Analysis: What does this pandemic mean for poor people in Vermont?

There are 140 million poor people in the US

The COVID-19 pandemic has created an unprecedented public emergency.

Thousands of people in Vermont require immediate attention to meet the basic needs of our families. Many of us have lost our jobs and are scrambling for an income. Schools and childcare centers are closed, throwing daily rhythm into crisis. And those of us still required to go to work as essential workers are on the front lines of this crisis, every day putting ourselves and our families in harm's way.

In understanding how this crisis came about and what we can do about it, we need to start by acknowledging that most of us were already living in crisis before this pandemic: the crisis of an unequal society that ignores the needs of the poor and teaches us to blame one another instead of getting together to change our circumstances.

Our response must start from an understanding that all of us have a right to live with dignity, here in the US and around the world. We can transform our health care system and our society to meet everyone's needs, but only if we organize to take social wealth back from those who are hoarding it and put it to use for the public good.

Allowing hospitals to focus on healing

"Flatten the curve." We hear this phrase on the news every day, referring to how we can reduce the infection rate to avoid overwhelming our hospital system. Hospitals don't have enough beds for the surge of COVID -19 patients and are struggling to get enough masks, ventilators, and other equipment to keep health care workers and patients safe. But why is there such a shortage in the first place?

COVID-19 is showing that our healthcare system is organized to produce profit for a small network of global investors controlling large sums of money. Inspired by the automobile industry, hospitals have been reorganized to maximize revenue by moving patients through the system as quickly as possible, reducing hospital beds to meet these goals. Medical device manufacturers also swear by this doctrine of "just-in-time" production, which eliminates inventories and stockpiles of products. But maintaining reserves of hospital beds and equipment to provide care during a surge is exactly what is called for in a public health emergency like a pandemic. 

It turns out that running a hospital like it's a business is a terrible idea from the standpoint of public health. Big hospitals like UVM Medical Center are forced to prioritize expensive procedures like elective surgeries to make money, while smaller rural hospitals that serve low-income and elderly patients are shutting down. Last year, six of Vermont's 14 hospitals lost money and Springfield Hospital declared bankruptcy -- meaning that sick or pregnant people will have to travel even farther to get the care they need. Unfortunately, Vermont's lawmakers have so far responded to this predicament by doubling down on privatization and austerity, handing control of our healthcare system to a private company called OneCare Vermont run by UVM Medical Center and Dartmouth-Hitchcock, while telling smaller hospitals to "sink or swim."

With elective surgeries cancelled for the duration of the pandemic, Vermont's smaller hospitals are already warning that they may not be able to stay afloat through the crisis, raising the prospect of state intervention to keep them open. Lawmakers should immediately move to keep our hospitals open by establishing public ownership and direction of our hospitals in the interests of the public good, using the successful Veterans Health Administration system as a model.

Centering elders and people with disabilities

This crisis has been a wake up call for how our society supports our elders and those of us with disabilities. Here in Vermont and across the country, nursing homes are the emerging epicenter of COVID-19, with preventable tragedies unfolding at facilities like Burlington Health & Rehab. Millions of health care workers, oftentimes women, work in these and other residential facilities, which are notorious for paying low wages and having unsafe staffing ratios.

We didn't get here by accident. From the perspective of global finance capital, aging populations in countries like the U.S. are a goldmine for profits, leading companies to develop and market products specifically for those of us in the final decades of our lives. For-profit companies like Genesis -- which owns Burlington Health & Rehab -- take advantage of a steady stream of Medicare and Medicaid funding, while private equity firms operate like vultures, buying up senior care facilities, squeezing value out of them by cutting corners and wages, then selling them off for a huge return on investment.

While investors treat elders as a cash cow, the opposite dynamic is happening to those of us with disabilities. For years, politicians have made a concerted effort to steer Medicaid funding away from long-term care for people with disabilities and towards younger, able-bodied Medicaid recipients -- perpetuating the old canard of "deserving" vs. "undeserving" poor people. At the root of this is a capitalist worldview that ranks us according to our ability to be "productive workers" -- a disturbing ideology made even more dangerous in this era of medical triage due to shortages of hospital equipment.

Here in Vermont there's a real risk to the thousands of us who work and live in residential facilities, as well as home care workers who support elders and people with disabilities. Lawmakers need to immediately raise wages for all health and home care workers to a livable wage and ensure protective equipment and free childcare for the families of these and all essential workers on an ongoing basis. Moving forward, we need a paradigm shift that truly values care work, so often done by women, and keeps family members at home or in independent living situations of their choosing, instead of warehousing people in facilities that are extremely vulnerable to outbreaks like this one.

Getting the medicine we need

For many people, the coronavirus pandemic is also reconfirming the profound immorality of the pharmaceutical industry, which was already under fire for sparking the opioid epidemic. Rather than developing essential medicines to meet public health needs and fighting dangerous viruses like this one, drug companies focus most of their attention on non-essential drugs for wealthy consumers -- which is where the money is. This failure of priorities, combined with the underfunding of public institutions like the National Institutes of Health, meant that our response to this crisis was weeks behind where it could have been, with potentially thousands of lives in the balance.

Global finance is heavily invested in drug companies because their business model is hugely profitable: Tweak the recipe for an already-existing medicine, lobby politicians to give you a patent for your change, then jack up the price and charge everyone else boatloads of money to use or produce that medicine. What's worse, oftentimes these new medicines result from years of research at publicly funded universities. At the root of this business model is a farce: Privatizing centuries of socially-produced medical knowledge that should be available for all of us to use.

Here in Vermont, price gouging by the drug companies hangs on our healthcare system like a dead weight, driving up costs for all of us. Vermont's lawmakers should take advantage of this moment by calling on the federal government to end so-called "intellectual property rights" (patents) in medicine and establish a publicly owned pharmaceutical sector designed to meet public health needs so we can get the medicine we need to heal through this crisis and beyond, free of charge.

Guaranteeing health care for all

So far, lawmakers in Montpelier have taken important steps to prevent and contain the spread of COVID-19. But other than waiving the cost of getting tested, surprisingly few steps have been taken to make healthcare more affordable, despite thousands of people being out of work and living in limbo.

In the meantime, health insurance companies have every intention to make us foot the bill for this crisis, with premiums projected to go up as much as 40 percent next year. This comes after years of rising health insurance rates and an overall cost-shift to workers through the growth of high-deductible plans.

It's morally unacceptable to allow this industry, which makes its money by preventing people from accessing health care, to exist any longer.

Our representatives in Montpelier must ensure immediate access to the health care we need by expanding Medicaid to cover everyone, regardless of immigration status or any other factor. Lawmakers already have the authority to expand public health care to everyone under a law called Act 48, which people fought for and passed in 2011, but which was never implemented. This is the time to act.

Where do we go from here?

"True compassion is more than flinging a coin to a beggar; it comes to see that an edifice which produces beggars needs restructuring." - Rev. Dr. Martin Luther King, Jr

The coronavirus pandemic is shaking the foundations of global capitalism, with analysts predicting another global recession and possibly a depression. Millions of people have already lost their jobs or are uncertain if they will have work when the crisis is over. Local businesses may never be able to reopen. Making the situation worse is the fact that consumer and corporate debt was already at record levels, while many states' budgets are still suffering from austerity measures passed after the Great Recession a decade ago.

How will the economy recover from this crisis? We know from history that the people who control the corporations and finance capital will fight to resolve the crisis to their benefit, shifting the burden of "recovery" onto the backs of the poor and working class. In addition, there is a very real possibility that the current crisis will accelerate the automation of retail, transportation, mining and other sectors, with the prospect of millions of workers being permanently replaced with robotics and artificial intelligence. This would result in tremendous numbers of people losing their homes, foregoing adequate nutrition for their families, and going deeper into debt in order to survive.

We can find glimpses of this future in the present moment, as elders are asked to sacrifice their health for the sake of "the economy", doctors are forced to choose whose lives matter more for treatment, and workers are told to keep working despite an absence of masks and other protective measures. Increasingly, we can see who matters to the owning class: workers who can produce goods and services that can be sold to make profits. Our neighbors who are most vulnerable to COVID-19 -- people with disabilities, elders, poor people, incarcerated and formerly incarcerated people -- are the canaries in the coal mine as more and more of us are cast aside by our economic system.

In response to the pandemic and grassroots pressure from the growing ranks of desperate people, state and local governments are taking surprising action to halt evictions, foreclosures and debt collection, move homeless people into hotels and restore water shutoffs, loosen Medicaid requirements, and make it easier to apply for unemployment.

When millions of poor people are potential carriers of a pandemic, suddenly we're seeing how easy it is for politicians to take steps toward meeting our human rights. But we can't afford to abandon these so-called war-time measures and go back to "normal" after this pandemic passes. The daily emergency of poverty was the pre-existing condition for 140 million poor people in this country. We must organize to ensure that the steps taken to meet our human rights during this pandemic become permanent measures, so that all of us are able to live with dignity.

During the Great Depression of the 1930's, millions of poor and working-class people moved into action, with many organizing for true social and economic transformation. Fearing these efforts to "restructure the edifice", the ruling class rolled out a series of concessions through the New Deal to take the edge off the crisis and co-opt our energy, redirecting desperate people toward a route that ultimately strengthened capitalism and the ability of corporations to dominate our lives. In the 1960's, when widespread unrest sparked similar fears, President Johnson instituted the War on Poverty to similarly soften the edges of a system that is, at its core, exploitive and puts profits over people.

In this moment, we're called upon to organize a mass movement that is politically independent and learns from history. The crisis we face today has deep roots that pre-date President Trump or other current politicians. As we build a mass movement of the poor and working class, we need to resist efforts to co-opt and redirect us -- just as we must stand against divide-and-conquer racism and the xenophobic scapegoating of Asian Americans or any other section of the population.

We also need to look beyond the borders of Vermont and the United States. The war on the poor abroad is just another arm of the war on the poor here, and we're fighting the same opponent: global finance capital. Even before the pandemic, U.S. economic sanctions on countries like Iran and Venezuela were preventing critical food and medical supplies from reaching thousands of people who need them. As this public health crisis deepens, we call on our government to lift these inhumane sanctions and commit to a foreign policy that respects human lives and the sovereignty of other countries.

In fighting for the right to live, we're fighting to guarantee land and housing, health care and education, income and dignified work for everyone -- a transformation of the edifice from the ground up. Any response to the coronavirus disaster must be long-term and comprehensive to address the multiple crises that affect our communities. We cannot return to a system in which 140 million people live paycheck to paycheck.

We have a choice in this moment of crisis: to give in to fear and division, or forge a new path rooted in solidarity and the fulfillment of all of our human rights. For many of our families, our lives depend on us coming together to find a new direction forward.