Wednesday, December 23, 2020

USA
The wealthiest people in this country are pushing to the front of the line to get vaccinated

Photo via Shutterstock.

Dartagnan and Daily Kos December 21, 2020

More than any single event in recent memory, the COVID-19 pandemic revealed the gaping chasms of inequality in American society. From the very outset it was accepted wisdom that "essential workers," i.e., those forced to risk their lives in unsafe workplaces throughout the country, would include not only medical personnel such as doctors, nurses, and hospital orderlies; not only police, firefighters and first responders; not only operators of public transportation and critical government services such as postal workers; but also the folks who worked behind cash registers at the Lowe's, the 7-11, and those whose jobs involved the processing, delivery, preparation and transportation of food items and consumer goods that kept the moribund economy from congealing into a second Great Depression.

The "essential" nature of these workers was loudly touted by companies from Amazon to WalMart to Domino's pizza, who extolled the selfless bravery of their employees in warm and touching TV ads, ads that served as a new type of PR for those same companies with sordid past track records about treatment of workers. Meanwhile, the highly compensated officers and executives of these companies bore the brunt of the pandemic not by interacting daily with a stressed and potentially infected public, but from their snug and expansive estates and second homes where they continued to bark orders and issue their edicts remotely.

And this was also the case with the so-called "professional class," as six-figure income lawyers and corporate managers developed new ways to work from home, reallocating firm IT services and equipment while the lower-tiered employees such as clerks and secretaries were mostly told to return to the office, if they were to keep their jobs at all. Probably the most telling example of the disparities in treatment afforded between high managerial and service-level, clerical employees is the current, never-ending circus continuing to unfold in our Congress this weekend, in which financial and rent assistance to ordinary middle and lower income Americans is being held hostage to liability protections insisted upon by the corporate "owner" class in the persona of Republican Senate Majority leader Mitch McConnell.

In short, this was never going to be an "equal opportunity" pandemic. Its inherent unfairness has been even more apparent in the medical treatment received by the wealthy as opposed to ordinary Americans, personified by no less than Donald Trump and his White house cronies who, being infected with the COVID-19 virus through their own carelessness and recklessness, nonetheless have instantly received the quickest, most cutting edge care available. Nor are they alone—as described by Mark Sumner here, the gross disparity between medical treatment available to this countries' richest citizens and its less fortunate (but so "essential") workers, mostly those people of color who couldn't work from home due to the very nature of their jobs, often with substandard health insurance, if any, was bound to surface before too long.

And now that multiple vaccines are looming, we are seeing the same sense of natural entitlement among the top 1% playing out, as reports emerge daily of attempts by these same people to bribe their way to the front of the line for vaccination, the better to allow themselves to carry on with their lives as soon as possible, with an eye to traveling and frolicking amongst their islands (both metaphorical and real ones) while the rest of Americans prepare to stand in line for months.


As reported by the Los Angeles Times:
They're offering tens of thousands of dollars in cash, making their personal assistants pester doctors every day, and asking whether a five-figure donation to a hospital would help them jump the line.

The COVID-19 vaccine is here — and so are the wealthy people who want it first.

"We get hundreds of calls every single day," said Dr. Ehsan Ali, who runs Beverly Hills Concierge Doctor. His clients, who include Ariana Grande and Justin Bieber, pay between $2,000 and $10,000 a year for personalized care. "This is the first time where I have not been able to get something for my patients."


A few years ago, in what came as a bit of a surprise to my woefully provincial sensibilities, I first heard the term "concierge medicine." It refers to health care offered—at substantial cost—by an elite network of physicians and other medical providers designed to allow wealthier Americans (who may not wish to dirty their hands with the type of medical care provided to the vast majority of us) access to the best medical treatment money can buy. As described by Hayley Fowler, writing for the Miami Herald:

Many wealthy Americans pay for concierge medical services — a "kind of high-quality, primary care most Americans can't afford," the Los Angeles Times reported. Some of those services have already procured the expensive freezers needed to store the vaccine and put their patients on wait lists as soon as it becomes available for widespread distribution.
The cost of such "concierge care" can run in excess of $250,000 per year, and guarantees, as noted in the LA Times article, personalized 24-hour access to physicians who provide their services to a small segment of wealthy clients. These physicians' groups have the financial wherewithal, for example to have immediately secured the types of freezers necessary to hold the Pfizer vaccine in cold storage at -94 degrees Fahrenheit
for significant lengths of time. That in itself provides these groups with a leg up on receiving the vaccine, despite whatever state restrictions may be in place as to who receives it.
Doctors in boutique practices say they'll adhere to public health guidelines in determining who gets priority. But being on a waiting list at a practice that has special freezers and other high-quality resources means you're already near the front of the line once the supply opens up.


Doctors in these "boutiques" confirm this. One co-founder of a "concierge" medical service "with clinics in New York, the Hamptons and Beverly Hills" told the LA Times that his group started soliciting these expensive deep-cold freezers as soon as it was apparent the vaccine would be on the market.

While the Trump administration has not yet been caught offering the vaccine for private distribution, these physicians groups feel it is just a matter of time before such allocations are made, in part due to the demanding and entitled nature of their patrons. The LA Times specifically refers to instances of these "concierge" patients offering huge payments to these groups for the privilege of jumping to the first in line. In one case a person asked if he could accelerate his receipt of the vaccine by making a $25,000 "donation" to a hospital. And, as CNN reports, other physicians with "A-list" clients have been fielding hundreds of calls, all conveying the message, of course, that their money should give them priority:
Dr. David Nazarian, of My Concierge MD in Beverly Hills, said a number of his A-list clients are contacting him, saying that money is no object if it helps them get the vaccine early. "They wanted it yesterday," said Nazarian. "We will play by the rules but are doing everything we can to secure and distribute the vaccine when its available to us."

State officials quoted through these articles are adamant that they will do everything they can to prevent such "line jumping" and they are obviously sincere in that intent. The LA Times article cites no instances yet of physicians succumbing to these types of pressures, but that is likely because the vaccine rollout has just begun, and also because physicians fear the public consequences if they are found out providing the vaccine to those people whose only qualification to receive it is that they are not familiar with taking "no" for an answer.

Another concern described by the Times is the potential for wealthier people to arrange to have their symptoms "fudged" so that a minor history of asthma, for example, could be highlighted or stressed by their doctor for the purpose of receiving the vaccine on a priority basis. And there are always those people closely connected with pharmaceutical executives who believe they ought to warrant special treatment due to the nature of those relationships. Beyond this, as reported by Stat News here, once a vaccine is developed that does not require such stringent storage, there is virtually no doubt that a "black market" will develop for it, with access provided to the highest bidder.

As bluntly emphasized by Timothy Egan this week, writing for the New York Times, this pandemic is hardly close to reaching its conclusion. The next three months are going to be a living hell, with American deaths by March now expected to reach or exceed 500,000. We already know that the Trump administration will pay scant if any attention to the way this vaccine is allotted once it finally gets its act together on distribution. It is the individual states that will ultimately determine the priority of how the vaccine is dispensed, at least officially.

Which brings us back to those so-called "essential workers." If they were as essential as they were roundly described in all of those solemn advertisements, one would expect that, after health care workers (which seems obvious) they would be the first to receive the vaccine, right?

As reported by Stat News, not necessarily:
"Essential workers" are expected to receive early access to the vaccine, and the definition of this category is open to interpretation by state health departments, creating a means for influential industries to lobby for priority. "The devil's going to be in the details of how the state runs their program," Lang said he tells his patients.

Members of the Advisory Committee on Immunization Practices (ACIP), the federal panel recommending how to distribute the vaccines, want to prioritize essential workers to help ensure people of color, who are often the hardest hit by the virus, get early access. But the predominantly white workers in the financial services industry are also considered essential, according to guidance from the Cybersecurity and Infrastructure Security Agency, which was referenced by ACIP, as well as executive orders from several states including New York, Illinois, Colorado, and California. Public-facing bank tellers face contagion risks in their work, but aren't the only financial services employees included.

"It was left a little bit nebulous but basically covered people who oil the movement of money, so exchanges, trading floors, trading operations, and people who keep money moving at the retail [banking] level," said Lang.

Again, it seems that the people who have the money will be prioritized to receive the vaccine, as well as—not coincidentally-- the people whose job it is to move money for those same people.

A more telling verdict on our society's priorities could hardly be imagined.

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