When you can’t breathe, how do you live? When you have to stay home, how do you get food? When your whole society is in dire straits, how do you (plural) react? This is the three-part dilemma now exposed for all to see (the “di” part of “dilemma” meaning cut apart and not just “two”.)
The breathing question relates to the health issues exposed so cruelly by the coronavirus epidemic. The health issues can be dissected into two halves. First, there has been so little investment in public health: in prevention, in the study of infectious disease, in how to test, trace, develop mitigating medicines, and vaccines, for example, in the face of more viruses skipping species, like indeed the coronaviruses. Second, there has also been a cruel lack of investment in universal, curative and mitigating medicine, compared to the money sloshing around in the commerce, the waste and the over-prescription, that underpin the big pharmaceutical industries that now control most research in the West. It is not a question that can be resolved by any one individual – although it is each of us that breathes to stay alive.
Food and Housing
Where do you get food if you have to stay home? And, for that matter, where do you stay if you haven’t got a home or live in doorways or six per room or on an aircraft carrier?
Suddenly, everything is exposed. In Mauritius, the Government exposed the poverty when it had to deliver food parcels. When a man, who was SDF, died of Covid-19 the same day as a millionaire. Religious organizations popped up, too, exposing inequality – the givers and the receivers. Perhaps more hideous is in the richest of societies, like the USA, seeing how the essential service workers like supermarket workers, care home workers, lower echelons of hospital staff, rubbish collectors, delivery workers are more exposed to the virus, while at the same time, it is exposed that they are amongst those in the lowest paid work, in insecure jobs, jobs without health insurance in a society where you have to pay for a doctor, for hospital care and for all medicines, and they literally die more. It was only the Covid-19 epidemic that made me see that health care workers in the US, from doctors to domestic workers, from nurses to trolley-handlers, work at “two or three health facilities” – to put it in US jargon that masks the inequality. The people with less income, and less secure income, who do the essential services, also live in the more crowded housing, where social distancing is not an option. They live near toxic waste, where pollution has weakened the lungs of even the strongest. So, they die more from the virus. And we now learn that millions of Americans have to queue up for charity organizations to give them food parcels, even from before the epidemic, and more millions after the lockdown. We find out that over two million Americans, or 22% of the world’s total, are in jail when the US is 4% of the world’s population. People in jails are more exposed to the virus by being squashed together in profit-making institutions, as many per square yard as possible. We find out that on-line schooling is not an option in many areas of the US – the children, like so many children in Mauritius, have no access to computers, or if they do, they don’t have Wi-Fi. All this was kept under wraps, until the virus, small as each virus is, tore away the wraps. The low-paid, insecure jobs are suddenly the most important and everyone agrees. The lack of housing becomes “our” problem because the homeless will give “us” the illness. They become people. The insecure jobs are done by people who become dangerous – because people cannot stay away from work when they are sick because they might not get paid and thus might not get food. Thus they might give “us” the illness. The 22 million people now drawing unemployment benefit in the USA since the lockdown there have now gone and joined the other 28 million without any proper health insurance cover. And we find out this appalling truth only when they are out of a job? The toxic waste, the food parcels, the full jails, and the lack of computers get exposed – by the virus, on the one hand, and by the food fairies who, in the absence of any proper service as of right, help with parcels, on the other. The lack of computers was exposed yesterday when basketball star, Russell Westbrook donated 650 computers for Texan children without. A computer fairy.
The epidemic tears away the lies that only come out, in other times, as tumbrils.
When people say, “the USA has the greatest health service in the world” – a phrase I have been subjected to in the US media literally hundreds of times, and by individual Americans another hundred times, it is one of those figures of speech called a “tumbril”, in particular a class tumbril. And the coronavirus has really exposed the tumbrils of the elite, like this one. But this one is worse than an ordinary tumbril. I’ll explain later.
Tumbrils, for those not in the know, were originally carts that opened at the back end in order to dump garbage or human waste. Metaphorically speaking, they are defined beautifully in a witty Christopher Hitchens essay about them, as the remarks that reveal the “essence” of the “subconscious mentality of the uncontrollably well-off”. Tumbrils suddenly expose, as if in uncontrollable expulsion of waste, “the polite upper-class incredulity at the sheer inconvenience of having to put up with other people”. Like the late Princess Margaret’s tumbril (I learnt it from an LSE Professor who heard it in person). In the 1960s, she said that she likes going to Jamaica because, “There’s absolutely nobody there.” As the film The Bank Job showed 40 years later in 2008, once the D-notices calmed down, there were people there. The coronavirus epidemic has shown that it is a “tumbril” to say “the USA has the greatest health service in the world”. This implies that the 28 million American adults who, before the epidemic, had no health insurance at all did not deserve to be seen or heard, or to have the cheek to exist at all. So, the statement “the USA has the greatest health service in the world” is a tumbril. Now, with another 22 million people sacked – when most health insurance is tied to your job – the tumbril becomes embarrassing to the speaker.
But why this statement is worse than an ordinary tumbril is that, firstly, it exposes a lack of understanding of what health care is. Private health insurance is not about health care at all but about the care or non-care of the sick. It is not at all about preventing epidemics, for example. It is not about avoiding illness at all. This would not make money. Secondly, it exposes exactly this: Private health insurance and private medicine is there to make money. That is its aim. So, it ends up being responsible for doing the worst of all medical crimes: it does not avoid doing harm. The maxim from the Hippocratic Oath of Do no Harm is ignored. Thus there is the chronic over-prescription, for example, that became so visible during the opioid crisis, as the tip of the over-prescribing iceberg. There is over-testing (just for the money made by the provider), and over-surgery, as we have seen in operations like unnecessary hysterectomies (just for the money made). So, private medicine starts by doing harm. Then moves on.
And it is thus that the epidemic causes us to pause. And to criticize Pravind Jugnauth’s proposal to force all civil servants into private insurance and private health care. This means taking tax-payers money and handing it over (by the million) to private insurance bosses, who hand over a part, in turn, to private money-making health bosses. And a big share ends up, as always, in the deep pockets of the big pharmaceutical multinational mafia. All this weakens the entire free, universal health care system, instead of strengthening it. Which is why LALIT calls on all unions and federations to continue opposing this iniquitous plan. Pravind Jugnauth’s plan is, indeed, a tumbril. It shows how people using the universal, free health system are being made invisible. If the free, universal health care system is not good enough for people who work in it, what does this mean? Except that those who use the system are invisible. So, the epidemic has come and put us in such dire straits, as a society, that it obliges us all to think for us all.
In times of the epidemic, what is invisible changes. Here, as I sign off, is a story-poem about fairies by a friend:
Lindsey Collen, for LALIT
A personal view.
Covid Conte de fée
Lazurne finn ale
20 avril 2020
Conte de fée ape kondire
Living Rake finn perdi laparol...
Lizye muye muye – napa pe truv kler
Pak wadire Lanwel “in the interstices”:
Laport lantre finn vinn arbdenwel.
Lazurne finn ale aswar finn arive
Living Rake pa pe retruv laparol.
Ziska yer kumadir “food restrictions”
azordi – apre trant-e-enn zur –
Conte de fée ape kondire.
Living Rake konfine pa pe fini ramase:
Ziska marmalad mezon finn arive.
Lizye muye muye - napa pe truv kler
Living Rake pankor retruv laparol...
Covid invizib finn fer mazik
Ala li kopye Bonom Nwel invizib:
conte de fée ape kondire,
leker Living Rake ape bat so mantra:
mersi mersi mersi mersi... conte de fée!