This article continues in Part 2.
My fellow Americans… we’re currently in month 784 of 2020, aka The Plague Times, so let’s take stock:
- 8.4 million Americans have contracted the novel coronavirus.
- 41.4 million have been infected worldwide.
- 222,000 Americans have died from the disease.
- 1.13 million have died worldwide
It’s… a lot, I know. The facts are grim, and they’re only getting grimmer.
But if you’re feeling like all of this death, economic destruction, and tragedy came out of nowhere, I have even worse news for you: it didn’t. For the sad effects of the pandemic are neither sudden, isolated, nor unpredictable.
Rather, they are the results of a system that has been balancing on a precipice for decades. A global pandemic was simply the last push needed to send this car over the cliff and hurtling spectacularly to the rocks below.
The coronavirus has singlehandedly revealed the pre-existing conditions our country has been ignoring, denying, and dismissing since
dinosaurs Ronald Reagan roamed the Earth White House.
A brief history of “pre-existing conditions”
The United States has struggled with healthcare prices for decades. The issue became even more politicized by the passage of the Affordable Care Act. Love it or hate it, it’s currently the law of the land. So let’s put a pin in the ACA for now. I promise we’ll definitely go over it in much greater detail when [trails off into incoherent mumbling].
Before the ACA, insurance providers could deny people health coverage on the basis of something called “pre-existing conditions.”
A pre-existing condition was a health problem you had experienced in the past, which insurance companies used to deny health insurance claims in the present. In some cases, they wouldn’t deny the patient insurance itself, but they’d deny insurance claims. In others, you’d be denied insurance altogether!
So you’d pay into your health insurance plan for years. Then you’d break your arm and ask your insurance company to help pay the bill. Only they’d tell you, “Nah, sorry. Says here you fractured your wrist when you were eight. That there’s a pre-existing condition, so we’re not paying for your broken arm. What’s that? How long did it take us to comb through your medical records looking for any excuse not to pay up? Sir, I resent the implication, sir!”
This is a minor exaggeration. But not really!
Pre-existing conditions make things… risky
So yeah. Pre-existing conditions were really a thing. Hence the overarching metaphor of this article.
The theory was that a pre-existing condition made you more susceptible to certain illnesses and injuries. And therefore, you should’ve seen it coming (or you had it coming… either way). With hoops like that to jump through for insurance coverage, you were probably better off entrusting your life to Miracle Max than the American healthcare system.
To use the parlance of our current medical hellscape, it sounds a fuckova lot like the “underlying conditions” that the CDC says make individuals more likely to experience severe complications due to coronavirus.
Thus, our country’s pre-existing conditions made it particularly susceptible to catastrophic collapse at the hands of a global pandemic. And just as the virus is particularly vicious to the elderly, the impoverished, and the immunocompromised, so it is to our nation.
Healthcare in the United States is fucking expensive af. (Yes, that’s two fucks in one sentence, that’s how seriously I take this issue.) Who knew?
The pre-existing conditions
Privatized health insurance, medical lawsuits, for-profit pharmaceuticals, and extremely limited options for single-payer health insurance or government-subsidized insurance drive up the costs of medical care for everyone.
If you can afford top-level insurance, great! You have the freedom to access top-level medical care on a regular basis. You get routine check-ups to head serious issues off at the pass. And you seek immediate care when you get sick or injured. Man, isn’t modern medical science great?!
If you can’t afford good insurance, then you do anything possible to stay away from the doctor. You don’t get regular check-ups because you can’t afford it. When sick, you wait to receive care until your symptoms are truly dire. Yet waiting to receive care because you can’t afford a trip to the doctor every time you’re sick means that the care you eventually receive to save your life is even more expensive… and your problems more likely to kill you.
I can’t imagine why medical debt is the leading cause of bankruptcy in the United States!
Here’s more from the Bitches on healthcare costs:
- How to Pay Hospital Bills When You’re Flat Broke
- I Think I Need to Go the Emergency Room?
- Financial Lessons Learned from a Night in the ER
- How To Start at Rock Bottom: Welfare Programs and the Social Safety Net
- It’s More Expensive to Be Poor Than to Be Rich
Enter the coronavirus: highly contagious, deadly, and completely blind to economic status.
With (limited) respect, Governor… no it’s not.
Is it any wonder, in light of the overwhelming cost of health insurance and medical care, that the poor are contracting coronavirus at a higher rate than the wealthy? That they’re dying at a higher rate? And that even those who survive the virus are saddled with the kind of medical debt that can cost them their entire life savings, their homes, or their livelihoods? Those are some vicious pre-existing conditions.
According to the CDC, “Social determinants of health (SDOC) are conditions in the places where people live, learn, work, and play that affect a wide range of health and quality-of life-risks and outcomes.” And one of the biggest social determinants of health? Poverty.
Not having access to nutritious food, regular medical care, and secure housing all contribute to a lowered immune system and overall health. Poverty is basically rolling out a welcome mat in front of the virus.
The American healthcare system was like a Dickensian Sorting Hat separating the rich from the dead. It was just waiting for a universal killer like COVID-19 to illuminate just how fucked up that shit is.
I was laid off at the beginning of the pandemic. A few weeks later, all my remaining coworkers went on furlough. We were not alone.
The pre-existing conditions
We could tell the history of the United States in labor rights battles. It was here that we began the fights for an eight-hour work day, a fucking weekend, rules for a safe work environment, an end to child labor, a minimum wage, collective bargaining, and an end to employment discrimination on the basis of race and sex.
Yet it’s still legal to fire employees for being gay in seventeen states. So the fight for a truly humane and equitable culture of employment is far from over.
Before coronavirus, here are some of the causes for which workers were demonstrating:
- Paid parental leave. Currently, there is no federally mandated, protected, paid parental leave in the United States. Which means that if you give birth, you have no legal right to take paid time off from work to recover and take care of your infant. You can literally lose your job for getting pregnant—whether by being outright fired for not showing up to work days after giving birth, or by being forced out by an employer who makes no accommodations for your recent delivery. Good news tho: gender discrimination in the workplace is definitely all in our heads and not something to worry about! (Be warned: that link causes rage aneurisms.)
- A higher minimum wage. The current federal minimum wage ($7.25 an hour) has not kept up with inflation. We’re paying minimum wage workers like it’s 1999. Yet they’re expected to pay rent like it’s 2370 and they’re renting a berth on the USS Enterprise. More good news, tho: everyone who works a minimum wage job is a 16-year-old working part time to save up for college and definitely not single parents working three jobs, adult immigrants, elderly folks subsisting on social security, and people of color of all ages! Whoops, my sarcasm is dripping…
- Employer-sponsored health insurance for all employees. Currently, if you don’t work full-time, you don’t get employer-sponsored health insurance. It’s definitely a huge problem that employment and health insurance are intrinsically linked (see above). But some employers are suuuuuper shady about only scheduling employees to work twenty-nine or fewer hours a week specifically to avoid the federal mandate to provide them with health insurance.
Labor rights activists have their work cut out for them!
On top of all that, the working poor in America accounted for about 7 million people before the pandemic. The Bureau of Labor statistics defines “working poor” as “individuals who were in the labor force for at least 27 weeks during the year, but still had incomes below the official poverty level,” with that poverty level being under $12,760 per individual per year.
Allow me to translate. During non-Plague Times, millions of people in this country work like dogs and still can’t make ends meet because of insufficient incomes. Haven’t they ever heard of cutting lattes?!?!?!?
All of which is to say that low-wage American workers were barely scraping by before an unprecedented disruption to the entire global economy forced the majority of them out of work.
The Pew Research Center estimates 15% of adults in America have lost their jobs due to the coronavirus. Half of these people are still unemployed at the time of publication.
That’s… SO MANY people suddenly finding themselves without a steady income. So many businesses closed and jobs simply taken off the market. And many, many of the COVID-unemployed are the working poor—people who were balancing on a tightrope of complete financial instability before laborers got knocked into coronavirus-infested waters.
These Americans found themselves without employment, without an income, and without employer-sponsored health insurance (if they even had it in the first place) with almost no warning. A pandemic is a great time to lose health insurance!
Needless to say, unemployment insurance was stretched to the breaking point. And we’ve talked about unemployment insurance before. Like any form of insurance, we all pay into it so that some day, when one of us needs it, they can take money out.
But what happens when suddenly everyone needs unemployment insurance, all at once? The system simply was not designed with mass quarantine in mind. People had to wait billions of years just for approval. Let alone make it through to their state’s UI offices to even apply!
Ok so you got laid off and you can’t get a new job because no one’s hiring because the companies where you’d otherwise work just… don’t exist anymore. Instead of saving money… you’re spending it on essentials. Instead of investing in your retirement fund, you’re cashing it out. The amount of UI you’re entitled to is finite. And you’re still having trouble paying bills.
So how do you pay your rent? Buy your groceries? Remember: even at the best of times, a staggering 40% of Americans don’t have $400 to cover an emergency.
Our labor and employment safety net has been letting individuals down for years. Along came coronavirus, and suddenly it was dropping millions and millions of my countrymen all at once.
Meanwhile, rent came due.
Hey, look at these sequentially yawning puppies in formalwear! Look at how heckin’ cute they are! With their widdle noses, their widdle ears, and their complete ignorance of world affairs and politics:
These puppies are innocent and carefree. They believe in you and a brighter future. (Thought you guys could use a palate cleanser to get the taste of sweeping injustice out of your mouth. Hang in there, puppy lovers.)
Sociologist Matthew Desmond wrote his groundbreaking, heartrending, and Pulitzer Prize-winning work on the eviction crisis in the United States in 20-fucking-16. You’ll know Desmond’s name because every news outlet from here to Siberia has been interviewing him in 2020 to explain what he’s been desperately trying to tell us for the last four years: eviction was an epidemic in the United States long before COVID-19 claimed that title.
The pre-existing conditions
According to research from Desmond’s Eviction Lab, poor families regularly spend over half of their income on housing. When they can’t pay their rent—whether because they lose their jobs, they have no savings to cover a medical emergency or unexpected bill, or their insufficient income just can’t keep up anymore—they’re evicted at alarming rates. And evictions are traumatic. Here are just a few expensive and depressing complications of eviction, according to Desmond and his team:
Complications of eviction:
- If you’re evicted even once, you’re automatically ineligible for some housing. Many landlords just won’t rent to someone with an eviction in their rental history. This means your options for housing close to your work, your child’s school, your support network of family and friends, a well-stocked grocery store, and affordable public transportation shrink dramatically. Not to mention your options for affordable housing. In fact, poor families who have been evicted even once regularly pay inflated prices for substandard housing in dangerous neighborhoods. Because they have no other options.
- Children in families who are forced to move because of eviction often have to switch schools in the middle of a school year. Lacking stability, these kids often exhibit behavioral issues and psychological trauma. Their grades suffer. Their emotional well-being suffers. And they can find it hard to maintain the kind of close social bonds that help all children thrive.
- Eviction is expensive af. Along with all the usual expenses of moving out, evicted families can lose all of their belongings for lack of storage fees. They then need to pay to replace those belongings. People risk losing jobs if they miss shifts while appearing in eviction court or hunting for new housing. Motel rooms, parking fees, storage, childcare, and court fees all add up. Someone who couldn’t pay their rent in the first place will find it damn hard to rustle up the funds to qualify for a new lease.
- Eviction is violent. It is traumatic to lose the roof over your head, to lose the stability and safety of a home, a front door that locks, four walls within which you can hold your loved ones close and hope for a better tomorrow.
I recommend reading Desmond’s Evicted with a minimum of three bowtied puppies in your lap for moral support. Or at least an elderly cat.
It’s not like the pandemic walked into a marginally stable housing landscape. No, COVID-19 was like some kind of medieval disease sweeping over a battlefield as the survivors struggled to stand. Grim? Yeah, that’s kind of the point of these pre-existing conditions.
People who suddenly found themselves unemployed due to the lock-down and with no chance of a new job had no way to pay their rent. So they lost their housing. And with mass unemployment, these newly evicted had nary a prayer of finding a new place to rent.
It’s hard to social distance on the street or in homeless shelters, which only amped up the health risk to these newly evicted individuals. Imagine: you’ve lost your job, your home, and now your health. No one deserves that kind of triple face-punch all at once.
As a result of coronavirus-related evictions, the homeless population in our country has spiked.
To be fair, some landlords and local governments stepped up to halt the predictable wave of mass evictions at the start of the pandemic. They instituted moratoria on rent and evictions, extending grace periods for as long as possible. This allowed people to stay safely in their homes even after a job loss.
But no matter how compassionate the landlord or practical the state eviction moratorium, often landlords were left in a pickle if they owed taxes or mortgages on their properties. Eventually, someone would have to pay.
That’s not the half of it
[Billy Mays voice] But wait! There’s more!
You might have noticed this article is “Part 1.” That’s right, weary travelers! Part 2 is coming your way very soon! I couldn’t fit all of our country’s pre-existing conditions into a single article. Not without committing heinous crimes against reader attention spans. Don’t cry. It’ll be ok… probably?
In Part 2, I’ll be walking through my favorite topic: systemic inequality on the basis of race and gender. That’s right! This motherfucking disease has swallowed the Red Pill and donned a white hood to join forces with our already racist and sexist institutions!
The good news is that so many of you have joined our Patreon recently that I was able to devote a lot of my time this past week to researching this topic! I read so much history and stuff before distilling it all down to our contractual number of profanities and Harry Potter jokes just for you guys.
It’s an absolute privilege that our readers trust us to deliver this kind of analysis on a weekly basis. I am in awe of our patrons’ generosity and encouragement. Especially since all they get in return is chicken videos, drunken sing-alongs, and even more of our questionable advice!
We’re dangerously close to making BGR a sustainable venture. If you like what we do and you want us to keep it up, you can help us meet our Patreon goal right here:
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This article continues in Part 2.
8 thoughts to “Coronavirus Reveals America’s Pre-existing Conditions, Part 1: Healthcare, Housing, and Labor Rights”
Love your work! You needn’t publish this comment, but I wanted to state my experience with insurance contradicts what you’ve written about pre-existing conditions. I may be some special sort of sucker, but before the ACA when I left a job and tried to purchase insurance on my own (thinking, I’ll get a high deductible plan, no sweat!) I was outright denied a plan because I had experienced ‘back pain’ in the past.
Of course we’ll publish it–it’s relevant!
And this is even more damning. I’ll update the article to reflect that people like you were even denied insurance because of pre-existing conditions. Most of my research was about those who were approved for insurance, but had their claims denied.
Absolutely what Deborah said—as soon as I found out I was infertile I became uninsurable. Even though I eventually had two kids.
And back in the bad old days you would start a job and not be eligible for health insurance until a month later!
When I looked for gap insurance for my husband and me between graduating college & finding jobs, although we were the same age, my insurance costs were MUCH higher than his. I suspect (although did not try to confirm in any way) it was because I was of “prime babymaking age” and insurance companies assumed I’d cost them more when I inevitably had a baby. (Eye roll) Luckily I found a job quickly, but even then the waiting period to get on any benefits (insurance, 401(k) etc) was 90 days I believe.
This makes me so fucking angry.
What the everloving fuck!?
I had to wait 90 days to get on my last employer’s health insurance plan, which was dumb. Fortunately, I had COBRA from my previous employer, but like… yet again, why should this even be an issue? Just separate health insurance from employment!
The fact that health care is tied to employment status is so ass-backwards. You pretty much covered the entire avalanche caused by the pandemic, but much of that avalanche would have succumbed to a stiff breeze anyway. What a post!
Thank you so much!!! And very well said.
I think separating health insurance from employment in most cases could solve a helluva lot.