Who gets what and why? And how broken is this system? Very.

Dear President Trump,

It’s always this way, isn’t it? The floodwaters inundate the low lands and sweep the shanties and shacks away while permanently infesting the more solid, yet still humble, brick dwellings of the not-quite-as-poor with black mold. Funny how those floodwaters never seem to make it all the way up the hills where the rich people have their homes and their resplendent views. Pretty much the same pattern plays out when hurricanes and wildfires hit, but there’s the added twist that wealthy people are able to pay exorbitantly high insurance rates to build back bigger and better and this tempers the impact for them when they choose to build in high risk places. So it is and so it shall be, forever more.


This is the game we were all born into, the rules we all play by on a board supported by the tacit understanding that those who have more (wealth, health, safety, privilege, respect) have it because they are more deserving, they worked harder and were smarter, and they were never, ever lazy. Not once. Not even for five minutes. Many of us buy into this bullshit because we benefit from it – we draw the “get out of jail free” cards and when we dip into the community chest we win all the beauty contests and all the bank errors go in our favor. Why? It certainly isn’t that we are white or that we were born into wealth. No, by God (literally), it’s because we deserve these things, we’ve earned it all. And no one (again, by God) can take any of it from us. Why should we share all our hard earned stuff with less deserving people who are stupid enough to build shanties by rivers that flood every other year or who let themselves get Type II diabetes and hypertension by eating crap and never exercising?


These are the basic rules of the game and by God (still, literally) we will defend our right to our stuff that we deserve by buying up all the guns and ammunition we can get our hands on. We will then sit in our castles with our guns cocked and loaded and we will wait for anyone we don’t like the looks of, anyone who we can conjure some righteous fear about, to cross us so that we can unload on them. And in the meantime, we will watch our televisions and we will tut-tut about the stupid poor people who don’t follow the public health guidance to call your doctor if you think you might have covid-19, but who still go to the ER to get checked out, never mind that they don’t have insurance or a doctor they can call. That’s not your problem. They got themselves in that predicament.


We could go on and on with this bullshit, couldn’t we? And indeed, we are approaching a time, like tomorrow, when healthcare systems and individual providers are going to have make decisions about who is and isn’t going to get one of the precious ventilators that currently exist – not one of the ones that might be ready in May or June or July. Seriously, nice going with the Hunger-Games-like deal you’ve set up with ventilators, test kits, PPE, and masks. Galton would be proud (look him up).

There’s all sorts of on-paper effort to make these horrible life or death formulas look like they are unbiased, but we all know which hospitals and medical centers are and are not going to even get ventilators to dole out. We all know which communities do and do not even have hospitals that can realistically host more ICU beds and ventilators. No amount of fancy-pants ethical debating is going to correct the centuries old racial disparities that leave individual Black people at greater risk for having terrible covid-19 outcomes and that also leave huge swaths of Black people without access to adequate medical care under the best of circumstances, let alone now. And millions upon millions of us are not going to see any problem with this as long as we are allotted one of those ventilators or our mother is. So many of us have been breathing this air and drinking this Kool-aid all our lives and we fervently believe (without even knowing we believe it) that those who don’t make it by dint of their health status and their zip codes deserve their fate.

May we be safe from bias that kills.
May we be willing to give ourselves, our culture, the hardest of shakes.
May we stop systematically undermining certain people’s health and wellbeing.
May we accept that our systems, including our belief systems, are broken.

Tracy Simpson

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