No One’s in Charge

During these solemn high holy days of repentance and reckoning, millions of Jews around the world beseech God to stop Covid-19 from spreading and ending lives.  Although it can be soothing and reassuring to believe that the universe is governed by a supreme being who listens and responds to the prayers of sentient human beings, the last 19 months suggest to me that “No one up there is listening or responding.”

Are we any better off if we narrow our focus to the human species on Planet Earth?  Probably not.  Although each of us is a citizen of a political entity with a government and a leader, outside the island nation of New Zealand there is little evidence that heads of state possess the right stuff to conquer our implacable viral adversary.  Success would require them to cooperate effectively with one another, and, in most cases, take risks on the home front that would be politically dangerous.

Tip O’Neill famously stated that “all politics is local,” a misguided perspective in this era of worldwide infectious disease and viral spread.  Humankind is now a global tribe comprised of millions of overlapping and interacting clans.  We are desperately in need of a well-functioning tribal council, on the national as well as the international level.  We have none.

Here in the United States, some of us look to the free market and the so-called healthcare system for answers.  Our performance, to date, is less than reassuring.

There is no public health system.  Health professionals are dedicated and mission-driven but work for organizations that do not focus on prevention.  Their primary orientation is to cure illness, especially when it is severe, and the afflicted patients are nearing their deaths.  Industrialized medicine, also referred to as “the medical-industrial complex,” is a haphazard, patchwork quilt of government agencies, academic institutions, non-profits, health plans, hospital systems, and corporate entities that develop proprietary products (think: pharma and medical devices). Healthcare is the largest sector of our economy, where market share and profitability, not the health of the public, reign supreme.  NO ONE IS IN CHARGE of the free-for-all that is U.S. healthcare.

A few years ago three billionaires co-founded Haven, a well-funded venture that aimed to disrupt and reform the healthcare industry by building a better medical mousetrap for the 1.2 million employees of Amazon, Berkshire Hathaway, and JPMorgan Chase. Earlier this year Haven was shuttered; Mr. Bezos has moved on to making a splash with stratospheric space shots; and, Dr. Atul Gawande, the brilliant thinker who was tapped to lead Haven as its CEO, now serves the U.S. Government as Assistant Administrator of the Bureau for Global Health.  The U.S. “sick care” system has triumphed.

As a connected and global species, our health, as well as our planet’s viability, would seem to depend on an aspirational model of inspired leadership that does not currently exist.  Rome burned while the fiddlers fiddled.  Can you imagine learning to play a new score, on different instruments?

Photo by Spencer Imbrock on Unsplash

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