REPORTED BY NORMAN J CLEMENT RPH., DDS
FROM DAVID APSEY DDS., MS:
NATIONAL HEALTH CARE AND COVID 19
BY DAVID APSEY DDD., MS., from Michigan
April 25, 2020
It took a national public health crisis as big as the COVID 19 pandemic to lay bare the destruction of our health system wrought by insurance companies and government over the last 40 years.
Let’s take a look at how a single payer system would deal differently with this crisis.
As the virus outbreak was announced internationally and urgent warnings were publicized, national health care systems like S Korea, Japan and China jumped into action, mobilizing testing, social distancing measures much sooner and stronger than in USA. Health workers received necessary protective equipment and health facilities, with China in an extraordinary effort building a 1000 bed hospital in a little over a week to treat Covid patients.
In addition, in national health care models, all people have equal right to the same quality health care. Even in the United Kingdom as the Prime Minister became severely and acutely ill, the nurses and Prime Minister proclaimed he had care no different than anybody else in the public system with everybody else. In United Kingdom, the response was slower than necessary but in that case, everybody has the equal right to exactly the same health care whether they are employed or not.
In the USA, the response has been quite different. Despite our great wealth and physical ability to prepare, the health care system is built and maintained for the profit of giant transnational pharma, hospital, insurance payers and staffing firms. These firms are owned and controlled by the largest investment fund managers with a close eye on one factor, the profit for their investors. The billionaire class covets their coordinated investment funds controlling trillions of the world’s wealth. The health care system in the USA and the world is one of the most profitable businesses on earth and these fund managers are expert at extracting everything for their owners.
So what’s the effect on the ground? Water is shut off to homes of people too poor to afford the bills, people including frontline health workers are laid off by their staffing agencies and entire hospital systems closed because they cannot generate enough profit during this crisis. Those workers have their health insurance canceled by midnight the day they are laid off leaving their physical health and their families at the mercy of disease that may strike because they cared for the patients in the hospital before it closed.
Workers in all other employment who had insurance have already lost it with no legal remedy since they are laid off or terminated by this crisis. They are left unable to pay for testing or treatment and many are dying at home without treatment or evaluation due to inability to pay. Their old habits die hard. They will not seek care because they know it’s too expensive even though it’s their death warrant.
These staffing agencies are one of the most scandalous aspects of the modern for profit health system. They operate in unregulated manner with no coordination as to the public health need and only pay attention to the profit. They are allowed to remove health labor from our system at a time when an increasing health workforce is needed more than ever in our nation’s history. All the while, nursing home residents and prison inmates are put to death by the system. Their death certificate is signed in a boardroom that decides which workers will be assigned the duties of care but only when a profit is turned upon their backs. National health care wywtems with a public health mandate increase the available workers during a public health crisis because they are needed and profit is non-existent or takes a back seat in the crisis.
PPE we have heard about is so critically low with no central coordination of efforts to ramp up production leaving health facilities operating at low margins already to pay highest prices which are legally charged at 500% of original prices charged just weeks before. Suppliers are not able to supply what is needed even at high prices. We have laws such as Defense Production Act allowing the President and military to take over factories to make and distribute the PPE but with the profit motive standing in the way the factories remain closed until the corporate board determines they will make a profit producing what they did before. The president stands aside and declares “it’s up to the states” how to respond. The Defense Production Act is a federal law and no state can use it without federal coordination. To leave the response in a national emergency up to states is to ignore their federal responsibility to deal with the crisis at all.
If we had national health care it would be different. Nobody would lose insurance which would guarantee right to health care in healthy and disease crisis times alike. We would stand together in equality and justice. Our health system would be in the hands of public health officials and Congress and the President would be bound by law to act to coordinate factories to respond in coordinated fashion to guarantee the best public health outcomes. We would have necessary PPE for workers and the public and it would be freely distributed based on need in a centrally coordinated system of the Medicare Trust fund and Defense Production Act. The necessary testing and treatments would be mobilized as fast as humanly possible without the handwringing politicians trying to manage crises they have no ability to understand. Science must lead the efforts and government is required by law to be a servant to the actual objective scientific needs. No President would have power to “leave it up to states” to coordinate response.
We need national health care “Everybody in Nobody Out”. It is a political solution. The resources are available – how else can we explain the government calling up $2.5 Trillion USD in a matter of weeks to fix a totally humbled system that cannot go forward without it. We need to demand our political leaders turn our health system into a nonprofit foundation which can guarantee the needs of USA inhabitants from cradle to grave without barriers of cost. There is no other way to stay healthy.
In the meantime, everyone should be aware this viral disease is oropharyngeal in nature – it begins in nose, mouth and throat. The dentists are medical practitioners and are specialists of the oral and pharyngeal environment. They should be recalled onto the field in this fight for testing and implementation of proper oral health preventive measures against this virus. They will need proper equipment and ability to screen people for exposure along with all other first responders.
Mouth rinsing with disinfectant mouthwash, brushing teeth and flossing with baking soda and nasal lavage (rinsing out nasal cavity) with salt water solution can serve to prevent invasion of your body by the virus. The virus doses will be much reduced and less likely to become established. It can prevent person to person transmission by reducing dosage levels in aerosols produced during medical care or other activities in public. This is not a cure for covid, it is a preventive measure and is every bit as important as hand washing and disinfecting surfaces we touch. So far it has not received as much public attention as it deserves.
FOR NOW
YOU ARE WITHIN THE NORMS
I agree that dentists should be on the frontline in the diagnosis tests for covid 19, not only to increase testing but for the protection of the dentists, their staff and patients.
I also believe that due to quarantine, or with patients hospitalized, there will be an increase of plague and calculus due to poor oral hygiene or even lack of oral hygiene.
I hope the ADA stands behinds the dentists and allows additional codes for these circumstances, and the insurance companies will issue payment for additional needed PPE, facesheilds,isolation gowns additional precautionary antiseptic mouthrinses.
We will all have to change our scheduling, meaning treating
less patients, 1) due to fear of contracting the virus, some patients may not return to dentists or 2) to allowing for “super” disinfection of the entire office setting between patients and 3) treating less patients per day, let’s call that social distancing.
I hope the ADA, CDC, the local health departments step up to the plate to endorse the dentists by stressing the importance of good oral hygiene and dental prophylaxis,and scaling and root planing. Such an announcement will aid the dental profession to rebuild, revive and places us as frontline essential workers.
It is appalling that we were shut down out of fear of spreading the virus, when our profession inherently protects ourselves, our staff, and our patients by wearing masks, gloves, lab coats. We religiously disinfect our operatories, and sterilize our instruments,twice, once with a discide, and second in an autoclave. However in comparison, we were thrust in the same whirlpool as tattoo artists, hair and nail salons and not permitted to return to practice, except for emergencies. Pardon my French, but wtf, why are those professions permitted to resume while we are limited to emergencies only. Keep in mind most toothaches did not happen overnight, many of those patients are high risk, poor oral hygiene, many of those have not seen a dentist for several years. But they will permit us to render treatment for those circumstances.