Fight for health care to treat everyone, not to make profit

By Róger Calero
August 17, 2020

The big-business press tells us COVID-19 is “the great equalizer,” that it strikes without regard to “wealth, fame, and prestige.” And, most importantly, they tell us, “We’re all in this together.” But these claims are lies that clash with the grim reality faced by millions of working people in the U.S. and around the world. The fact is, your chance of surviving COVID-19 is determined largely by which side of the class line you are on.

In the early stages of this disease, those who can afford to be treated in well-equipped and adequately staffed private medical centers, with access to specialized and trial medications, sufficient working ventilators, etc., do far better than those who are told to stay home until they’re gasping for breath, with their lips and fingernails turning blue; or those who do manage to get a bed, but at an understaffed, crowded public hospital. And especially those who are elderly and get trapped in nursing homes, which in the U.S. have been the main incubators of the disease and of death.

These factors are consistent with what working people face with all  illnesses. One example that underscores the truth about health and health care access for working people under capitalism is the current epidemic of diabetes and related amputations.

More than 30 million people in the U.S. have diabetes. Another 84.1 million have prediabetes, which if not treated can lead to diabetes within five years. It is the seventh leading cause of death in the U.S.

The disease can be managed if you have accessible health care. But it is in working-class areas — especially in Appalachia, the South and in urban neighborhoods across the country with large numbers of Blacks and Latinos — that the disease is most prevalent and destructive.

Every 17 seconds someone is diagnosed with diabetes, and every day 230 people will suffer a diabetes-related amputation in the U.S., according to Dr. Foluso A. Fakorede, a specialist whose work has brought attention to the devastating impact of untreated arterial disease among working-class patients.

The rate of amputations across the country grew by 50% between 2009 and 2015, with diabetic patients now undergoing some 130,000 amputations a year. The biggest toll is among the poor and the underinsured, with African Americans losing limbs three times as often as others.

Fakorede says there are relatively simple limb-saving screening and treatment procedures that could be done that could determine whether surgery is needed before applying a blade to a diabetic patient. But those are not being promoted by the medical “establishment.”

Atherosclerosis and peripheral artery disease are common circulatory problems among patients with uncontrolled diabetes. This can complicate the healing of a blister or foot injury, and turn them into a life-threatening infection that requires amputation.

By performing an angiogram — an imaging test that shows precisely where blood flow is blocked — millions of amputations could be prevented by cleaning the arteries out and widening the blood vessels, says Fakorede. But, as ProPublica magazine said in May, “General surgeons have a financial incentive to amputate; they don’t get paid to operate if they recommend saving a limb.”

Some 50% of diabetics who undergo amputation die within two years of the surgery, Fakorede says. Once an amputee, they’re far more likely to lose their jobs and a productive life. Depression, and the feeling of being a burden to their family, often follows.

“It’s the norm to go to Walmart and see an amputation or a permacath [a permanent catheter to facilitate frequent dialysis] in the neck,” of fellow shoppers, said a medical device sales rep friend of Fakorede. “If you don’t see one, then you didn’t stay more than two minutes.”

It’s common to see relatively young people missing limbs rolling in wheelchairs on the sidewalks of Harlem, Queens or the Bronx, in the Mississippi Delta or Appalachia.

The high rates of diabetes, high blood pressure, obesity, and other so-called comorbidities for COVID-19 among working people in the U.S. are not because of the lack of “awareness,” or an “education problem,” as the capitalist rulers and Democratic and Republican politicians say, blaming us for getting sick and dying. These are social consequences of capitalist economic relations that determine access to health care, proper nutrition and other necessities.

One in 10 Americans does not have access to a grocery store that sells fresh food, much less at affordable prices. In 2015, 23.5 million lived in so-called “food deserts” — areas where the majority of residents don’t live near a supermarket.

The bottom line is, capitalism is bad for your health.

When health care is not for profit

In Cuba, a popular revolution in 1959 eradicated capitalist social relations as workers and farmers took political power and formed their own government. They began to rebuild their health care system after thousands of doctors whose main motivation was to profit from their practice fled to the U.S.

They based the revolution’s health care on prioritizing the education and training of large numbers of doctors and other health care workers, who operated out of facilities located in working-class neighborhoods where they lived. They provided health care — especially preventative health care — at no cost to all.

In Cuba, medical and scientific advances serve the needs of working people, and the number of amputations due to diabetic complications is declining.

Since 2007, Heberprot-P, a new kind of therapy for hard-to-heal foot ulcers has been used in health care centers and hospitals throughout the island, showing great results. Diabetes patients treated with Heberprot-P have an amputation rate four times lower than those without. More than 17,000 amputations have been avoided, Cuban newspaper Adelante reported last year. 

By 2019, more than 300,000 patients in 26 countries had received Heberprot-P treatment. Tens of thousands of volunteer Cuban doctors and nurses provide medical services in the most hard-to-reach parts of countries around the world and also make available vaccines and medications developed in Cuba, like Heberprot-P. And like Interferon Alfa-2B, these are being used to fight the effects of COVID-19.

This is only possible because capitalist relations were overturned in Cuba.