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Let Them Eat Cake

People were appalled that Marie Antoinette said, “Let them eat cake,” when the French complained they had no bread during the French Revolution in the late 1700s. (There is no evidence she said that, by the way.)

But I can’t help but see the parallels between that tone-deaf statement and this one: “COVID is a manageable disease,” with the implication that “oh well, let’s just everybody catch it and get it over with.”

I recently read a thought-provoking piece in TIME entitled America Is All Too Happy to Let People Die by Gregg Gonsalves, an expert on policy for infectious disease and professor of epidemiology at Yale School of Public Health. Gonsalves cites this quote from Leana Wen, the former health commissioner of Baltimore:

“[A] key lesson is that it’s inevitable that everyone—even the president of the United States—will be exposed to the coronavirus…. COVID-19 is a manageable disease for almost everyone, so long as they use the tools available to them (emphasis mine).”

Asian father sits on bus with young daughter

Nodding my head, yes. Yes, the tools available to them.  Manageable, except that COVID deaths continue to occur at some 400 per day, making the U.S. the worldwide leader in COVID-19 associated mortality.

Gonsalves addresses that pretty succinctly:

“You may think it’s the biomedical innovations of the past century that save the most lives, often it’s much simpler than that: having a roof over your head, food to eat, a good job. It’s no coincidence that those who are better off do better in terms of health as they purchase what we call the social determinants of health at a premium. Second, for all the money we spend on healthcare, we spend a fraction of that on public health, with estimates between 1.5 to 2.5 cents spent on public health for each dollar on healthcare…. With a public health system under-funded [and] under-staffed, keeping America healthy is almost impossible to do.”

And about those tools – you know, accessible and affordable doctor’s appointments, physicians who speak the same language you do, employer-provided health insurance… yes, those tools you mention are not readily available to all.

Health care inequity is not a new topic in this space in Feel Good Friday.  It’s not a surprise that people who are impoverished have higher rates of life-threatening health-related conditions beyond COVID-19  such as high blood pressure, diabetes, low-birthweight babies, poor maternal health outcomes, smoking, mental health conditions and far more.

Gonsalves claims that America is all too happy to let people die from COVID. But for generations, America has been just as happy to let the neediest in our society suffer premature death because they do not have the same access to health care as those more privileged.

Gonsalves condemns those who say, “Oh, well, everyone is going to catch it,” while people are dying in the hundreds each day.  I suggest we apply that same indignation to this country’s broken and inequitable health care system across the board.  Or, we could just let them eat cake.


Michelle Taylor
President and Chief Executive Officer
United Way of Delaware

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