Health And Wealth

Ageing populations, income inequality and dysfunctional insurance frameworks have challenged public health systems for years. However, a global crisis has focused minds both globally and locally.

I am sitting in the ‘West Wing’ of my home office. Rooms, corners, even furniture pieces have been given new names to inspire a sense of space in The Emergency but the brain remains unmoved. That must change. There are potentially even greater socio-economic transformations ahead. Was it only a few days ago the political leaders of the UK and the US were attempting to calculate a public health and economic trade-off in their Covid-19 containment strategies?

Thinking at the highest levels of the oldest capitalist democracies on the planet was actually trying to figure out was there an ‘acceptable’ human cost to ensure economic activity was sustained. The outcry was predictable but possibly misplaced. Yes, a failure to “flatten the curve” would lead to much higher death tolls. But, this raises an existing uncomfortable truth for many societies. Ageing populations, income inequality and dysfunctional insurance frameworks have challenged public health systems for years and resulted in unnecessary loss of life. That death toll rises every year and will continue to do so without fresh thinking. Clearly, this curve wasn’t steep enough to care enough. However, a global crisis has focused minds both globally and locally.

Ireland, fresh from elections dominated by images of hospital trolleys and homeless statistics, has impressively responded to the Covid-19 pandemic with the rapid deployment of funds, medical resources, beds and even properties. All is utterly changed, and in record time. In the UK the railway system has been nationalised by a Conservative government. In Ireland the caretaker centre-right Fine Gael government is effectively nationalising private medical facilities. Arguably, capitalism is due a re-set. At the epicenter of this socio-economic inflexion point is the fundamental right of a country’s citizens to access healthcare and safe living conditions.

A full-blown crisis has unleashed a massive effort to ensure limited medical resources can meet the needs of a supra-normal demand. It is a war. And wars can leverage combined intelligence to deliver huge efficiencies and innovations. Ventilators are the key weapons in the Covid-19 battles waged in all hospitals but they are expensive. As the likes of Dyson and GM apply their engineering expertise to mass-produce these life-saving devices one can be reasonably hopeful that the pricing point for such equipment will permanently fall for future generations of the sick. Closer to home, a drive to make our health system more efficient and capable to serve more patients has accelerated the embrace of technology.

Wellola was a recipient of Spark CrowdFunding investor support and is now delivering a Covid-19 communication portal to allow patients remote access to GPs. Similarly, the Mater Hospital is using software robots to input data and save nurses hours of administrative work. It has taken a crisis to force decisions and change working practices and technologies in healthcare. The benefits will last beyond this crisis and highlight the dangers of dysfunction and utilitarian capitalism.

The US is fast becoming the poster child of how a profit-based healthcare system can struggle to deal with a universal crisis.  Apart from 60 million citizens excluded from its health insurance system, we have witnessed extraordinary bidding wars between state and federal entities for the same urgently required medical equipment. It remains to be seen how the huge private hospital industry in the US deals with the expected surge in the numbers of Covid-19 patients requiring acute treatment but it is likely to be ugly. After the tiny orange finger-pointing is over expect a social and political backlash against a healthcare industry designed for dollars and not for disaster. The ultimate capitalist society will possibly have to consider another way to look after all its citizens.

Indeed, as students ponder public exams being taken remotely, I am reminded of a literary figure from my own school days. Charles Dickens created the Thomas Gradgrind character in ‘Hard Times’ to illustrate the coldness of utilitarianism. One might hope the words of Gradgrind will echo in Washington political lobby chambers in the coming months…

“Some persons hold that there is a wisdom of the Head, and that there is a wisdom of the Heart. I have not supposed so; but, as I have said, I mistrust myself now. I have supposed the Head to be all-sufficient. It may not be all-sufficient…”

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