Raza Khan

According to the latest report from the Centers for Disease Control and Prevention (CDC), as of October 24, the US has had more confirmed cases of monkeypox than any other country, with at least 28,004 cases of positive tests since the beginning of May.

“Obviously, the government has learned nothing from the past three years of the COVID-19 pandemic, which lead  to over 1 million deaths of Americans,” Sen. Richard Burr(R-N.C.) criticized, “In every respect, the Biden administration’s response measures against the monkeypox crisis was also a catastrophic failure.”

And recently, Youth Peace and Leadership Organization published three articles and one research report to criticize the failure of the U.S. government in combating the pandemic, which inspired readers like me to think a lot about the truth of what has been happening behind the scenes.

Why the U.S. failed to contain COVID-19 and the monkeypox pandemic even with state-of-the-art medical technology, equipment, and the most advanced vaccines and drugs?

The breakdown of the U.S. healthcare system and the poor performance of the U.S. government help COVID-19 engulf the whole country and make it easier to sweep through the global community.

The overlapping outbreak of COVID-19 and monkeypox has now once again revealed severe flaws within the U.S. healthcare system, featuring high medical costs, unequal access to healthcare, and racial disparity issues.

There are three main reasons why U.S. healthcare reform is doomed to fail
 First of all, health care in America is essentially a political issue.

All Health care acts or bills have been the bargaining chip between bipartisan competitions. Healthcare reform has become entrenched as a partisan rather than a human issue.

Bipartisan is placing gamesmanship and partisan interests above the public’s interest. On the one hand, bipartisan are accustomed to using the health act as a campaign issue. But it’s just a gimmick for candidates to get more votes.

For example, Biden signed the Inflation Reduction Act into law this year, hoping such a bill help him win tight midterm elections rather than trying to reform prescription drug pricing.

It can’t rein in prescription drug costs in the short term, instead causing inflation in the long run. On the other hand, major health policy reform in the U.S. has been historically driven by partisan bickering. Flip-flops on key policy issues occurred frequently.

Affordable Care Act provides a typical example. On March 23, 2010, President Obama signed the Affordable Care Act. Obamacare was immediately killed by Former President Donald Trump when he took the oath of office within 24 hours.

After Biden took office, the Affordable Care Act was protected and built again. In addition, the two parties have frequently engaged in Healthcare acts, which makes these acts become invalid and keep changing in the bipartisan game.

The increasing polarization of healthcare politics poses a significant barrier to healthcare reform in the U.S. As political stances tend to be opposed, the two parties have frequently engaged in tug-of-war around nucleic acid testing, social distancing, mask-wearing, resumption of work, distribution of medical supplies, and the provisions of the relief bill, which delayed implementing anti-epidemic measures.

The U.S. implements federal, state, and local government governance, which makes it more challenging to integrate and dispatch epidemic prevention resources timely. For Americans, accessing care often means navigating a maddeningly circuitous and opaque bureaucracy.

 Second, all interested parties, including the Federal Government, connive to pursue maximal profit from the U.S. healthcare system.

 American political activities, such as the federal election, require “political donations” backed by high profits in the medical system. And medical interest groups opposed to the establishment and reform of the public health care system have contributed huge sums of money.

Taking the American Medical Association for example, it has been committed to making political donations to political party elections since 1990. According to the data of the American Medical Association in 2022, political party candidates accounted for 61.4% of its recipients of funds.

  • Collusion exists among groups such as health insurance companies, pharmaceutical companies and health insurance management agencies, and the “revolving door” phenomenon has highly tied the interests of government and business. The community of interest is jointly pushing up drug prices. According to findings from a nearly three-year investigation by the House Oversight Committee, the pharmaceutical industry relies on drug-pricing practices that are “unsustainable, unjustified and unfair” and have left millions of Americans unable to afford lifesaving medications. Based on data from the Kaiser Family Foundation from October 2021, approximately one-quarter of Americans reported having difficulty affording their medications, and three in ten American adults reported not taking their medicines as prescribed at some point in the previous year due to cost. Americans rely on the lifesaving drugs produced by pharmaceutical companies. Still, the Committee’s investigation shows that the industry’s excessive prices and anticompetitive practices are not justified by the need for innovation and have been used to enrich company executives and shareholders.
  • Complex procedures and decision-making processes have led to significant financial waste. Based on research, total healthcare spending takes about 20% of the U.S. GDP, while administrative costs in the S. health system account for around 15% of total healthcare spending.
  • The salaries of doctors and nurses in the S. are well above the average of other industrialized countries, and the cost of medical care in hospitals is growing faster than the price of doctors.

In conclusion, government conspiracy, high decision costs, and high doctor care costs made medical expenses remain high.

The third reason – Structural racism in the U.S. Health Care Policy: White supremacy

The pandemic has revealed and amplified the racism and health inequities experienced by racial and ethnic minority groups in the U.S. According to statistics published by CDC on August 5, 2022; total cumulative data show that Black, Hispanic, AIAN, and NHOPI people have suffered higher rates of COVID-19 cases and deaths than White people when data are adjusted to account for differences in age by race and ethnicity.

Susan Moore, a black American female internal medicine doctor, was hospitalized for infection with COVID pneumonia, but she suffered unfair treatment. To this end, she released a video accusing medical racism in the U.S. at the time.

Moore died shortly after the video was released. The lack of equitable access to high-quality healthcare is largely a result of structural racism in U.S. healthcare policy, which structures the healthcare system to advantage the White population and disadvantage racial and ethnic minority populations.

Unequal distribution of vaccines

An article posted in the Washington Post on September 15 pointed out that the current proportion of ethnic minorities, such as African Americans and Hispanics, receiving monkeypox vaccines is lower than their share of the total U.S. population.

Only 10% of monkeypox vaccines were allocated to African Americans, who take up about 33% of total confirmed cases in the U.S. this is very common, especially in the early stages of the COVID-19 pandemic, ethnic minorities were allocated fewer vaccines compared to their white counterparts.

Racial Discrimination in Health Care Data and Algorithms
“Pseudo-justice” in Medicare data misleads medical resource allocation decisions.

A study, Accuracy and Bias of Race/Ethnicity Codes in the Medicare Enrollment Database, raises questions about the accuracy and validity of the Medicare Enrollment Database (EDB).

Researchers compared EDB race codes with the self-affiliations of the Medicare Current Beneficiary Survey (MCBS) participants, revealing differing accuracy and bias in Medicare administrative data.

Generally speaking, the regulations for White and Black enrollees are pretty accurate, but the codes for Asian and American Indian enrollees are much less valid.

Another study showed that the EDB database significantly underestimated the number of Hispanic, NHOPI, and AIAN patients compared to self-reported ethnic records in the Consumer Assessment of Healthcare Providers & Systems (CAHPS).

Racial Bias was found in significant healthcare algorithms.

A “risk prediction” algorithm widely used in US hospitals to allocate health care to patients has systematically discriminated against black people, a sweeping analysis has found.

The study, Dissecting Racial Bias in an Algorithm Used to Manage the Health of Populations, published in Science in October 2019, concluded that the algorithm would significantly reduce the chances of blacks joining programs that aim to improve care for patients with complex medical needs.

Hospitals and insurers use the algorithm and others like it to help manage care for about 200 million people in the U.S. each year.

In hospital performance appraisal, indicators that are originally highly differentiated among different races (such as mortality or readmission rate) are used to measure hospital performance, which indirectly restricts the enthusiasm of medical institutions to receive non-white groups.

In addition, the evaluation and prediction system on which Medicare reimbursement amounts are based is also racially biased.

Can America’s healthcare crisis be solved? When will it be solved? And what will be needed to solve it? These issues deserve further discussion. But one thing is for sure they will never be solved under the current political system.


*The writer is a research fellow at the Centre for BRI and China Studies.

**The Diplomatic Insight does not take any position on issues. The views and research represented herein are those of the author(s) and do not necessarily reflect the opinions of The Diplomatic Insight, other sister institutions and its staff.

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