Posts Tagged ‘Public Health’

Church, State and the weight of capitalism.

datePosted on 15:33, May 19th, 2020 by Pablo

Arguments by religious folk that they are being discriminated against under the Level 2 pandemic restrictions in NZ, which limit church services to ten people or less when schools, restaurants, malls and other service outlets are allowed to host many more people under voluntary self-distancing protocols, got me to think about whether people understand the rationale behind the government approach as well as the role of religion in society and particularly in a liberal democracy such as NZ. I wrote a tweet outlining my general view and it elicited some contrary responses from people who are either religious and/or dislike the current government. I will not dwell on their responses but I will below string together in fuller scope my side of the discussion.

I began with the first tweet:

“Liberal democracies are secular regimes where church and state are separate and the state treats all religions neutrally and equally while having superordinate authority over material (as opposed to spiritual) issues, including public health. Churches need to respect that.” That began a back and forth with the contrary minded readers, which elicited the following responses from me:

“Stage (sic) 2 is based on opening up commerce, with some social restrictions still in place. Education is critical for commerce in several ways. Services are critical to economic well-being. Religion is a social construct based on belief that is not economically essential. Big diff.

In medicine, the environment, engineering, economics, threat assessment, even political forecasting, among so many other material things, science must and will trump belief. With CV-19 science must prevail over belief. There is nothing “illiberal” about the govt response.”

The last sentence came in response to a commentator’s remark that NZ is an illiberal democracy because of the restriction on religious gatherings, among other things. The author went on to speak of a difference in values between the government and people like him when it comes to family and society. I replied:

“A secular democratic regime can, should and most often does value families and society, and its social policies demonstrate this. The level 2 re-opening is business driven because NZ is a capitalist country, and everyone’s welfare depends on capitalist survival, not churches.

So long as the economic imperatives of a capitalist society remain a paramount concern of govt, then commercial concerns will supersede (much variegated) spiritual ones. Hence the pro-business incrementalism of the govt approach. They respond to structural necessity, not values.”

And that is the bottom line. NZ is a capitalist society. It is a capitalist society because the means of production are mostly in private hands and subject to market-oriented logics, because the relations in and of production reproduce the material hierarchy on which the economic system rests, because it is inserted in a global capitalist system of production, consumption and exchange, and because the social division of labour that emerges out of it reinforces the hierarchical relations between the ultimate producers of wealth and the owners of productive assets in NZ and elsewhere. Most of all, NZ is a capitalist society because the welfare of everyone directly or indirectly depends on the welfare and investment of capitalists–if they do not prosper, no one does.

Regular readers know the I am not a fan of laissez fare capitalism or the various market-driven experiments of the last forty years. Nor am I entirely pleased with how the current government defers to capitalist logics rather than fully embrace the entire policy spectrum involved in well-being budgeting. I am just saying: when it comes to the economic motor of NZ society, it is what it is.

NZ has just faced and continues to be threatened by a deadly global pandemic. The initial government response was a public health campaign marshalled on scientific grounds that was mitigated by an unprecedented economic relief package designed to help people weather the financial storm caused by the disruption of economic activity. Capitalists and workers were included in the relief measures. This response was vetted by a pandemic emergency response committee chaired by the Leader of the Opposition and communicated in daily press conferences by the Prime Minister and Director General of Health, along with other officials. That is far from being the makings of a totalitarian police state that a fair few believe it to be.

Once the lockdown/quarantine phase of the restrictions was lifted (after six weeks), the government announced that its level 3 and 2 approaches were designed to get businesses back to work. This employed a type of pragmatic incrementalism where restrictions on commercial activity were slowly lifted in piecemeal, sectorial and graduated fashion over what is now going on 3 weeks. The government explicitly stated that this was not a social opening and that pre-pandemic social activities that do not have a commercial orientation were very consciously excluded from the stage 3 and 2 re-opening measures.

That is why churches are not allowed to resume pre-pandemic activities, indulging religious services, in the measure that they did before March 23. Note that they can still host church services and other activities but that they must adhere to the “fewer than 10” rule when doing so. No one has restricted their freedom of worship. Only group size when worshipping has been limited, and that is because churches are not considered to be businesses.

If churches want to claim that they are a type of commercial enterprise, then they have reason to feel discriminated against and by all means should air their grievances along those lines. But that might open questions about their tax-free status, real estate holdings, tithing practices and other non-spiritual aspects of their mission. So it is unlikely that we will hear this argument aired in public or as a defence of a church’s right to host large gatherings for religious purposes.

In any case, the “blame” for not including churches in the Level 3 and 2 re-openings is not the fault of government values when it comes to family and society. If anything, blame comes simply from the fact that NZ is a capitalist nation and the bottom line is, well, the bottom line. Spirituality is fine but it does not pay the bills, unless of course it is of the “prosperity doctrine” persuasion where the Lord commands that we should enrich ourselves before all others.

Speaking of which: why the heck was that charlatan fraudster Brian Tamaki and his Destiny Church minions allowed to defy the level 2 restrictions without punitive sanction? Were the police worried about a confrontation with a large crowd? Even if that was the case, if the letter of the public health order cannot be enforced even with enabling legislation conferring extraordinary enforcement powers on the police, what is the point of having them? Or are exceptions to the rule made for bully-boy bigoted loudmouth xenophobic lumpenproletarians posing as preachers?

We might call that a type of reverse discrimination.

A matter of definition.

datePosted on 12:43, May 16th, 2020 by Pablo

Recent reports have surfaced that hospital officials in some US localities are inflating the CV-19 death count by classifying anyone who dies in their care who is not the victim of an accident or other obvious non-viral cause as a CV-19 victim. Apparently this is because the US public health scheme, Medicaid, pays hospitals USD$5000 per non CV-19 death versus USD$13,000 for CV-19 related deaths. Most hospitals in the US are private, for profit entities so the hospital administrators (not doctors) who do the paperwork submissions to the federal government for Medicaid death reimbursements have financial incentive to falsify the real causes of death.

There is no independent body above hospital administrations regularly overseeing how cause of death in hospitals is classified unless some gross error comes to the attention of local and state authorities, and there is no way for the federal government to unilaterally challenge the legitimacy of CV-19 death claims. Moreover, since local coroners are swamped by an influx of CV-19 dead and Medicaid is stretched to the breaking point by the upsurge in (legitimate) CV-19 claims, there is little way to hold the dishonest hospital administrators to account unless a whistleblower from within a hospital provides concrete proof of institutional malfeasance.

In contrast, official Russian statistics show that there are over 263,000 cases in the country, with nearly 2.500 deaths and new cases exceeding 10,000 per day. That death count has raised eyebrows outside of Russia, as it is remarkably low when compared to other countries given the number of cases and rate of infection.

Russian officials counter the skeptics by claiming that their definition of a CV-19 death refers only to those that can be directly attributed to the pathogen. They deliberately exclude other causes that are exacerbated by CV-19 contagion, such as heart failures and smoking-related pulmonary embolisms, liver failures etc. Because of this the Russian CV-19 mortality rate is not only very low but also does not disproportionately affect the elderly, whose deaths are most often attributed to the underlying condition rather than to CV-19.

These differences in reporting remind me of an incident that happened to me when conducting research in Brazil in 1987. I had an interest in national health administration because I had worked on that subject when conducting Ph.D. dissertation research in Argentina earlier in the decade, I lived in Rio at the time and had experienced Carnaval in February, when thousands of sex tourists of every persuasion descended on the city in the middle of what was clearly an AIDS epidemic (in a cultural context where men refused to use condoms because that was considered “unmanly” and in which many (usually) straight men used Carnaval as an excuse to enjoy gay sex). Around that time I had to donate blood for my then-wife to use in a blood transfusion after she picked up a water-carried blood infection while cleaning vegetables and because we were told that most of the blood supplies in Rio were infected with both AIDS and syphilis, so I was acutely interested in how health authorities dealt with the convergence of viral calamities.

I managed to arrange an interview with a senior official in the Health Ministry in Brasilia, one who just happened to be involved in infectious disease mitigation. As part of our conversation I asked him how many AIDS cases there were in Brazil. He said “100.” I laughed and said “no, seriously, how many cases are there because I just came from Rio during Carnaval and it was a 24/7 bacchanal of unprotected sex, drug use, drinking, dancing and other assorted debauchery, plus I am told than the blood banks are unreliable because the supplies are infected with AIDS and syphilis.”

He smiled and leaned back in his chair for a moment, and then said “you see, that is where my country and your country are different. In this country a person gets the AIDS virus, loses immune system efficiency, and eventually succumbs to an infectious tropical disease such as malaria or dengue fever. We put the cause of death as the tropical disease, not AIDS. In your country a person gets AIDS and eventually dies of a degenerative disease such as a rare thyroid or other soft tissue cancer. Since they otherwise would not have likely had that cancer, your health authorities list the cause of death as AIDS. For us, the methodology for defining cause of death is not only a means of keeping the official AIDS count low. It also keeps the foreign tourist numbers up because visitors are not fearful of contracting AIDS and have much less fear of malaria or dengue because those are preventable.” I asked him what he thought about those tourists who did contract AIDS while in Brazil on holiday. He replied “that is a problem for their home authorities and how those authorities define their cause of death.”

I recount this story because it seems that we have entered a phase in the CV-19 pandemic where definition of what is and what is not has become a bit of a hair-splitting exercise that has increasing levels of political spin attached to it. It opens a Pandora’s box of questions: Is the lockdown approach overkill? Is the re-opening too soon? Are the overall US CV-19 death figures inflated because of the structural imperatives layered into their health system? Are the Russian figures underestimated because of their politics or because of their accounting methods? Has the PRC lied all along about the extent of the disease before and after it left its borders (in part by assigning different causes of death than CV-19)? At what point do honest medical professionals assign primary cause of death to CV-19 rather than an underlying condition?

There is one thing that I am fairly certain about. In Bolsonaro’s Brazil, I have little doubt that the rationale I heard in 1987 is still the rationale being used today, except that now it is CV-19 rather than AIDS that is the scourge that cannot be named.