Featuring Dr. Tony Iton, Senior Vice President for Healthy Communities at The California Endowment: Find out how the erosion of America’s public health system undermined our response to the deadly coronavirus pandemic. In this first of a podcast series, Dr. Iton explains how having a patchwork health insurance system, along with a weakened public health system, has left America even more vulnerable during the crisis. Host Brenda Gazzar asks “Would Medicare for All help?” The answer may surprise you.
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—– TRANSCRIPT —–
(Opening MUSIC – “Talk Back” 5 seconds, fade down)
Welcome to Code WACK!, your podcast on America’s broken healthcare system and how Medicare for All could help. I’m your host Brenda Gazzar. Today we’ll hear from a public health expert about how the coronavirus pandemic is affecting our healthcare systems and how we got here.
We have Dr. Tony Iton here with us. He’s the senior vice president for Healthy Communities at the California Endowment, a statewide health foundation and he previously served for seven years as director of Alameda County’s Public Health Department and was a county public health officer. This is the first episode in a series with Dr. Iton about the deadly coronavirus.
— FEATURE —
Welcome to Code WACK!, Dr. Iton.
Iton: Thank you.
We’re in the midst of the coronavirus pandemic, how would you characterize the coronavirus pandemic and its impact on Americans so far?
Iton: Well, this has been an unprecedented series of events — unprecedented unless you’re willing to go back 100 years and talk about the worldwide pandemic in 1918 and in the years around World War I. Unprecedented but not completely unpredicted … but the dramatic impact has been astounding. In fact, there has been an existential impact on virtually every country in the world. I don’t even know if we have the words to characterize the scale of this impact but it has been something that is enormous.
We’re hearing a lot about “public health” and the “healthcare system” these days. How do these two systems relate to each other and how effective are they at managing the pandemic?
Iton: You know we have a public health system which is really designed to sort of prevent, protect, defend and avoid the healthcare system (from) becoming overwhelmed but because our public health system has really kind of been eroded so dramatically, the healthcare system is incapable of, you know, defending itself. So the impact on the healthcare system depending on where you are in the country has been anywhere from catastrophic to very, very worrying.
The public health system has been eroded because the public health system depends on government funding…And all of the work that has been done for pandemic influenza preparedness like H1N, a little over a decade ago, when there was that epidemic… there were preparations made around having an extra supply of ventilators, an extra supply of PPE or personal protective equipment — particularly the N95 masks and the gowns and the face shields, all of that was in stockpiles both in California and in the federal government. Now you know one of the assumptions of those stockpiles is that you would have different parts of the country facing need at different times — not that you would have simultaneous demand from every part of the country and everywhere in the world so one of the assumptions underlying the stockpiling was flawed and as a result, the stockpiles ended up being less effective to address this particular type of epidemic because of the timeline. However, what you saw over that decade as well was that the maintenance as the stockpiles just fell apart and many of the supplies there are either expired or lacking maintenance and therefore can’t be put into active deployment immediately. They have to be refurbished. I mean really embarrassing failures of that stockpile which to my mind is clearly testament to the erosion of support for core public health functions over the past decade.
Now, when you have an erosion of public health — that’s your first line of defense in a pandemic or an epidemic — the healthcare system becomes your fallback position, and the healthcare system has moved even in the past decade from, you know, essentially independent hospitals and hospital systems that maintain their own supplies to much more consolidated systems that are operating on very thin margins and this “ just in time” supply type of mindset more like General Motors rather than a hospital that’s preparing for surges and various different levels of demand for health care.
Interesting. So would Medicare for All help to protect Americans in this crisis?
Iton: Yes, absolutely, I mean, America, we create our own problems. It’s like we get in our own way when it comes to these kinds of things. Having a patchwork health insurance system where people are afraid that they’re going to face catastrophic health care bills and which keeps them from going to the emergency room when they have a cold or a fever makes things worse for everybody so universal health care would be one of the first things that we should be addressing immediately in the wake of coronavirus it’s just stupid to have a system where people can’t actually access health care which just slows down the whole process and creates more infection in the community. It’s absurd.
The second thing that we absolutely have to address is paid sick leave for everybody. You know folks that can’t take a day off of work because they’re sick will go to work sick and they’ll spread infection at work and particularly with the coronavirus where you have a situation where people can spread it so efficiently in an asymptomatic state before they become symptomatic. Some people don’t ever become symptomatic. You know these issues are absolutely critical to slowing the spread of a virus allowing people to take time off when they get symptomatic, allowing people to have an affordable way to seek health care when they get ill. Those are just so basic and every other developed country in the world has these things in place except for the United States.
Thank you so much, Dr. Iton!
Iton: Thank you.
Find more Code WACK! episodes on ProgressiveVoices.com and on the PV app.You can also listen to our episodes at HEAL dash C-A dot org. This project is powered by HEAL California, which uplifts the voices of those fighting for healthcare reform around the country. And I’m Brenda Gazzar.
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