Capitalism and health-care.

In Corona Virus Pandemic – 1, it was briefly pointed out how global supply chains on the ‘just in time’ basis both extended the range of potential epidemics and accelerated the speed of their spread across the globe. One countries epidemic more frequently and more quickly becomes a Pandemic. However, the neo-liberal phase of the capitalist mode of production has also undermined the ability of communities to isolate an epidemic, to contain it’s spread and to slow it’s increase down.

The emphasis on profitable returns on capital and capitalist forms of efficiency has led to decades of low wages, precarious employment and cut – backs in public services. Thus measures suggested to contain or slow down the spread, cannot be fulfilled by sufficient numbers to make it effective. Self – isolation at an early stage – in order not to become infected and not to infect others – is only possible for those with sufficient income for them to stay home. Large numbers of low-paid workers, without sick pay entitlement and self-employed will not be able (or willing) to deprive themselves or their families of the income they need.

Workers over many decades have gone into work suffering from a wide range of injuries and illnesses, to keep food in their mouths and roofs over their heads. The mixed response to this new outbreak of contagion will be no different. Bear in mind the health service, which will be charged with caring for those most effected, also has large numbers of vacancies, shortages of beds along with a low-paid, over stretched workforce – all of whom – will face the same dilemma. If the pandemic does go on the most extreme rampage, the increasing numbers of infected people, shortages of doctors, staff and beds in hospitals and care homes, will be a neo-liberal created problem of huge proportions.

Although the old, the young and the sick may be the ones most vulnerable to death from a virus which overwhelms an already compromised immune system and those most vulnerable to it, that will not be the end of the serious global problems, triggered by Covid19. For there are those countries around the world which have little or no health services or sewage and clean water, yet still supply more advanced countries with raw materials or goods in numerous exchanges. The poor and low-paid in these countries will probably suffer more problems than more developed regions and the contagion will last much longer there before possibly finding it’s way back – just in time – for xmas.

So the neo-liberal phase of capitalism’s self-harming existential spasms will continue in one form or another. At the economic level, any serious pandemic of global proportions will of course trigger a cascade of economic collapses as supply chains become restricted or curtailed. That in turn will trigger shortages and financial collapses as loan payments funded by sales become defaulted and debts cannot be rolled over as credit dries up. Furthermore, the already crisis levels of national debts will increase as government tax receipts and income streams fall. Those effects in turn will create more unemployment, more poverty, more homelessness and another downward spiral of deprivation, dislocation and social protest.

In Europe and the UK the Covid-19 epidemic has also already revealed the chasm between private profit-based motivations and public service provisions. In this crisis, as in the 2008 finance crisis, no one turns to the private sector for general guidance on how to respond to a medical, economic, financial and social crisis. Everyone understands that governments and non-profit public services – as bad as some now are – are the only framework for national and international strategies to manage and combat epidemics.

For example, non-profit public organisations would never think of taking advantage of the present crisis by hiking up the prices of essential goods and medical supplies. However, the private sector has already done this with face masks, hand washing gels and many other things. When essential food supplies start to dry up, other sections of the private sector will undoubtedly view this current epidemic as an opportunity to manage their own type of profit-based killing.

But that’s not all. Government agents and health officials will also be calculating how best to manage the stages of infection, the progress of immunity and the number of deaths resulting from it. The calculation will be based around the need to ensure that national immunity gained (through survival) will leave intact the largest possible number of productive, tax – paying adults and children – the future tax-paying generation.

Thus from the neo-liberal capitalist perspective, the epidemic/pandemic must be allowed to spread but not at too great a pace to disrupt the economy and not in too great numbers to overwhelm the poorly funded, under – resourced health services. Hence, a policy of self-isolation for the majority and the under-resourced health services, as far as possible, being reserved for the old, the sick and the vulnerable. If, or rather sadly, when these latter categories become too great for the health service in countries with large ageing populations, the strategy of triage will be adopted. The badly infected will be formally or informally separated into the following categories:

Patients who are likely to survive, no matter what level of care they get;
Patients who with immediate care will probably survive.
Patients who are judged unlikely to survive no matter how much care they get.

When health resources are insufficient for expensive intensive care for all, as they invariably are in neo-liberal capitalist economies, then the judgement will be made to utilise them on the first two categories and not ‘waste‘ (sic) them on the third. Many ‘loved ones‘ will be ‘lost before their time’ as UK’s Boris Johnson intoned. That is the inherent logic of any socio-economic system not based on the humanist rights of all. Capitalism creates rich and poor and resources for the poor are always in short supply. Yet again many will die before they should.

Roy Ratcliffe (March 2020)

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