George Pyle: Burning off the idea of health care as a business

(Ian Vogler | Pool via AP) In this March 22 photo, British Prime Minister Boris Johnson gestures during his daily COVID-19 coronavirus press briefing to announce new measures to limit the spread of the virus, at Downing Street in London.

When I was a real journalist, a reporter covering City Hall and the County Courthouse, I spent way too much time bothering city department heads and county commissioners — and their secretaries, the ones who really knew everything — and way too little time out among real people. Which is why it is probably just as well that I don’t do that job anymore.

But I did learn a lot about streets, sewers, hydraulics, zoning applications, sealed bids, special assessments, open meetings laws, interlocal agreements, property tax exemptions, building inspections, sight-distance triangles and how futile it can be to sue the government.

I heard the guy in charge of building streets get a little bit upset at the guy in charge of clearing the snow off of those streets for the amount of salt city crews used. It was too much salt, the city engineer told the city public works director, which contributed greatly to the large number of cracks and potholes that had to be patched in the spring.

I also remember a woman on the city planning staff lament, mostly in jest, that the problem with modern cities was that they didn’t burn down nearly as often as they did 100 or 400 years before.

In those good old days, she said, you could count on an occasional good blaze to wipe out slums, decrepit buildings, disgusting sewage systems and other old creaky stuff so it could be replaced with whatever modern, more secure and more sanitary building methods had been invented and put into building codes since the last conflagration.

She didn’t really want the city to burn down, any more than anyone today thinks the COVID-19 pandemic is a good thing. But, as with a big fire, as tragic as the loss of life and property is, we may find that some of the things that were burned away were things we can very well do without.

Prime among them, of course, is the idea that health care is properly a business, a profit center, when it should be seen and operated and funded as a public service, like streets, sewers, zoning applications and all that stuff.

As we are now seeing in the United Kingdom, treating health care primarily as a public service does not inoculate a person or a society from a freak pandemic like the one the world is facing now. But it does change the way a nation faces the problem.

There is no doubt across the UK that the much-loved — and, because it is a ubiquitous public agency, much-cursed — National Health Service is on the front lines of the battle. And if it fails or falters, the blame lies with the national government.

Prime Minister Boris Johnson is appearing at press briefings behind a sign that says “Protect the NHS.” By which he means stay bloody home and help flatten the curve so as not to overwhelm the system.

Which is the least Johnson could do, as his thoroughly dishonest campaign for Britain to leave the European Union was based in part on a huge lie, the fiction that leaving the EU would save the NHS 350 million pounds a week. So he owes them.

Doctors and nurses and other health care workers in London, and New York, and Madrid, are being cheered and applauded.

In Utah, doctors and nurses who work for our largest health care provider, Intermountain Healthcare, are being told their pay is being cut.

Well, not all of the doctors and nurses. Just those whose practices deal more with the elective visits and procedures that are quite reasonably being put off so that the system can deal with the giant emergency.

But, never fear, IHC’s top suits won’t be giving up a cent. Including the CEO, who makes $1.6 million a year.

And IHC is “nonprofit.”

This should be the moment we see just how crucial health care — public health — is to our lives, our economy.

Administrators should get paid, like police chiefs. Doctors should be trained, at public expense, so they don’t start their practices deeply in debt. Nurses and orderlies and janitors and cooks should get paid, better. Contractors should make money, like the North American Rockwell guys who loaded Neil Armstrong into the space capsule they built for us.

There is no rational reason for health insurance to be tied to employment when, as we now see, employment is so fragile for so many.

A publicly financed system needs to be up and running, always prepared for the worst, always fully stocked.

If it isn’t, somebody gets court-martialed.

George Pyle

George Pyle, editorial page editor of The Salt Lake Tribune, argues that one thing we should keep from the coronavirus is Ben McAdams’ new beard.