“Our society is sick:” The Lancet condemns American capitalism
On Thursday, the British medical journal The Lancet published its official report, three years in the making, on the Trump administration’s health care record.
The report is, appropriately, dominated by the COVID-19 pandemic. The Lancet found the Trump administration directly responsible for the deaths of tens of thousands of people during the pandemic, and that over 200,000 people would still be alive if the United States had a COVID-19 mortality rate similar to that of other developed countries.
But The Lancet’s meticulously-researched report, written by over a dozen distinguished authors, goes far beyond condemning the record of Trump alone. It argues that the nearly half million dead in the US from COVID-19 should be added to the toll of the “missing Americans” whose deaths were attributable to the rise of social inequality over the course of the past four decades. The Lancet report presents both the pandemic and the Trump administration as the outcome of deeper and more profound tendencies in American society.
“An emboldened plutocracy, under the guise of deregulation and austerity, has augmented its wealth and power by re-regulating markets to their advantage and adjusting government budgets for their own gain,” wrote The Lancet. “Under this type of governance, wealthy firms and families receive generous government transfers” while “job opportunities have disappeared.”
The Lancet concludes, “The disturbing truth is that many of President Trump’s policies do not represent a radical break with the past but have merely accelerated the decades-long trend of lagging life expectancy that reflects deep and longstanding flaws in US economic, health, and social policy. These flaws are not only evident in faltering longevity … but also in the widening gaps in mortality across social class.”
The massive loss of life in the COVID-19 pandemic—centered in the American working class—only accelerated the decline of life expectancy in the United States, and more importantly, the stratification of life expectancy along class lines.
“At the time of Trump’s inauguration in January 2017, the health of the US population was already on a downward trajectory,” writes The Lancet. “Average life expectancy in the US had declined from 78.9 years to 78.7 years between 2014 and 2018, a period that included the first 3-year decline in longevity since World War 1 and the 1918 flu pandemic.”
The report noted that “since the 1980s, the disparity between social and economic classes has widened as high-paid manufacturing jobs disappeared. ... Despite a booming stock market … many people living in the USA were forced into precarious jobs that offered low pay and insufficient benefits. This widening income inequality has widened inequalities in health.”
The Lancet report offers a historical analysis of this process, in which both parties of American capitalism played a leading role. “Faced with economic stagnation and mounting inflation, President Jimmy Carter (in office from 1977–81) pushed to reduce government deficits through spending cuts.”
Democratic President Bill Clinton “embraced key aspects of the neoliberal, pro-corporate agenda.” Clinton deregulated “banks and telecommunications firms; imposing time limits and other restrictions on welfare benefits and nutrition assistance.” Under Clinton, “Stock prices rose rapidly,” while “income and wealth inequalities widened.”
The health care programs of Barack Obama “reinforced decades of market-oriented reforms that made profitability the fundamental measure of performance, drove the commodification of care, and increasingly vested control in investor-owned conglomerates.
“Declining US longevity between 2014 and 2017, and the minimal uptick in longevity in 2018, attracted substantial media attention. However, a focus on these recent trends risks obscuring how far the USA lags behind other high-income nations and how long these cross-national gaps have been in the making. Life expectancy in the USA was average among high-income nations in 1980, by 1995, it was 2.2 years shorter than the average of other G7 countries, and by 2018, the gap had widened to 3.4 years.”
The report comes to a shocking conclusion about the number of Americans who have died prematurely as a result of America’s soaring social inequality. “The extent of difference can also be quantified as the number of missing Americans—i.e., the number of US residents who would still be alive if age-specific mortality rates in the USA had remained equal to the average of the other six G7 nations. By this measure, in 2018 alone, 461,000 Americans went missing, an annual figure that has been increasing since 1980.
“Lagging life expectancy in the USA has coincided with growing income-based and education-based mortality gaps among adults. These inequalities in mortality mirror widening economic inequality, with rising incomes for the wealthiest decile of the population (and huge gains for the very rich), but stagnant real incomes for the bottom 50%. By 2014, the life expectancy of the wealthiest 1% of men was 15 years longer than that of the poorest 1%.
“Between 2000 and 2014, adult life expectancy increased by over 2 years for people in the top half of the income distribution, while the lower half of the income distribution had little or no improvement.”
The Lancet concludes, “The Trump administration represents the culmination of more than three decades of neoliberal policies seeking to privatise many public services and deregulate corporations to maximise profits.
“Trump’s election was enabled by the failures of his predecessors. A four-decade long drift toward neoliberal policies bolstered corporate prerogatives. … The rich got much richer while their taxes were halved. Workers’ earnings stagnated, welfare programmes shrank, prison populations greatly increased, and millions were priced out of health care even as government payments enriched medical investors.”
“The suffering and dislocation inflicted by COVID-19 has exposed the frailty of the US social and medical order,” notes the report.
“Americans’ health was deteriorating even as our economy was booming,” says Dr. Steffie Woolhandler, one of the committee’s co-chairs. “This unprecedented decoupling of health from national wealth signals that our society is sick. While the wealthy have thrived, most Americans have lost ground, both economically and medically.”
In its political conclusions, the report aims to convince the incoming Biden administration to carry out a fundamental break with the policies of its predecessors. But the very record presented in the report—of decade after decade in which the Democrats were the spearhead of a drive to redistribute wealth upward—makes clear that this is impossible. Biden was, after all, vice president under Obama, helping to organize the 2008 bank bailout.
The Lancet report, like a skilled physician, expertly lists the symptoms of America’s social disease. But if American society is sick, as Dr. Steffie Woolhandler insists it is, the appropriate medicine is not the Biden administration, any more than it was the Clinton or Obama administration. The disease they have identified is terminal. The solution is to be found in a fundamentally new and different political movement—one based on the struggle of the working class for socialism.
Democrats push ahead with school openings in California as state’s death total approaches 50,000
Yesterday, nearly 500 people died of coronavirus in the state of California, according to the Worldometer website, pushing the state's death toll to 45,971. While total infections and deaths in the state are down from their peak last month, daily infections are still averaging more than 10,000 every day.
In spite of the dangers, California Democrats, with the support of the teachers’ unions, are pressing ahead with plans to rapidly reopen schools in major cities throughout the state, in line with the nationwide campaign spearheaded by the Biden administration, which has described school reopenings as its top priority. On his second day in office, the Biden White House promised to have kindergarten through eighth grade students back to in-person learning by April 30.
The start of reopening yesterday of schools in Chicago, after the Chicago Teachers Union forced through a deadly and unpopular agreement with the school district, was only the beginning of a nationwide conflict pitting the ruling class, and above all the Democrats and their trade union lackeys, again teachers and the working class as a whole. One of the next major battlefields in the fight against the reopening of schools will be in California.
Los Angeles Unified School District, the second largest school district in the country, has yet to announce its plans on reopening but is working behind the scenes with Governor Gavin Newsom to open the schools as state and local officials grow impatient with refusals to reopen campuses.
Cases and deaths in Los Angeles County are staggering and on the rise. Reported cases have reached 1.2 million with more than 18,000 deaths. Currently, there are only 330 free ICU beds available in the county, as LA COVID hospitalizations just barely dip below a record high.
In the poorer neighborhoods of Los Angeles, nearly 1 in 3 school-age children tested are recording positive for COVID-19. The reopening of schools would be catastrophic for the families of students and teachers, as tragically the deaths of school workers, and even young children, are becoming less rare.
Last week, the Los Angeles city council published a letter in the Los Angeles Times to demand that schools reopen, and filed a lawsuit against the LA Unified School District for not reopening. LAUSD Superintendent Austin Beutner—who fully agrees with the need to reopen—argued the district cannot open immediately but only due to state restrictions. Beutner noted last week, “We are ready to reopen and want nothing more than to welcome children back to classrooms safely but we cannot break state law to do so.”
The United Teachers of Los Angeles (UTLA), meanwhile, has only requested that teachers be vaccinated before returning to the classroom. The demand for vaccinations, too, is a false choice. Even in the far-off scenario that every teacher in the United States has received their two vaccinations against COVID-19, children are still not vaccinated, and teacher vaccination does not prevent the contraction and spread of the virus among children. Moreover, the continued unabated spread of the virus produces mutations that are already putting the efficacy of current vaccines in question.
There is tremendous opposition to reopening schools among educators and other workers. “I am vehemently opposed to the reopening of LA schools and other school districts during a time when the pandemic surge has not totally subsided,” Elizabeth, a registered nurse from Los Angeles, said. “It is irresponsible and dangerous to place teachers, children and families at risk of contracting COVID-19, and more so now with the contagious UK variant taking hold in LA County and predicted to become the dominant variant by March.
“Teachers, parents and other sectors of the working class must stand together and oppose the murderous policy of the ruling class that is only concerned with protecting the profits of Wall Street. They will not be safe until the virus is brought completely under control through a vigorous vaccination campaign. Teachers and other sectors of the working class must push back on the Democratic Party leaders and unions who are pushing for this murderous policy in the name of profits!”
This week San Diego Unified School District (SDUSD), the second largest district in the state, reached a deal with the San Diego Education Association (SDEA) to reopen in-person “learning labs” offered to students from low-income or immigrant families, homeless or foster students, or students with special needs. This plan allows more than 22,000 eligible students on campuses, of the district’s estimated 97,000 student population. These “learning labs,” which will hold up to fourteen K-5 students and ten 6–12 students per classroom, are the initial phase of throwing teachers and students back into classrooms.
The city’s schools are continuing with “hybrid” school returns, where select students are to be on-campus for a limited amount of time, and their teachers perform regular full day instruction. Currently, San Diego County has more than 35,800 students in full in-person instruction, 103,000 students in hybrid learning, and 34,200 employees on campus.
In a statement on the tentative agreement, SDUSD Board President Richard Barerra declared that once more teachers are able to get vaccinated, the district will begin requiring them to return to in-person instruction, even if the county case rate still remains in the “purple tier.” The major hospitals in the county currently remain near 100 percent ICU occupancy, as they have for most of the winter.
San Francisco is also pushing forward with reopening. Last week, the city filed a lawsuit, the first of its kind, against its own school district, San Francisco Unified School District (SFUSD), claiming the district had “failed to offer classroom-based instruction whenever possible.” On Tuesday, the city attorney, Dennis Herrera, amended the lawsuit claiming “the district is violating the state constitution as well as state law by keeping students out of the classroom.”
SFUSD had originally planned to reopen schools for the district’s youngest as well as special education students under a hybrid model as early as January 25. Widespread opposition from teachers and parents effectively delayed reopening until March 25, as the district had not reached an agreement with the United Educators of San Francisco (UESF) in December. Since December negotiations with the district, UESF has demanded only that teachers be vaccinated prior to returning to classrooms.
Rank-and-file teachers and school workers understand that schools cannot be reopened safely, in any capacity, while COVID-19 continues to spread unmitigated and the vaccine distribution remains stalled. Resources must be equitably devoted to assuring students and teachers have the resources necessary to facilitate effective online education, and schools and non-essential production must remain closed until the spread of COVID-19 has been contained.
This requires a struggle not only against school administrators but the Democratic Party and the trade unions, which are serving as their chief instrument in beating back the opposition of teachers.
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