Many thanks to Lauren Weber for sending this major report by Kaiser Health News and The Associated Press: Hollowed out public health system faces more cuts amid virus. Here's an excerpt and then a comment, but you should just click through and read the whole long, grim story. Don't let it depress you, but do let it enrage you.
The U.S. public health system has been starved for decades and lacks the resources to confront the worst health crisis in a century.
Marshaled against a virus that has sickened at least 2.6 million in the U.S., killed more than 126,000 people and cost tens of millions of jobs and $3 trillion in federal rescue money, state and local government health workers on the ground are sometimes paid so little, they qualify for public aid.
They track the coronavirus on paper records shared via fax. Working seven-day weeks for months on end, they fear pay freezes, public backlash and even losing their jobs.
Since 2010, spending for state public health departments has dropped by 16% per capita and spending for local health departments has fallen by 18%, according to a KHN and Associated Press analysis of government spending on public health. At least 38,000 state and local public health jobs have disappeared since the 2008 recession, leaving a skeletal workforce for what was once viewed as one of the world’s top public health systems.
An Associated Press-KHN investigation has found a skeletal workforce facing more possible county budget cuts. KHN, also known as Kaiser Health News, and AP interviewed more than 150 public health workers, policymakers and experts, analyzed spending records from hundreds of state and local health departments, and surveyed statehouses. On every level, the investigation found, the system is underfunded and under threat, unable to protect the nation’s health.
Robert Redfield, the director of the Centers for Disease Control and Prevention, said in an interview in April that his “biggest regret” was “that our nation failed over decades to effectively invest in public health.”
So when this outbreak arrived — and when, according to public health experts, the federal government bungled its response — hollowed-out state and local health departments were ill-equipped to step into the breach.
Over time, their work had received so little support that they found themselves without direction, disrespected, ignored, even vilified. The desperate struggle against COVID-19 became increasingly politicized and grew more difficult.
States, cities and counties in dire straits have begun laying off and furloughing their limited staff, and even more devastation looms, as states reopen and cases surge. Historically, even when money pours in following crises such as Zika and H1N1, it disappears after the emergency subsides. Officials fear the same thing is happening now.
“We don’t say to the fire department, ‘Oh, I’m sorry. There were no fires last year, so we’re going to take 30% of your budget away.’ That would be crazy, right?” said Dr. Gianfranco Pezzino, the health officer in Shawnee County, Kansas. “But we do that with public health, day in and day out.”
This is not just a Republican failure; the Democrats are equally to blame. Both parties, since about 1980, have presided over an enormous project of social engineering: the transfer of wealth from working people and the middle class to the 0.1%.
"Government is the problem" was Reagan's mantra, and as people began to notice that their incomes couldn't quite cover all their bills any more, they were taught to blame government spending for their suddenly heavy taxes. (Never mind that Americans were already among the most lightly taxed citizens of any industrialized country.)
So tax cut after tax cut came from Republican and Democratic administrations alike, on all levels of government. Somehow the taxes were always too burdensome, the government spending too wasteful. Universal health care was for those overtaxed "socialist" Europeans and Canadians, and a little grudging support for public health came only to provide symptomatic relief—to provide a Band-Aid, not to prevent the cut in the first place.
"We're all in this together" rings hollow in a country that's been taught for 40 years that everyone is personally responsible for his or her success or failure, health or sickness. And now that the consequences of 40 years of wealth transfer are manifest, 126,000 rugged American individualists are dead, 2.6 million have been sickened (so far), and everyone but the 0.1% have been further impoverished. (The 0.1% have been doing just fine, thanks.)
It will take more than yet another transfer of power from Republicans to Democrats to roll back COVID-19. It will take a rollback of 40 years of systemic theft from the 99%.
