Friday 10 April 2020

Day 25 of self-isolation

Good news - Boris Johnson is out of intensive care.

Bad news - another 881 deaths in the UK.

So what will happen when we come out the other side of this? I mean, apart from a lot of wild parties?

Economies world wide will be very depressed; down at least 30%, maybe 50%, maybe even more. And the money hose that we turned on in the last few weeks, will have to be paid for, either via taxation, or by inflation. I think inflation . I'll post more in the economics some time in future.

In this post, I want to discuss the future of healthcare. Suddenly, it has been forced on us that spending money on healthcare isn't just a luxury, it's a necessity. We didn't expect Covid-19 - except that we did. We knew all along that something like this could happen, and people have been talking about it for many years. But suddenly, it's real.

Healthcare systems will change.

The biggest change will be in the USA, where the private insurance system has been exposed as ineffective. It will be unable to pay for the 2020 USA pandemic. In America, the cry will be "Medicare for all", calling for a system whereby healthcare is guaranteed for everyone.

Because, take New York. Do you think that hospitals are turning people away unless they have a credit card or insurance? Of course they aren't. At a time like this, it's "all pull together", and everyone who needs treatment, gets it, without being asked to pay at point of need. Just like our own dear NHS. And they'll work out how to pay for it later.

This might not happen on a federal level - congress seems to be deadlocked about even the most obvious measures, and I can't see Trump going for a policy that Bernie Sanders sponsored. But it could happen at a state level; for example, in New York. They have seen that health is something that is too important to be left to the private sector, who have demonstrated an inability to cope. And I could even imagine a cooperation between states without involving the impotent federal government - a "Cooperative States of America", whereby those of the states that wanted to be involved, all cooperated in a country-wide healthcare system, free at point of delivery.

But the UK systems will also change. Of course, it will still be our NHS, but the possibility of a pandemic will be taken really seriously now. The shortage wasn't hospitals - it turns out that we can turn an existing space into a huge hospital just by adding equipment and staff. No, the most obvious shortage was equipment, and the obvious answer is to build stockpiles of equipment. And not just PPE (masks, faceshields and gowns), beds and ventilators. And other stuff. We need expert medical people (it turns out that experts are useful after all) to think about all the possible pandemics, and stockpile equipment suitable for all of them.

A less obvious shortage, is staff. You can cancel all leave, you can ask people to work 96 hours per week with no weekends, you can recall retired staff and use final year students. But that still isn't enough. We need more medical people.

And the way to get more medical people isn't a weekly round of applause (although that is nice). The way to get more medical people, is to pay them more. Pay for their education, and pay them more per hour of work.

So in the UK (and I think in other countries) there will be a swing in the direction of better medical preparedness, via seriously large (and maintained) stockpiles, and improved pay and conditions for staff. Because surely we're all agreed that this situation should never happen again, in so far as we can make preparation.

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