Prof Campbell weighs in: What has the pandemic revealed about the U.S. healthcare system? What needs to change?
Seven MIT SHASS scholars see lessons and opportunities for U.S. healthcare
"My hope is that the pandemic renders...structural inequality visible. There is little point in improving medical or public health systems if we fail to address the structural drivers of poor health." Andrea L. Campbell, Professor of Political Science
Image: Stuart Darsch
Read the full article here. Contributors include:
Dwaipayan Banerjee, anthropologist
"The spread of the virus revealed shortages in basic equipment and hospitals beds, the disproportionate effects of disease on the marginalized, the challenge of prevention rather than cure, the limits of insurance-based models to provide equitable care, and our unacknowledged dependence on the labor of underpaid healthcare workers."
Andrea Campbell, political scientist
"My hope is that the pandemic renders...structural inequality visible. There is little point in improving medical or public health systems if we fail to address the structural drivers of poor health."
Jonathan Gruber, health economist
"The single most important change that we need to make to be prepared for the next pandemic is to recognize that proper preparation is by definition over-preparation. This means working now, while the memory is fresh, to set up permanent, mandatorily funded institutions."
Jeffrey Harris, economist, practicing physician
"The pandemic has revealed the American healthcare system to be a non-system. In a genuine system, healthcare providers would coordinate their services. There are already models out there to imitate."
Erica Caple James, anthropologist
"The pandemic has also revealed the biopolitics and even the “necropolitics” of care — when policy makers who are aware that disease and death fall disproportionately in marginal populations make public health decisions that deepen the risks of exposure of these more vulnerable groups."
Seth Mnookin, science writer
"On a global level, the pandemic has illustrated that preparedness and economic resources are no match for lies and misinformation....Without a global commitment to supporting accurate, scientifically based information, there is no amount of planning and preparation that can outflank the spread of lies."
Parag Pathak, economist
"The pandemic has revealed the strengths and weaknesses of America’s healthcare systems in an extreme way. The development and approval of three vaccines in roughly one year after the start of the pandemic is a phenomenal achievement. At the same time... we’re already seeing the need for international cooperation with vaccine supply and monitoring of new variants. It will be imperative that we continue to invest in developing the global infrastructure to facilitate greater cooperation for the next pandemic."
Andrea Campbell
Professor of Political Science
No doubt, the pandemic reveals the dire need to invest in public health infrastructure to better monitor and address public health threats in the future, and to expand insurance coverage and health care access. To my mind, however, the pandemic’s greatest significance is in revealing the racism woven into American social and economic policy.
Public policies helped create geographic and occupational segregation to begin with; inadequate racist and classist public policies do a poor job of mitigating their effects. Structural racism manifests at the individual level, with people of color suffering worse housing and exposure to toxins, less access to education and jobs, greater financial instability, poorer physical and mental health, and higher infant mortality and shorter lifespans than their white counterparts. Residential segregation means many white Americans do not see these harms.
Structural racism also materializes at the societal level, a colossal waste of human capital that undercuts the nation’s economic growth, as social and economic policy expert Heather McGhee shows in her illuminating book, The Sum of Us. These society-wide costs are hidden as well: it is difficult to comprehend the counterfactual of what growth would look like if all Americans could prosper.
My hope is that the pandemic renders this structural inequality visible. There is little point in improving medical or public health systems if we fail to address the structural drivers of poor health. We must seize the opportunity to improve housing, nutrition, and schools; to enforce regulations on workplace safety, redlining, and environmental hazards; and to implement paid sick leave and paid family leave, among other changes. It has been too easy for healthy, financially stable, often white Americans to think the vulnerable are residual. The pandemic has revealed that they are in fact central. It’s time to invest for a more equitable future. •
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