EIn “disaster”, “chaos”, “negligent homicide” – Donald Trump’s critics always found clear words for his crisis management in the coronavirus crisis. More than 302,000 people in the United States have now died after being infected with the virus. Trump played down the virus, his government reacted in an uncoordinated manner, often contradicting itself, Trump praised the opponents of protective measures and spread false information. And yet: the catastrophe that the virus is causing in America is not solely due to the Trump administration.
In the country, many crises and system defects are intertwined, which make fighting pandemics particularly difficult. Election winner and President-elect Joe Biden inherits all of these problems. When he takes office on January 20, his predecessor can still be held responsible for momentous decisions and the heating of an anti-scientific climate among his supporters. But then Biden and his cabinet will be responsible. And not all structural problems can be tackled by the central government in Washington.
Patchy health system
In times of crisis, people without health insurance are particularly vulnerable because they often go to the doctor too late and do not get the care they need. Almost 29 million Americans were uninsured in 2019. The policies are unaffordable for many people – also with “Obamacare”, which is still organized through private insurance companies. The average monthly premium is currently $ 462, plus deductibles of several thousand dollars before the insurance even pays. The most common cause of personal bankruptcies are excessive medical costs.
Cheaper health insurance is often linked to the job and ends with it. According to the Economic Policy Institute, up to twelve million Americans had lost their health insurance due to the pandemic by the end of August. Many now have to self-insure, risk periods of no coverage, or they can apply for temporary health care for the poor, Medicaid.
In 15 states, the governments also failed to implement the Affordable Care Act of 2010 and did not expand Medicaid. These states are either ruled by Republicans or the Republicans have a majority in parliament. The 35 states that expanded Medicaid were better prepared for the pandemic, according to the non-party research institute Center on Budget and Policy Priorities.
130 clinics closed within ten years
In many places, the health system also suffers from the profit orientation of hospitals. Interventions that are not medically necessary are often more lucrative than caring for the sick. Clinics specialize in certain services and neglect others – or they close completely under financial pressure. 130 hospitals across the country have given up in the past ten years. In rural areas, the supply is patchy and often of poor quality.
Joe Biden promised in the election campaign to add a “public pillar” to the “Obamacare” provision organized through private insurance companies. Critics note that with Senator Bernie Sanders’ Medicare for All, a popular concept for general public health insurance is on the table, the time of which has just come.
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