inequality has increased so dramatically. It explains one of many ways our entire system caters to the rich and powerful, not the public and what’s best for them. This is why that absurd argument is frequently trotted out to counter universal healthcare aspirations: people fly in from all over the world just to use our healthcare system because it’s so great! I’d love to hear that argument now. Even if granted though, they fly in because they have money! Yeah it’s a system that’ll be great if you can throw a million dollars at it, as systems are often inclined to perform. But if you’re not a multi-millionaire who can burn cash then you get to encounter a whole other system, the insurance system. Find me one person who loves the insurance system and I’ll find you one who has never had to deal with insurance.
Now, before, there were some small and medium sized companies who weren’t publicly traded, who perhaps weren’t so beholden to shareholders. In the 100 years since then, however, there has been massive consolidation of power to large corporations. This speaks to a related problem: if a few of those corporations get infected with the virus, an entire industry virtually is decimated overnight. This is exactly the issue that has caused certain shortages of food and supplies despite excesses of those supplies being produced. For example, while there are shortages of bread and milk in stores, it’s simultaneously the case that there is so much of it it’s being dumped and scrapped by farmers who can’t sell it. If there is demand, why can’t they sell?
The answer lies mainly in the fact the U.S. only has a few behemoth food processors, each having nearly attained a monopoly in its own sub-sector, such as Tyson with chicken. They are the middlemen counted on to take their products and get it to store shelves. Yet these processors are highly reliant on minimum wage and immigrant labor, with extremely close quarters rapidly spreading any outbreaks that are already likely to occur on a normal day in a place that processes thousands of dead animals and foods. Clearly, it is not worth it to most the population to take these jobs on any given day, and that appears to be 100 fold truer to everyone in the midst of a pandemic. Thus, the plants are forced offline or degrade their capacity (because of course these plants refuse to pay any livable wage, lest they cross their shareholder directive to pay shit and maximize profit) and there are no small or medium sized processors to pick up the slack. Thus farmers are producing still — animals are still being born every day to full barns and crops still grow — but no one can buy from them because no one can process much. The result is gross waste in the form of dumping all manner of foods while there is simultaneously a shortage for consumers. We aren’t talking about a charity system and saving wasted food for poor nations, we’re talking about our primary food supply chain that has systemically broken down despite there being plenty of supply and demand.
It is clear then, that this extreme emphasis of the profit motive above all else — “shareholder value” as the Court puts it — has created a massive problem, and forced corporations to be even more ruthless than even they may want to be. Profit is of course not the enemy, but profit over people is simply inhuman. It is the legal equivalent of arguing “people would rather die for the economy” that Texas’ Lt. Governor so eloquently stated. It puts a very low price on human life, and really goes a long way to explain our entire system. It manifests itself in numerous ways, such as the EPA allowing self-regulation by polluters during the pandemic despite evidence that pollution not only kills and worsens health on its own but actually can transport the virus itself and make this all worse. Profit is paramount, even at the cost of lives. Incidentally, that aptly describes much of President Trump’s operating style. Why else personally allow another manifestation of this, which the Supreme Court thankfully shot down this week, allowing toxic coal ash to make its way to our oceans, rivers and wells? Does anyone but the coal companies want that? It’s simply about making money at the cost of human life, and that is the kind of logic that has brought us here.
It is the history that brought us here though, Trump has simply added fuel to the fire. It is our incessant focus on profit over people, enshrined even in our healthcare system and laws, that has brought much of these fundamental issues to bear. Low wages cause breakdowns in the labor system when a pandemic hits, and companies are left trying to convince their workers they’re heroes for risking lives to make minimum wage rather than put their money where their mouth is and pay a hero’s wage — or even a human’s wage. Massive corporations and corporate consolidation has made the spread of a pandemic more rapid, likely, and paralyzing, without anyone left to pick up the slack. Outlawing the prioritization of humanitarian and community concerns to the extent necessary to keep shareholders happy with maximized profit has led every industry to neglect people and focus on profits, and this is why you see things like the U.S. spending more on healthcare than any country yet having some of the worst outcomes in healthcare among any industrialized nation. The U.S. has systemically failed in more ways than I care to count here, and these are self-inflicted wounds, highlighted by— not created by — the pandemic. We can address them, but we must be willing to challenge fundamental assumptions about our system if we are ever to fix systemic problems. I hope we do. Here’s a start.