close up of hands signing contract.

Using Contracts to Lessen Inequities in Access to Medicines in Pandemics and Epidemics

By Sapna Kumar and Ana Santos Rutschman

Research funding contracts can help to safeguard against profound inequities in global allocation and distribution of lifesaving diagnostics, drugs, and vaccines.

During large transnational public health crises, global demand soars for diagnostics, drugs, and vaccines. Although some of these products can be developed within compressed timelines, global production capacity remains limited. Against a backdrop of product scarcity, wealthier countries can out-bid their lower-income counterparts and capture most of the supply during the early stages of pandemics and epidemics. This leaves the vulnerable low-income populations waiting months, or even years, for their turn.

This predictable, inequitable pattern can be held off before the next pandemic. At the research and development (R&D) stage, government funders can bind producers to equity goals through targeted contractual provisions, as we explain in a recently-published Nature Biotechnology article. We summarize our proposals in the following sections. Read More

Washington DC 09 20 2021. More than 600,000 white flags honor lives lost to COVID, on the National Mall. The art installation " In America: Remember" was created by Suzanne Brennan Firstenberg.

Depoliticizing Social Murder in the COVID-19 Pandemic

­­By Nate Holdren

Lire en français.

The present pandemic nightmare is the most recent and an especially acute manifestation of capitalist society’s tendency to kill many, regularly, a tendency that Friedrich Engels called “social murder.” Capitalism kills because destructive behaviors are, to an important extent, compulsory in this kind of society. Enough businesses must make enough money or serious social consequences follow — for them, their employees, and for government. In order for that to happen, the rest of us must continue the economic activities that are obligatory to maintain such a society.

That these activities are obligatory means capitalist societies are market dependent: market participation is not optional, but mandatory. As Beatrice Adler-Bolton has put it, in capitalism “you are entitled to the survival you can buy,” and so people generally do what they have to in order to get money. The predictable results are that some people don’t get enough money to survive; some people endure danger due to harmful working, living, and environmental conditions; some people endure lack of enough goods and services of a high enough quality to promote full human flourishing; and some people inflict the above conditions on others. The simple, brutal reality is that capitalism kills many, regularly. (The steadily building apocalypse of the climate crisis is another manifestation of the tendency to social murder, as is the very old and still ongoing killing of workers in the ordinary operations of so many workplaces.)

The tendency to social murder creates potential problems that governments must manage, since states too are subject to pressures and tendencies arising from capitalism. They find themselves facing the results of social murder, results they are expected to respond to, with their options relatively constrained by the limits placed on them by capitalism. Within that context governments often resort to a specific tactic of governance: depoliticization.

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Ponta Grossa/PR/Brazil - July 15th 2020: Home office, working from home layout during covid-19 pandemic

Employers Should Bear Responsibility for Making Remote Work Environments Accessible

By Christopher A. Riddle

Remote work meaningfully facilitates inclusion of people with disabilities in the labor market.

But, to truly fulfill its promise, employers must also take steps to ensure that remote work accommodations are not made at the expense of the employee, simply because their labor is conducted in their own home.

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Person in nursing home.

Struggles Over Care Will Shape the Future of Work

By Andrew Milne

The future of work will largely be the future of care work. Health care is rapidly becoming the largest employer in the U.S., expanding to serve the fastest growing demographic, aging seniors. As a lawyer for seniors in need of free legal services, I see my clients struggle to access care made scarce by the for-profit care industry’s understaffing and underpaying of workers attempting to meet the growing need. The future of work and of aging will be shaped by struggles over care from both giving and receiving ends, perhaps against those profiting in between.

Recall that the first COVID-19 outbreak in the U.S. spread between nursing homes. These facilities, like most nursing homes, are for-profit businesses that pad their margins by cutting labor costs. The resulting understaffing has deadly effects in normal times. The pandemic intensified those effects, as underpaid care workers, forced to work at multiple facilities to survive, unintentionally spread the virus between facilities.

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Empty nurses station in a hospital.

The AMA Can Help Fix the Health Care Shortages it Helped Create

By Leah Pierson

Recently, Derek Thompson pointed out in the Atlantic that the U.S. has adopted myriad policies that limit the supply of doctors despite the fact that there aren’t enough. And the maldistribution of physicians — with far too few pursuing primary care or working in rural areas — is arguably an even bigger problem.

The American Medical Association (AMA) bears substantial responsibility for the policies that led to physician shortages. Twenty years ago, the AMA lobbied for reducing the number of medical schools, capping federal funding for residencies, and cutting a quarter of all residency positions. Promoting these policies was a mistake, but an understandable one: the AMA believed an influential report that warned of an impending physician surplus. To its credit, in recent years, the AMA has largely reversed course. For instance, in 2019, the AMA urged Congress to remove the very caps on Medicare-funded residency slots it helped create.

But the AMA has held out in one important respect. It continues to lobby intensely against allowing other clinicians to perform tasks traditionally performed by physicians, commonly called “scope of practice” laws. Indeed, in 2020 and 2021, the AMA touted more advocacy efforts related to scope of practice that it did for any other issue — including COVID-19.

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Social Security Administration Important Information letter next to flag of USA.

Blue Booking Long COVID: Accounting for Long-Term COVID-19 Complications in Social Security Disability Benefits Evaluations

By Jacob Madden

Long COVID has left an estimated 1.6 million Americans unable to work. Those experiencing Long COVID face long-term neurological issues, heart problems, lung damage, and myriad other complications following an initial bout with COVID-19.

Though some who are incapacitated by Long COVID will eventually be able to return to work, others may never work again. Going forward, we must find a way to account and provide for these individuals. Here I suggest a potential solution in amending the Social Security Administration’s Blue Book to include Long COVID in the evaluation of disability benefits.

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Professional business teleworkers connecting online and working from home for their corporate company, remote working and networks concept.

Introduction to the Symposium: Build Back Better? Health, Disability, and the Future of Work Post-COVID

By Chloe Reichel, Marissa Mery, and Michael Ashley Stein

This week marks the two-year anniversary of World Health Organization Director-General Tedros Adhanom declaring COVID-19 a pandemic.

It is at this particular moment that we, in the United States, are beginning to see the sociological construction of the end of the pandemic: metrics measuring COVID-19 transmission have been radically revised to reshape perceptions of risk; masks are, once again, being shed en masse; and remote workers are being urged back to the office. “It’s time for America to get back to work and fill our great downtowns again with people,” President Joseph Biden said during his March 1, 2022 State of the Union address.

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Physical therapist helps person in wheelchair.

Balancing Patient Rights and Costs in Medical Malpractice Claims

By John Tingle and Amanda Cattini

The issue of the high and increasing costs of clinical negligence (medical malpractice) in the National Health Service (NHS) in England has long been a contentious one. There are common themes in the debate. The economic arguments supporting reform explain that the NHS is spending a considerable amount of money out of its health budget on malpractice claims, which otherwise could be put into front line health care services.  While the economic arguments are important, others contend that the patient’s voice must be heard more widely in the reform debate. They emphasize that it is important to look deeper as to what compensation means to victims of clinical negligence, and caution against unnecessarily fettering patients’ reasonable pursuit of claims.

Two recently published reports provide several key perspectives on these issues.

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