COVID-19 Discussions Over The U.S. Healthcare System

Ekim Kılıç

Since the beginning of January 2020, COVID-19, aka Coronavirus, has continued to devastate peoples’ lives, specifically working classes across the world. Internationally, a prominent aspect of the pandemic is that all working people feel a similar level of fear and anxiety, even to some extent petty-bourgeois classes despite their considerable economic privileges. It has created an unprecedented platform in which more working people and intellectualstend to see and discuss the inability of capitalist political economic system to address itself to a health crisis and its understanding of public health system.

One of the most affected countries is the United States, which has almost one-third of the international cases, with 815,491 as an outcome of 4,162,922 tests by April 21. On this date, the number of death reached 45,097. The total number of recovered patients is 82,620. This means that there are 2,464 cases and 136 deaths per 1M people.[1] One-third of the national cases are from the State of New York.[2] In the U.S., the primary reason that the epidemic spread like a wildfire is the weak healthcare system along with several other political and social problems here. Especially, the pandemic shook the base, revealed lack of organized working class, fetishism over individualism combined with puritan work ethic, a healthcare system abandoned at the mercy of banks and companies, widespread and dire mental health problems, homelessness, structural racism, a violent prison-industrial complex, a divided American political system over extremely libertarian federal system, and the discourses of nationalist functionalism and blind petty bourgeois ethicism.

The pandemic came as if a “god’s gift” in a time when economic measures have been taken by and for capital to prevent the deepening consequences of the 2008 financial crisis and the present galvanizing crisis. The extortion of abortion rights in several states and the elimination of union elections by the National Labor Relations Board (NLRB), escalating interventionist moves against Venezuela, cutting financial support to World Health Organization (WHO), and expectation for the presidential executive order to suspend immigration reveals for whose benefit the pandemic process was used.[3][4][5][6][7] Even American exceptionalists face stark contradictions, as countries such as China, Vietnam, South Korea, and Cuba have effective attitudes towards the epidemic, Russia’s military aircraft to aid the US with medical equipment, then from Vietnam, and the US’s seizure of medical equipment to Barbados, called modern piracy.[8][9][10][11][12]Also, President Trump’s attempts to blame the pandemic on Chinese conspiracy remark their unpreparedness and desperation to get away with their responsibilities, later framed COVID-19 as “Chinese Virus.”[13]

Although unions, which have a strong bureaucracy, cannot lead the workers, and the government disregards urgent measures for “essential workers,” they, especially healthcare and logistics workers, feel compelled to struggle for vital, urgent demands.[14] In that sense, the working class politics’ wave of the last years definitely shows its effect. Coinciding with the Bernie Sanders campaign in a country where even the limited healthcare demand of “Medicare for All” was almost a joke, universal healthcare became a major part of public agenda. However, in a country where nurses have to make protective uniforms out of big garbage bags due to lack of personal protective equipment (PPE), it turned out that the lives of workers and laborers, who are called “essentials,” hypocritically, are worthless. One has to remember that political elites have always been shamelessly outspoken with their disdain for workers.[15][16][17]

Even after the $2 trillion stimulus package is distributed, details reveal the gap between what was promised and what the reality is. For example, $1,200 aid for individuals and $2,400 for couples is much more meaningful in the Southern states, where the taxes are lower than the states like New York and California. It has to be said that these checks will almost certainly go for student loans, and rent, besides given the fact that almost 1/3 of the country didn’t pay rent for the last month and has that rent due.[18] Students that were graduated last summer or winter, are not be able to get checks. In this regard, and in these new and challenging times, it is a calamity that will trigger millennials and generation Z to question “meaning, morality and mortality in ways they never did before.” This generation has experienced life-altering disruptions, such as 9/11, the Great Recession, the decline of American prestige to a housing affordability crisis, global warming to crushing student debt according to academics at the University of Southern California.[19]

An Overview of the U.S. Healthcare System

The U.S. has always been named as the most developed capitalist country with a liberal democracy that has been perceived alongside western European liberal democracies.[20] Relying on individual liberty in a libertarian sense, the U.S. understanding and structure of organizing daily affairs leave everything to the individual, including healthcare services. Healthcare is a responsibility of the individual, not the state and society. Because of this individualistic conception, it can be said that the U.S. is the most developed country with the worst skewed and insufficient healthcare system.

Becoming an emergent discussion in the wake of former Democratic 2020 presidential primary candidate Bernie Sanders’ campaign, healthcare has been a privilege in the U.S. for a long time except for some reforms called Obamacare, the Patient Protection and Affordable Care Act, which became law on March 23, 2010. Nevertheless, the main requirement of having health insurance with sufficient coverage is to have a full-time employment.

After emerging from the 1929 Great Depression, the Franklin Delano Roosevelt (FDR) government and state institutions utilized the conditions of World War II to provide opportunities for the social democratic expansion of capital. In 1942, the Stabilization Act “limited the amount of wage increases employers could grant, but at the same time permitted the adoption of employee insurance plans.”[21] By 1949, employers benefits programs became common in collective bargaining agreements.[22] In the meantime, the Internal Revenue Service (IRS) decided that, “employer contributions to health insurance premiums were tax free, which meant workers paid less out of their pocket.”[23] After FDR, President Harry Truman signed the National Mental Health Act, which called for the establishment of a National Institute of Mental Health.[24] Under the Johnson presidency, Medicare and Medicaid programs were set up in 1965. By accepting the Health Maintenance Organization Act of 1973, the Nixon government unleashed healthcare as a profitable industry.[25]

The Obama presidency evoked hope among the US people over the crumbling healthcare system. However, insurance companies were the one which benefited from a developing market, although his reforms alleviated the situation a little by extending children on their parents coverage and mandating mental health coverage one very plan, those without insurance were burdened with the tax penalties and forced into high deductible plans.[26] Since 2016, the Trump government began to repeal Obamacare by redoing the enabling acts.[27] While it is claimed that it lessens the tax burden coming from healthcare payments, it is also constricting the accessibility to healthcare.[28]

Recently, there were around 800,000 people with “freelance contracts” working in New York. According to the contract, the employer does not have to make a person’s health insurance because the character of their job is temporary and in a limited time. If the person works at or above the 32-33 hour limit, it is considered full-time. Therefore, bosses are able to force flexible employment without any reservations, being aware of the fear of unemployment or underemployment that dominates the US job market. This exemplifies how the messy system has worsened the crisis substantially.

 As another example, unemployment climbed by another 5 million people this week, increasing the total number of people who have applied for unemployment to 22 million in the last month. According to the Economic Policy Institute, “approximately 9.2 million workers have likely lost their employer-provided health care coverage in the past four weeks.”[29]

Neo-liberal policies in the healthcare system have left the working class and laborers vulnerable to the epidemic. However, the Trump administration focused on the economy to function as smoothly as possible, rather than taking measures that could be taken more or less against approaching epidemic. They refrained from taking the necessary precautions. Even then, for example, the statements of Trump continue to insist for reopening country on May 1, despite major obstacles from authorities.[30] His persistence on reopening the country was also a matter on April 12.[31] Several expressions of political and economic elites are supportive of this: “I’d rather die’ from coronavirus ‘than kill the country.”[32][33][34] As one of the countries that experienced the 2008 crisis deeply, the sensitivity of the USA to the capitalist capital accumulation in the face of the epidemic caused more people to die.

 An article from the American prospect addresses, for example, the share in the stimulus package for businesses. Out of $2 Trillion package, $500 billion will be used for companies. $75 billion goes to the airline industry and the mysteriously named “businesses critical to national security.” The rest $425 will be used to capitalize a $4.25 trillion, leveraged lending facility at the Federal Reserve.[35] Additionally, seven other industries are lobbying for more stimulus, such as tourism, restaurants, mortgage servicers, hotels, airlines, franchises, and distillers.[36]

Other Aspects of the Crisis

Although we have listed the other problems that have accelerated the severity of the crisis, once again, those have to be elaborated to make sense in their context. To begin with, fetish over individualism elicits an “I don’t care, no-one can decides for me” mentality, which disregards social well-being and solidarity. This fundamental bourgeois idea frustrated many people at the beginning due to its ignorance of the crisis, and refusal to heed the advice of healthcare workers. Different aspects of this same idea might be felt over the larger, individual based healthcare system: “It is every (hu)man for himself.”

Similar to this “I don’t care” individualism, even the excessive mental health problems have been treated “as an individual’s incapacity to function normally within a given setting” by serious academic researches. These problems can be found mostly among poor whites and blacks who are more prone to mental disorders than richer classes.[37] Combining with homelessness, and other problems stemming from unemployment, the mental health question requires urgent social attention, especially during the crisis. People, who are relying on social circles, families, and solidarity, are isolated, trapped, and helpless. On the other hand, homelessness, specifically student one, made states hesitate to cancel schools at the beginning. Many college students were also thrown out of their dorm, with nowhere else to go.

Over all these, as another aspect of “American” values, nowadays, right-wing demonstrators have called to end quarantine by blocking roads with caravans, carrying Confederation and Nazi flags, utilizing the 18th century American revolutionary slogan of “Give me liberty, or give me death!” The other, “liberal” side of American nationalism is not innocent in weaponizing the crisis and its human costs, framing healthcare workers as “heroes,” food and workers from other vital industries as “essentials,” “frontliners,” “soldiers,” who are, fundamentally, expendable. Even the liberal call for “stay home” and “practice social distancing” is full of lack of consideration and clarity, solely blind ethicism, a performative virtue.

Workers’ and the lives of the poor are at the stake, which involves racial and gender issues, too.[38] In the center of epidemic in the country, New York City, most of cases and deaths are coming from poor working class neighborhoods.[39] According to formal data, those who have died have been 34% Hispanic, 28% blacks, 27% white and 7% Asian.[40] Economically and racially segregated neighborhoods are particularly vulnerable in this crisis. These groups’ share in the population are 29%, 22%, 32%, and 14%, respectively. The prison-industrial complex also has figured prominently in the crisis. According to activist and journalist Shaun King, the U.S. is the only nation in the world with 250% more prison cells than hospital beds.[41] That complex is another example of structural racism: “These racial disparities are particularly stark for Black Americans, who make up 40% of the incarcerated population despite representing only 13% of U.S residents.”[42] In other words, it is not surprising that places where COVID-19 has been most devastating, are generally black neighborhoods and towns.[43] Beyond racial lines, the rate of incarceration for women incarceration follows that of the black population: “The same is true for women, whose incarceration rates have for decades risen faster than men’s, and who are often behind bars because of financial obstacles such as an inability to pay bail.”[44] During the pandemic, the issue of rising domestic abuse of women trapped at their home receive almost no public or media attention. Additionally, the LGBTQ population is not independent from same abusive behavior. They are also vulnerable to discrimination, homelessness and other economic problems that increase the likelihood of contracting COVID-19.[45]

There are a considerable amount of cases and deaths especially among transportation, food and market workers.[46] Lack of protective equipment and the government’s token appreciation to workers has pushed many workers to take several actions, from warehouses to hospitals. Until now, over 100 workers’ actions are recorded since the beginning of the pandemic.[47] The most unique one is that General Electric workers’ struggle for their company to shift to produce ventilators.[48] Beyond all, the common quality of workers actions are mostly led by millennial generations. In that sense, it can be counted as a sign which generation of the working class might lead advanced struggles post-pandemic. However, in terms of youth struggle, it is hard to say what might happen, because online education may continue in fall 2020, and beyond.

All in all, other aspects of the crisis are complex and entangled, and reflect all the emergent demands of the US people and working class. However, the struggle against pandemic has been shaped by the political struggle between democrats and republicans towards the 2020 Presidential Elections. The governors of Illinois, New York and several other state governors’ have critiqued president Trump for not utilizing the Defense Production Act exemplifies the tension between democrats and republicans along with federal and state fault lines.[49] For instance, while some smaller states have made commitments to end quarantine on May 1, New York and California are against that, and the federal government doesn’t necessarily intend for imposing an extension to quarantine.


It has been discussed that the working class as we know it is gone, especially by the liberal intellectuals of all spectrum in defense of cold war theories. There was also an illusive reality, in which public spaces has been dominated by petty bourgeoisie and some upper sections of working class. It should be noted that another reason to this for the USA and Western Europe is the surplus value they transfer from the dependent countries through the imperialist exploitation mechanism. While this post-cold war argument has lost credibility for a long time now, it is shattered with the COVID-19 crisis.

The U.S. is experiencing a moment of “the king is naked,” where petty bourgeois classes retreated from streets, and left working class people to fulfill busses, train cars, factories, warehouses, workplaces, and unemployment lines. On the one hand, framing some sections of working class as “essentials,” primarily “hero” healthcare workers, and on the other, failing to provide essential protective equipment to these “essentials,” shows one certain aspect in the contradictions of classes: “Workers’ lives do not matter.”

Due to the same reason, it can be said that president Donald Trump is backing up right-wing demonstrators, who wants to lift the quarantine. Concurrent with deepening polarization of the U.S. political system through several impasses between the Democrats and Republicans, the presidency plays with the libertarian positioned citizen-against-the-government to take advantage of the crisis to gather and energize its avid supporter base for the upcoming elections. However, the statements of the government to end quarantine aim to make people reconcile the situation, while continuing to infuriate workers and saturate the air with fear and resentment.

[1]  United States. (n.d.). Retrieved April 21, 2020, from

[2] Ibid.

[3] Smith, K. (2020, March 25). Abortion-rights groups sue Texas over abortion ban amid coronavirus outbreak. Retrieved April 25, 2020, from

[4] In Midst of a Pandemic, Trump’s NLRB Makes it Nearly Impossible for Workers to Organize a Union. (n.d.). Retrieved April 25, 2020, from

[5] Borger, J. (2020, March 31). US ignores calls to suspend Venezuela and Iran sanctions amid coronavirus pandemic. Retrieved April 25, 2020, from

[6] Sullivan, P. (2020, April 15). Trump WHO cuts meet with furious blowback. Retrieved April 25, 2020, from

[7] Stelloh, T., Welker, K., Pettypiece, S., & Bennett, G. (2020, April 21). Trump says he is suspending immigration over coronavirus, need to protect jobs. Retrieved April 25, 2020, from

[8] Lisnoff, H. (2020, April 6). American Exceptionalism in the Face of Covid-19. Retrieved April 25, 2020, from

[9] Kuttner, R. (2020, March 24). The End of American Exceptionalism. Retrieved April 25, 2020, from

[10] (n.d.). Retrieved April 25, 2020, from

[11] Sweeney, S. (2020, April 16). Vietnam ships 450,000 protective suits for U.S. health care workers. Retrieved April 25, 2020, from

[12] Steve SweeneyMonday, A. 6. (2020, April 6). US accused of ‘modern piracy’ after seizing ventilators bound for Barbados. Retrieved April 25, 2020, from

[13] Tisdall, S. (2020, April 19). Trump is playing a deadly game in deflecting Covid-19 blame to China. Retrieved April 25, 2020, from

[14] Chediac, J. (2020, April 20). Essential worker strike wave: ‘We fight COVID-19 for ourselves &… Retrieved April 25, 2020, from

[15] Montanaro, D. (2016, September 10). Hillary Clinton’s ‘Basket Of Deplorables,’ In Full Context Of This Ugly Campaign. Retrieved April 25, 2020, from

[16] Gruenberg, M. (2019, April 25). GOP lawmaker’s idiotic remark about nurses goes viral and backfires. Retrieved April 25, 2020, from

[17] Alternet. (2019, April 9). When the GOP uses the word “bartender” to mock Alexandria Ocasio-Cortez, it shows its ugly classism. Retrieved April 25, 2020, from

[18] Bahney, A. (2020, April 11). New data shows more Americans are having trouble paying their rent. Retrieved April 25, 2020, from

[19] Polakovic, G. (2020, April 3). How does coronavirus affect young people’s psyches? Retrieved April 25, 2020, from

[20] The Economist Intelligence Unit. (n.d.). Retrieved April 25, 2020, from

[21] Scofea, L. A. (1994). The development and growth of employer-provided health insurance. Monthly Labor Review, 3–10. Retrieved from

[22] Ibid.

[23] How did we end up with health insurance being tied to our jobs? (2019, April 29). Retrieved April 25, 2020, from

[24] National Institute of Mental Health (NIMH). (2017, February 17). Retrieved April 25, 2020, from

[25] Gruber, L. R., Maureen, S., & Polich, C. L. (n.d.). From Movement To Industry: The Growth Of HMOs. Retrieved April 25, 2020, from

[26] Amadeo, K. (n.d.). Pros and Cons of Obamacare. Retrieved April 25, 2020, from

[27] Simmons-Duffin, S. (2019, October 14). Trump Is Trying Hard To Thwart Obamacare. How’s That Going? Retrieved April 25, 2020, from

[28] Gonzales, R. (2019, October 5). Trump Bars Immigrants Who Cannot Pay For Health Care. Retrieved April 25, 2020, from

[29] 9.2 million workers likely lost their employer-provided health insurance in the past four weeks. (n.d.). Retrieved April 25, 2020, from

[30] Trump’s plans to reopen the country face major obstacles. (n.d.). Retrieved April 25, 2020, from

[31] Harris, J. F. (n.d.). ‘I’d love to have it open by Easter’: Trump says he wants to restart economy by mid-April. Retrieved April 25, 2020, from

[32] Samuels, A. (2020, April 21). Dan Patrick says “there are more important things than living and that’s saving this country”. Retrieved April 25, 2020, from

[33] Fredericks, B. (2020, April 15). Congressman says US should reopen economy – even if more would die. Retrieved April 25, 2020, from

[34] Concha, J. (2020, March 25). Glenn Beck: ‘I’d rather die’ from coronavirus ‘than kill the country’ from economic shutdown. Retrieved April 25, 2020, from

[35] Dayen, D. (2020, March 25). Unsanitized: Bailouts, A Tradition Unlike Any Other. Retrieved April 25, 2020, from

[36] Gangitano, A. (2020, April 2). 7 industries lobbying for more stimulus. Retrieved April 25, 2020, from

[37] Baran, P. A. & Sweezy P. M. (2020, March). The Quality of Monopoly Capitalist Society: Mental Health. Monthly Review. Volume 71. Pg. 41-43.

[38] Conn, M., Kelly, J., & Heimpel, D. (2020, April 3). Lack of Shelter Beds in New York for LGBTQ Youth During Pandemic. Retrieved April 25, 2020, from

[39] Virus Hits NYC Hardest in a Few Working-Class Neighborhoods. (n.d.). Retrieved April 25, 2020, from

[40] Workbook: NYS-COVID19-Tracker. (n.d.). Retrieved April 25, 2020, from

[41] SHAUN KING: The United States is the Only Nation in the World with 250% More Prison Cells Than Hospital Beds. (2020, March 30). Retrieved April 25, 2020, from

[42] Sawyer, W., & Wagner, P. (n.d.). Mass Incarceration: The Whole Pie 2020. Retrieved April 25, 2020, from

[43] Johnson, A., & Buford, T. (n.d.). Early Data Shows African Americans Have Contracted and Died of… Retrieved April 25, 2020, from

[44] Ibid.

[45] Conn, M., Kelly, J., & Heimpel, D. (2020, April 3). Lack of Shelter Beds in New York for LGBTQ Youth During Pandemic. Retrieved April 25, 2020, from

[46] Chediac, J. (2020, April 20). Essential worker strike wave: ‘We fight COVID-19 for ourselves &… Retrieved April 25, 2020, from

[47] Elk, M. (2020, April 23). COVID-19 Strike Wave Interactive Map. Retrieved April 25, 2020, from

[48] GE Workers Protest, Demand to Make Ventilators. (2020, April 16). Retrieved April 25, 2020, from

[49] Trump, Facing Criticism, Says He Will Increase Swab Production. (2020, April 19). Retrieved April 25, 2020, from

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