America Is All Too Happy to Let People Die

Last week, we were told the President of the United States has COVID-19, but it wasn’t a big deal, as White House press secretary Karine Jean-Pierre told the media: “We knew this was going to happen. At some point, everyone is going to get COVID.”

Leana Wen, the former health commissioner of Baltimore, chimed in in the Washington Post endorsing Jean-Pierre’s fatalism, adding: “Another key lesson is that it’s inevitable that everyone—even the president of the United States—will be exposed to the coronavirus[…]COVID-19 is a manageable disease for almost everyone, so long as they use the tools available to them.”

Manageable. Except that we are experiencing around 400 deaths per day. This makes us the world’s leader in COVID-19 related mortality. We also have very few competitors among countries of our size and wealth, if you look at the per capita figures or extra deaths per capita. In addition, we’ve had about 40,000 people hospitalized, about 4600 in intensive care over the past week or so.

And this is on top of what Boston University’s Jacob Bor calls our “missing Americans,” those we have lost to early death compared to other rich nations. Bor’s team estimates that 626,353 lives could have been saved if the U.S. mortality rate had been comparable to other rich nations in 2019, before COVID-19. In 2021, there were 1,092,293 “Missing Americans” in the midst of the pandemic.

So much winning.

You have to wonder why. When did it become aspirational as a nation, to reach for the top slot in COVID-19 mortality, to ignore the fact that we are losing hundreds of thousands of Americans yearly to early death even before the pandemic and that our life expectancy ranks in the 30s or 40s compared to other nations, and we’re expected to drop down into the 60s by 2040.

In fact, the manic insistence that we “get back to normal” from the White House on down, that we have the tools to manage the pandemic, that public health is now a matter of “you-do-you” in terms of mitigation efforts (wear a mask if you want to, but don’t if you don’t!) Part of the problem.

You see we have a wonderful healthcare system in the U.S., the best money can buy, and we spend more on it than any other nation as well, even as our life expectancy as just described should make us think hard about the return on investment we’re getting. What we don’t have are two key ingredients needed to raise us up to a healthier state of affairs.

First, we simply don’t have what we need to keep us healthy—a robust set of social protections like our peer nations, which strongly determine our risk for getting ill and getting better in the first place. You may think it’s the biomedical innovations of the past century that save the most lives, often it’s much simpler than that: having a roof over your head, food to eat, a good job. It’s no coincidence that those who are better off do better in terms of health as they purchase what we call the social determinants of health at a premium.

A second fact is that for every dollar we spend on health care, only a small fraction goes to public health. There are estimates of 1.5-2 cents per dollar for public health. People have complained about the COVID-19 response for the last two years. However, with this information in mind, we might be able to agree that these expectations have been similar to asking an old car to run like a Ferrari right out of the showroom. America’s health is difficult to maintain because of a weak public healthcare system that has been under-funded and over-staffed.

The current U.S. response to COVID-19 tells me that it is unlikely things will get any better. While the White House and its surrogates trumpet “we have the tools” to combat the pandemic, they ignore the fact that in the U.S., access to these tools is not guaranteed and once again your personal resources determine your fate. The most vociferous of these commentators, like the New York Times’ David Leonhardt, even castigate those trying to keep themselves and those they love safe as barriers to getting back to normal. While President Trump and well-known Americans have the most access to all they need, many Americans still live in poverty. This policy is based on privilege. Their only problem right now is the slow return to normal.

There will be more deaths, hospitalizations, and new infections for the remainder of 2022. While some are riding out these infected because they have everything they need, others are struggling to keep their families together. Many also suffer from COVID which many policymakers try to ignore. Jacob Bor brings to the forefront the ghosts and missing Americans. Their memories are our shame.

We don’t have any interest in fighting this pandemic anymore, and we do not really want to be competitive in American saving lives. We’re happy to be content with the death. It’s the American way of life.

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