2021-04-07 15:53

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COVID-19 series:  Rebuilding America After The Insurrection 

Derek Maylor, NW BT Unions H&S Co-ord member and Health & Safety Officer (Telecom section) of the CWU's Grter Mersey Amal Branch; reports on a Royal Society Of Medicine webinar, which provides an insight into the state of the US system of Healthcare, which many feel is where our NHS is heading:

Pic:Don Berwick, President Emeritus at the Institute for Healthcare Improvement, former Administrator of the Centers for Medicare and Medicaid Services under President Obama discussed the handling of the pandemic by the Trump administration, the current state of the nation, and how President Biden plans to get the virus under control in a session chaired by RSM President Professor Roger Kirby.

Dr Berwick also offered insight into the wider healthcare reforms expected from the Biden administration, and whether he can heal the inequalities further exposed by the coronavirus pandemic.

Political differences has politicalised the science of the pandemic, there is almost a line between pandemic deniers and political leaning. The senate is 50/50 and it may be difficult to get issues through although the Vice-President has the casting vote, Biden may therefore need to use Executive Action to move things at a pace. Regarding mobilisation against the pandemic, 40% of US population say they will not get vaccinated, this has been compared with that of rearmament for WW2, in 1940 the USA had very few tanks or planes, within two years they were producing a plane every four minutes. 

There are still 30% of people in the US who do not have any medical insurance and this need addressing. There is a ratio of two or three to one people of colour compared to white people being adversely affected by the pandemic and there are many reasons for this but not one is skin colour. There’s the poverty and poor housing, low wages and poor quality work, unsafe or insecure work (you can’t complain when may be sacked), low life goals expectancy and so on. It is not the colour of the skin but where and how people are living that is the cause of the marked differences and this inequality has to be addressed. There will be outreach and new approaches to vaccinating racial and ethnic minorities, in the longer term, leading to an approach to reducing inequities in routine healthcare, mainly it about non-insurance and cost that is the primary source of inequity.

There are several states where 70% of the electorate voted for Trump and US federalism will put the onus on mass vaccination to be done state by state but the supply chain is national. This may cause a problem if the state legislators are anti-vax; no matter how much vaccine they are given if they do not positively push the vaccine it will not get done by many let alone the overwhelming majority it needs for community immunity to rid us of the virus.

Regarding climate change – the virus will go away eventually but the problems for the climate will remain and must be addressed, President Biden put it at the top of his agenda throughout his campaign to follow to the addressing of Covid. Wind power is very promising for development in the in the USA, plenty of sites marked, an employment opportunity and so on. John Kerry (international) and Gina McCarty (domestic) have been appointed already as climate leads and are both respected in their field, Congress will support climate initiatives. The fires around the world, the water insecurity, food insecurity and so on may lead to wars – despite the virus this may be worse and action is need today not tomorrow.

USA health organisations are leading the thinking on the health effects on climate change and this will be influential more than politicians who may be seen to have an agenda, Trump has ruined this leadership and it will take time to pull back. In Chicago you can travel across the city and you will lose 16 years in life expectancy, these inequalities must be addressed.

The early days in a child’s growth is crucial, as is their education, then fairness and adequate employment; community resilience as an adequacy of local travel, physical security, food security and so on – this is science not politics. Don’t just build the hospital, prevent the person needing to go to the hospital, address the causes or you will just need a bigger hospital.

Society has to start form the point of us all being equal and all deserve safety and security or else it will not happen. Bizarrely it is not just the wealthy who need to be brought back to believe in equality, a weird dynamic is that some of our poorest (in both USA & UK) people are told to believe that making someone else worse off will make them better off. It may put them higher up in the league table but it but this does not improve their living standard, they will have stood still and just watched someone else’s life deteriorate.

This is done by creating division, commonly race or religion but can be anything where there can be a smallest difference in peoples that can used to divide. Evidently, today already, a senior Republican politician has already responded to Biden re-joining the Paris Agreement by accusing him of partiality to the people of Paris and not the workers in Pittsburgh.

Notes by Derek Maylor 21 January 2001

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