Healthcare Workers Punished For Challenging ‘Profit Over People’ Management
The US medical system's drive to maximize profit has always been at the cost of public health, and amplifies the danger healthcare workers and their patients face from COVID-19.
The US medical system's drive to maximize profit has always been at the cost of public health, and amplifies the danger healthcare workers and their patients face from COVID-19.
This is a rush transcript and may contain errors. It will be updated.
Jacqueline L.: This is Jacqueline Luqman with The Real News Network. The world is facing an unprecedented moment in human history, a moment probably not seen since the outbreak and spread of the Spanish flu of 1918 and the Great Depression of 1929. But various countries around the world respond to the spread of COVID-19 in a myriad of ways, with many electing to enforce strict measures to limit the movement and contact of people with one another to slow the spread of the virus.
The response of the US has been markedly different, to the point of now proving to be wholly inadequate. Nowhere is the weight of the consequences of the US response more evident than on the front lines of the fight against the spread of COVID-19, which is in medical facilities around the country.
So joining me to talk about what the current situation looks like for medical personnel, what we’re facing as a nation because of it, and how capitalism has skewed the priorities of this society to the detriment of a certain class of us, in it is Dr. Michael Pappas, who is a left activist and contributor to leftvoice.org, who also happens to be a resident physician currently working at a hospital in New York City. Dr. Pappas, thank you so much for joining me.
Dr. Michael P.: Thanks for having me.
Jacqueline L.: So first, I want to ask you something basic, because we keep hearing this in the news, “It’s the end of this week.” We keep hearing that the next few weeks are projected to be significantly more difficult for medical staff around the country, with an expected strain on the healthcare system to be exponentially worse because of higher resulting infections and possibly more deaths. Why is this the case?
Dr. Michael P.: I think that to understand what we are in for the next couple of weeks, it’s important to understand what our medical system was experiencing even before the pandemic hit. So prior to the pandemic hitting, I’ll just use New York as an example, nurses in New York were already advocating strongly that they needed improved staffing ratios in hospitals throughout New York City.
I work in a hospital where staff, the nurses who work in the emergency room sometimes care for 16 to 18 patients for every one nurse. And anybody who has experienced being in an emergency room can imagine what that would be like if one individual was being split between 16 or 18 patients. They were completely overworked, completely short-staffed. It got to the point that the largest nursing union in the country was pushing to potentially strike in five hospitals in New York City, advocating for safer staffing ratios.
At that time, hospitals pushed back, and I’m sure we’ll get into this a little bit later why, but they pushed back and they refused to give those staffing ratios. This was all prior to a pandemic hitting New York City or the United States and the rest of the world. So we can only imagine what an emergency room would look like or what a hospital would look like with a pandemic hitting the city.
I work with other physicians who are working in emergency rooms, and they say that they’re currently intubating or putting a tube down people’s throats to help them breathe, the same number of people in one day that they typically do in an entire week in a normal setting. They’re typically seeing the same number of people die in one day that they typically do in an entire month. And that’s right now. And I think that as we’re going to see more and more of this virus spreading, partly because the United States did not have a proactive response to the viral outbreak whatsoever.
The country had several month head start to prepare. And instead of upscaling mass production of masks, ventilators, supplies that would be needed, recruiting staff, those types of things, they, many hospitals that’s now being documented, opted for something called just-in-time production, which would basically be something where they wouldn’t have to buy supplies in advance. Instead, they could wait to see if the pandemic actually hit or not, because buying supplies in advance would be an extra cost for hospitals if the pandemic never hit. So they didn’t buy supplies, they didn’t prepare, and now we’re seeing what we’re seeing.
So it was a combination of a very ill-prepared medical system from the get-go, combined with not actively taking steps to mitigate the spread of illness, and then combined with a president in office right now who did not take things seriously whatsoever. It was said that the entire administration was talking about how, “Oh, this is just a democratic hoax,” and then, “This is just as bad as the flu,” and then, “It’s not that bad at all,” and now, “Oh, maybe it’s a little bit worse than we were thinking.”
And all of those delays and all of the conflicts of interest in the administration, it A, caused the public to question what was going on and not actually protect themselves, and B, the conflicts of interest kept any measures being taken for preparation. So I think all of those things combined to lead to the point that we’re going to be seeing this exponential increase in the coming weeks.
Jacqueline L.: And all of this led, as you said, to people not taking precautions. So more people became infected with the virus than would have had they were taking the proper precautions. Most of those people didn’t even know they were exposed to the virus at all. And now after the incubation period, we’re assuming the incubation period has factored into this, 14 days I think is the incubation period that’s been explained, now more and more people are starting to become sick. So does that wrap it up in a little bit of accuracy so our viewers can understand why the numbers of sick are going to likely skyrocket in the next few weeks?
Dr. Michael P.: Yeah. I think that that’s accurate. I think the only other point that would be important for people to think about is just the fact that the United States is the only industrialized country that doesn’t guarantee paid sick leave to its population. So I think that that was something that really factored into this, because when individuals have to work to make ends meet pretty much, and people are living in such precarity throughout the country, that if they are feeling a little bit sick, then they tend to just go to work anyway because they need to because it’s a necessity.
So this virus is one that acts in very odd ways. You hear a lot of times in the media, “It’s a dry cough and fever.” And it’s not always a dry cough and fever. We have people present to our emergency room with very, very bad abdominal pain and nausea, some vomiting, to the point that we think that maybe they need to have surgery because something’s wrong with their bowels. They get a CT scan, things look fine, but we do a swab and they’re COVID positive.
So part of this is that because people couldn’t take the necessary precautions because their social safety net and things like that have just been completely deteriorated in the United States over the years, even people with atypical symptoms or even if they were the telltale signs are less likely to stay home and protect themselves and then hence decrease the spread to others. So I think that’s another thing that factored in there.
Jacqueline L.: And that definitely brings into this discussion, the issue of class. But I want to go back for just a second to what you said about just-in-time purchasing that hospitals decided to pursue rather than ramping up purchasing of supplies in anticipation of this pandemic exploding in the United States, because this decision comes in the mid of hospitals across the country, or the results of this decision comes in the middle of hospitals across the country now taking action to punish healthcare workers who are doing exactly what you’re doing Dr. Pappas and what other doctors have done, doctors and nurses in frontline healthcare workers did an action earlier today in New York City, and who other healthcare workers have done across the country, and that is speak out about this insufficient supply of PPE for frontline healthcare providers.
Now the healthcare management say that this gag order, if you will, protects patient’s privacy, and that these guidelines about not talking to the media aren’t new for most medical facilities. But what does this mean in this particular moment? How is this helpful during this time? Does it do more harm than good, not just to citizens and patients, but to you and your colleagues?
Dr. Michael P.: Yeah. I find it comical the claim that health administrations make that these gag orders protect patients in any way. Before I actually respond to the funny joke that they like to make, I actually want to just talk about PPE really quickly. I think that it’s important for people to recognize the degree of the lack of PPE that healthcare providers are currently working with and why these actions are so necessary. There are people currently working in hospitals, so typically use a mask called an N95 mask, which is called N95 because it filters out around 95% of airborne particles.
And when certain procedures are being done or you’re around somebody often that are positive with coronavirus, you wear this N95 mask to protect yourself. In units in hospitals and in my hospital, for example, an individual gets one N95 mask per day that they are supposed to reuse the entire day. That under any other circumstance in any other situation would be something that could get somebody fired. You always would use an N95 mask for a patient, and then you would dispose of that N95 mask because there’s a chance of you contaminating yourself or contaminating other patients if you do not dispose of that N95 mask.
But currently, our hospital is asking healthcare workers to use one N95 mask per day. And while that may sound ridiculous based on the information I gave around potential exposure to the healthcare worker or to other patients, that’s actually a better situation than a majority of the hospitals in New York. Other hospitals in New York City give somebody an N95 mask that they’re supposed to carry around in a paper bag and they’re supposed to use that N95 mask for one week at a time. So they get the same N95 mask for an entire week. Now, you can just guess the potential of contamination and those types of things when it comes to N95 mask.
So this is how dire the situation has become, and why healthcare workers across the country are mobilizing to demand adequate PPE. If we are willing to put our lives and our wellbeing and the wellbeing of the people we love when we come home and potentially expose them on the line, then we expect to be provided adequate protective equipment when we’re caring for patients. So I think that that’s important to know.
Jacqueline L.: Yes.
Dr. Michael P.: When it comes to addressing the questions around healthcare executive saying that this is protect patients. I mean, the whole claim is comical. The HIPAA laws are in place to protect personal medical information when it comes to patients. Healthcare workers going out and speaking about the lack of PPE or supplies that they have that’s actually going to negatively affect the care for patients in hospitals has nothing to do with exposing personal information of patients.
No healthcare worker that is part of any of these actions is going around saying, “Jerry on the fifth floor, who’s 56-years-old.” That’s not the type of information that’s being disclosed. And if that information ever was being exposed, people have the common sense to obtain consent from those individuals before doing that.
What this is really about is that for large hospital corporations in the United States, their entire image is like their brand. They do not want their brand damaged. So they do not want this type of publicity. The healthcare system in the United States and the large industries that function inside of it, ultimately put profit over all else. Profit and the bottom line supersedes everything else inside of the United States healthcare system. The United States healthcare system does not care about community health or individual patient health if profit is being maximized. That is the prime goal.
So if that is the prime goal inside of this healthcare system, then healthcare workers going out and potentially exposing how hospitals are functioning, exposing facts like the fact that CEO at Mount Sinai Hospital while they talk about how we are all in this fight together they are hiding away in their condos in Florida. All those things look bad.
So they damage the brand of the specific hospital corporation or of the specific health center. And by damaging the brand, you might harm the number of individuals who want to come into your center and potentially get care there, which is a potential for profit to be extracted from that ill individual who enters that healthcare setting. So in order to protect that, you need to try to shun any semblance of openness, that when healthcare workers try to come out and speak about these problems, you need to try to come down on that right away.
There are stories that some of the nurses in another hospital at Mount Sinai on the West Side of New York who exposed the lack of PPE, their managers were saying to the rest of the staff, “We are willing to make examples out of them. We’ll also make examples out of you guys.”
Jacqueline L.: Oh, wow.
Dr. Michael P.: This is the mentality of the higher level management inside of these hospitals. So this is really why they’re doing these types of things, not because they remotely care about patient privacy.
Jacqueline L.: And again, I can’t help but emphasize that we are in the midst of a global viral pandemic where we’re not talking about a situation where people can decide if they want to use a particular medical facility or not, people will have no choice but to be taken to a particular, any medical facility that has the capacity, and a lot of medical facilities don’t have the capacity already to see and treat whomever is literally dropped on their emergency room doors.
So Dr. Pappas, the response by the United States has been to call for contracts to produce the PPE that’s needed by frontline medical staff, but we’re not seeing a mass production of what healthcare providers need to protect themselves and to protect patients. Why is this contract business an inefficient response to this crisis for frontline workers, and what would the better answer be?
Dr. Michael P.: The contract idea is it falls under this category of believing that the underlying mechanisms of the capitalist system address this crisis. And they’ve proven time and time again that they will not, and they cannot address this crisis. So the idea is that you don’t want to disrupt the mechanisms of the capitalist machine. So you want to keep the ownership of the means of production in the hands of these wealthy few individuals.
Jacqueline L.: Right.
Dr. Michael P.: So you basically say, “Well, they’re well-meaning. And since they’re so well-meaning and they’ve always been so well-meaning, we’re just going to give them a contract and they’re just going to see what needs to be done. And out of the goodness of their heart, because the invisible hand of the market somehow works that way, they will produce the adequate PPE that’s needed. And if we give them a little bit more of an incentive here and there, maybe give them a little bit more of a contract, they will produce what’s needed.”
And we’ve seen now if we ever needed to test that again, that’s not the way that things work. Even during this pandemic, companies that were producing ventilators were looking at ways that they can get larger grants or bigger bonuses to produce ventilators. All these companies knew pandemic was coming. They never shifted production. They sat there and they waited for their grants to be given because that’s how things have worked over the years.
They wait for these grants to be given from the government so then they can make more money that way, and then they’ll produce what they need to produce, still trying to drive down costs as much as possible, still exploiting their workforce as much as possible, and then they’ll produce some masks. And that’s what they were looking at.
And even during this pandemic, again, there were investment banks that were literally talking about how this might be an opportunity to maximize profit. This pandemic might be a great opportunity to maximize profit. That is the way that capitalists view these dynamics, even during a global pandemic. And I think it shows the literal rot at the center of this completely disgusting parasitic system that has shown time and time again that it has no ability to care for the masses of the population, it has no ability to be a steward to the earth that it’s destroying. It has no ability to do any of those things. And it’s just proving itself again during this pandemic, as people die, and as healthcare workers like myself are saying, “We still don’t have the adequate PPE and supplies that we need.”
Now as the alternative option, I think that what we really need right now is first off, one small step that could be taken, and finally it’s starting to be taken slightly more is, we have the Defense Production Act that should have been used much, much earlier to force these companies to produce the supplies that are needed.
Jacqueline L.: Right.
Dr. Michael P.: That should have been a no-brainer. But of course, we needed to first wait on the kindness of people’s hearts that don’t have hearts, to see if they’ll do something for the rest of the population. And then when they didn’t, now we’re going to try to twist their wrists a little bit to get them to produce the goods that are needed.
What really needs to happen is, these industries need to be nationalized. The entire healthcare industry needs to be nationalized and put under democratic worker control. And that isn’t just the hospitals, it isn’t just the clinics, it’s the pharmaceutical industry that cares more about blockbuster drugs than it does producing anything that benefits the mass of the population. That also would mean eliminating the for-profit insurance industry that only exists to deny care to the patients that I see.
I was just in clinic earlier today trying to get patients medications that they needed during a pandemic, and now I have to call insurance companies to try to get them to approve it because they’re denying it. So it’s eliminating those. It’s outside of the strict healthcare system. It means that these companies that are producing the supplies that are needed need to be nationalized and put under democratic control of the workers. That’s on a small microscale.
That’s why we developed our frontline workers Coronavirus Task Force at Mount Sinai Hospital, which is an interdisciplinary group of physicians, nurses, other medical workers, who basically what we’re saying is, “We know as workers what we need. We know what we need best.” A CEO hiding in Florida, eating their caviar, worrying about what champagne they’re going to drink that night, do not have any idea what the workers on the frontline in the workplace need. And I think that that goes for all of these industries. The workers need to rise up and need to control these industries because they know what’s needed best.
Jacqueline L.: It seems so logical, but we have to remember that capitalism is not a logical system at all. Last thing, in your latest piece for leftvoice.org because you are also a regular contributor to left voice, you write that Governor Cuomo and the liberal elite like him are more deadly than coronavirus. Can you quickly with the last few minutes we have left explain what you mean by that, and then wrap up by telling us how the viewers who are watching this can support you and your comrades in arms?
Dr. Michael P.: So to answer that question, I think that one of the things that often happens is we have liberal lead individuals like Governor Cuomo or Bill de Blasio, who for some reason because they’re able to speak in complete sentences, have now become the darlings of the corporate-controlled mainstream media because they give this idea that they care about the general population. All of a sudden, the mainstream media is now proposing that Cuomo runs for president, all of these types of things.
And really, I think part of the reason that I make that claim in that piece is because they, I think more than any other sector of our society, help to disguise the rot that is at the center of this capitalist system. They help to give it a friendly face. And what I mean by give it a friendly face is, they speak about that… Governor Cuomo may talk about the meatball sandwich he had with his daughter the other night, how he’s just one of the general population, and they disguise the fact that they are nothing like the rest of the working class. They experience nothing that the rest of the working class experiences, and they know nothing of the troubles of the rest of the working class. And they make it seem as if, if we just elect another one of them, everything will just go back to the way it was.
Well, that’s not the case because under Obama is where we had bailouts to Wall Street and all of those types of things. Under Obama is where more and more black and brown people were thrown into prisons. So they act as a disguise for all of these horrible, horrible systems, and they don’t allow us to see the fact that it is the system as a whole that is a problem. And neither the corporate Republicans or the corporate Democrats are going to be the solution to that. So that’s why I think that they’re more deadly than coronavirus, because they keep us from actually making the true changes that are needed. They keep disguising the capital system.
The last thing I’d say is, if people think that the suffering due to coronavirus is bad, the suffering due to climate change the capitalist system is causing is going to be exponentially worse than anything that coronavirus is causing. This is just the tip of the iceberg. So they help to defend that system. So that’s the problem.
I’d say the way that people can support frontline healthcare workers is a number of things. I think, one, we need to collectively push as a population that we need adequate PPE in healthcare settings right away. And I think workers who are in production industries need to start… I mean, they know what they need best, they all have always known what they needed best, but they need to start if they haven’t, many already have… if they have, continue mobilizing, if you haven’t, start mobilizing your workplace, start mobilizing your workplace to push. If they haven’t started producing the needed supplies, then mobilize your workplace to force the hand of the elite executives who are running it to do that.
The other thing that I’d say that the general public can do is, there’s a lot of pressure put on the general public from the capitalist elite to get people back to work. President Trump was talking about how, “Everybody is going to be back to work by Easter. Everything is going to be fine. Everything is going to go back to normal.” Wow! That’s obviously for anybody who has the smallest sense of common sense and more than one functioning neuron, that that makes absolutely no sense.
It also exposes, I think, the need of the capitalist economic system for the labor of the masses. That’s why it wants everybody to get back to work so quickly because it needs to exploit the labor of people to continue the process of wealth accumulation at the top that has been going on for forever now. So I think that one thing that people can do is when they see propaganda like that in the media, they can actually by actively trying to protect themselves and their family members, and for pushing for even spreading ideas like this, “We won’t die for Wall Street idea,” it spreads the idea throughout the population that people should not be exploited and should not lose their lives just because the wealthy elite need a few more dollars.
So I think that that’s the other thing that people could do, just even on their own on an individual level, that could really help in this fight.
Jacqueline L.: Dr. Pappas, I cannot thank you enough for not just your time and coming to talk with us today about these issues but your work, which we say someone’s tireless work pretty frequently and almost flippantly, but that is not even a flippant term to use in the case of the work that you are doing and the work of your colleagues, who are not only on the healthcare front lines caring for patients who are infected with the COVID-19 disease along with everyone else who has to come to the hospital and needs help, and also fighting for the health and safety of yourself and your comrades as well as the patients you take care of in the general public. So thank you so much for your time, and absolutely your definite tireless efforts in your works. We really appreciate the illumination you brought to this discussion today.
Dr. Michael P.: Thank you. Thanks for having me.
Jacqueline L.: And this is Jacqueline Luqman with The Real News Network in Washington DC. I’m not going to die for Wall Street, and neither should you.