It’s time for America to take its medicine
In the midst of the most disruptive global event we’ve seen in decades or generations, looking at where we are and how we got here, I’m struck by a thought I just can’t seem to shake.
The United States of America has enjoyed a long period of staggering prosperity, together with a concomitant period of growing wealth inequality. For a very long time now, with only a handful of exceptions, America’s ceilings have risen and its floors have fallen. Its focus has been hyperproductively narrow on some axes and self-destructively absent on others.
In other words, America has cleaned the whole house top to bottom, but hasn’t slept in three days. America has run fifteen miles on the treadmill, but forgotten to make dinner for the kids. America has filled out a thousand job applications, but hasn’t written any of the cover letters. America has been skipping leg day for decades.
In other other words: thanks to COVID-19, America is finally slowing down enough to make it clear that it has spent a very long time in a deeply manic episode. It has made the classic mistake of many patients: it started feeling better and went off its meds, even though the meds were precisely what was making it feel better. (Thanks, Reagan.)
COVID-19 has shown us, and will continue to show us, the profound lapses in our healthcare system. The ability of America’s governed to access healthcare resources has long been tenuous at best, gated by a complex and expensive insurance system and by the whims of employers, and this global health crisis has revealed just how tenuous. But, of course, this crisis is about more than health. Health is how it got in the door, but it has also shined a spotlight on the deficiencies of our labor protections, of our access to secure housing and food, and so on. These, too, are things America has been neglecting in its hyperfocused pursuit of profit.
There has been a growing hope among progressives that this pandemic would be a watershed moment, that the suffering would be on such a wide scale that even the most rugged of individualists couldn’t help but surrender to empathy. Though I share this hope, I… am not holding my breath. I’m skeptical that even this magnitude of suffering — and the magnitude of suffering we’ll see in the coming months — is sufficient to sway people whose social politics are by design indifferent to this kind of empathy.
The good news is that it doesn’t have to. Because even if we take the most alienating, objectifying, nakedly exploitative capitalist position, completely disregarding human interests in favor of the interests of capital, the hidden lesson of COVID-19 is that this kind of infrastructure — health, housing, food, basic income — is essential to capital, not just to humans. COVID-19 has stress-tested the infrastructure of our daily lives, both as individuals and as a society. By and large, this is a test that we’ve failed.
And it’s crucial to note that what I’m saying here is not just that we need more healthcare infrastructure, though of course we do. Ultimately, it doesn’t matter how robust our healthcare infrastructure is, how well-stocked our hospitals and how well-trained our doctors, if people don’t have meaningful access to it. It doesn’t matter how high we raise our ceilings if we let our floors drop away. What I’m saying is that meaningful healthcare access — like food security, like housing security — is itself the infrastructure that we must develop. That sort of social infrastructure is the medicine that America has — cheerfully, productively — gone off of.
Even in a maximally (comically, absurdly) capitalist mindset, COVID-19 reminds us that at the end of the day, the human body is the artery that delivers labor to capital, the vein that delivers demand to supply.
We tend to see calls for social programs presented in moral or emotional terms: “Everyone deserves to eat,” or “Do we want to be a country that abandons its citizens?”, etc. But providing for the material needs of the body politic, the body economic — attending to its health, to its nourishment, to its shelter — is not merely a matter of the abstract “What is a human entitled to?” or the sentimental “What kind of society do we want to live in?” The real lesson of COVID-19 is that, in very pragmatic terms, social welfare is itself the infrastructure of society, of capitalism. (Whether and to what extent we want to preserve a society that’s coextensive with capitalism is another question, of course. But that’s the society we have today, and we need to make it keep us alive.)
It’s worth remembering that a lot of people go off their meds not just because medicine is expensive and a hassle, but because being the sort of person who needs medicine is cognitively costly. It feels like a threat to my identity as a healthy and powerful and independent person to have to take cholesterol pills or antidepressants or whatever. Societies more broadly, it turns out, are susceptible to the same kind of cognitive distortion — being the sort of person who needs social support is an identity threat for many Americans, and being the sort of society that gives out “handouts” is an identity threat for America itself. At the end of the day, though — no matter how threatened your identity is, no matter how painful it might be to turn away from your delusions about your vigor and independence — you still need to take your medicine. In fact, it’s precisely taking your medicine that makes possible your return to vigor and independence.
I hope we can collectively learn this lesson and get back on our meds, though I imagine it’ll be a little while yet before we start feeling better. In the meanwhile, advocate for the development and deployment of more robust social infrastructure, and don’t let yourself get derailed into conversations about rights or entitlements or national identity.
We live in a world so interconnected that there is no longer such a thing as a “local problem.” All problems today are global problems. That’s why, ultimately, this isn’t about what we’re owed or what we owe to each other. It’s about laying the absolute minimum groundwork for a functioning society resilient against the system shocks that are coming.