First In the Room, Back of the Line: America's Profiteering Health System Does It Again

 Saturday, December 19, 2020

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Abby Zimet, Further columnist

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With Pfizer's welcome COVID-19 vaccine here, so are America's unwelcome rich and privileged, clamoring for their entitled spot at the head of the line. In a harbinger of let-them-eat-cake things to come within a grossly inequitable health system, frontline residents at Stanford Medical Center just held a rowdy protest after the hospital distributed almost all its 5,000 first-round vaccines to executives and other suits who've stayed safely home for months. The move by Stanford reflects the longtime reality of a profit-driven system that asks the sick how they'll pay for treatment before asking where it hurts; from one critic, "America doesn't have a health CARE system, it has a health INSURANCE system." The pandemic has only re-enforced that fundamental inequity: If you don't think COVID's about privilege, think Trump's chopper ride and pricey, speedy, limited-edition drug cocktail vs. people of color dying silently, stoically at home.

Now we have an ever-unctuous Mike Pence getting the vaccine on TV, and anti-choice, LGBTQ and COVID relief millionaire Rep. Virginia Foxx (R-NC), who once said we have "more to fear" from Obamacare than terrorists, happily, shamelessly posting a photo of herself getting the vaccine with, "This is the power of American innovation at work!," except FYI it's German. With the vaccine's arrival, bio-ethicists say, many of the rich and powerful are frantically offering hefty bribes to hospitals, pestering boutique medical facilities, looking to redefine "high-risk," and buying up low-temp freezers for vaccine storage, all to skip the plebs' line; it's also deemed likely a vaccine black market will appear. Given an already grossly skewered system, experts say, “They don’t have to really do anything sinister. All they have to do is access the system that they are a part of.”

Stanford's decision to prioritize high-level executives and administrators was viewed by many young doctors as more of the same, confirmation of their lack of representation within a corporate autocracy. The hospital's initial plan left out all but seven of 1,349 residents and fellows, many of whom regularly treat COVID-19 patients in often stressful, overtime situations; oddly, the seven were orthopedic surgeons, nurses treating outpatients, a dermatologist. At Friday's walkout, protesters blasted the implied definition of "essential" human beings with signs that read, “Health-Care Hero, Support Is Zero...Residents Can Die Too...Time For the Suits To Take the Floor...In This Together.” "I saw 16 COVID patients in the last 24 hours, more than double the number residents getting the vaccine,” said one, noting many recipients "haven't even touched an N-95 mask."

Meanwhile, notes a letter to hospital officials from the Chief Residents Council, "(We) strap on N95 masks for the tenth month of this pandemic without a transparent and clear plan for our protection in place." Citing their anger, hurt and sense of betrayal "given the sacrifices we have been making and the promises that were made to us," they express support for other workers getting vaccines, from nurses to food services, but call the hospital's decision "defenseless on the basis of science, reason, ethics and equality." 

Soon after the hospital apologized - they cited an algorithm error, though doctors noted it was earlier identified but not corrected, and algorithms are made by people who evidently consider them "an afterthought" - and said they are "working quickly to address the flaws in our plan." All good. Maybe next they can get to an unconscionable system that rewards CEOs and millionaires before everyday people. 

One critic: "This is all you need to know about American healthcare."