Over the coming months, hundreds of thousands of people in the United States are going to come down with severe forms of COVID-19 infection. How many of them will pull through and how many will die of suffocation depends crucially on the availability of life-saving ventilators in the intensive care units of hospitals. A recent survey found that even acute-care hospitals have on average only eleven ‘full-feature’ ventilators. Failing urgent acquisition of many tens of thousands of additional ventilators, hospitals will be overwhelmed as the pandemic spreads.
In a desperate attempt to mitigate the disaster, hospital staff are preparing to link up each of their ventilators to two or even four patients. A video posted on YouTube shows how to link up a ventilator to four patients. As the instructor admits, this is an ‘off-label use’ of a machine designed to serve one patient at a time. I can’t help wondering whether it is really going to work.
Initially Trump took the orthodox ‘neo-liberal’ view that there was no reason for government to get involved. ‘Unfettered free enterprise’ could be trusted to rise to the occasion. However, he ended up brokering a deal for a joint venture between General Motors and Ventec Life Systems. General Motors would retool a car parts plant in Kokomo, Indiana as a ventilator production facility using Ventec’s technology. A government order for 80,000 ventilators was to be fulfilled in just two months. Trump’s enthusiasm was unbounded. ‘Go for it auto execs,’ he tweeted excitedly on March 22, ‘let’s see how good you are?’ [1]
Then suddenly it was announced that the deal was off. Officials in the Administration were unhappy about the cost – over a billion dollars, a large part of which had to be paid upfront. True, it worked out at only $13,000 per ventilator – not bad, considering that the machines usually sell within the range $25–50,000. But for Chrissake, lamented officials at the Federal Emergency Management Agency, for that money you could buy eighteen F-35 fighter jets! And if you think I made that up for ironic effect then you are wrong. They really find it distasteful to spend large sums of government money for the benefit of ordinary people.
An interdepartmental working group under the direction of Trump’s son-in-law Jared Kushner (who was admitted to college only after his dad paid a hefty bribe – I mean ‘donation’) is now exploring the issue in detail. The GM-Ventec project remains on the table, but another dozen or so other proposals are also under consideration. The target of 80,000 ventilators has been whittled down to 20,000 and then to 7,500. You see, some officials are worried that too many ventilators may be ordered, leaving them with a wasteful surplus.
To give credit where it is due, Trump must have started to get impatient, because on March 27 he issued the following statement:
Today, I signed a Presidential Memorandum directing the Secretary of Health and Human Services to use any and all authority available under the Defense Production Act to require General Motors to accept, perform, and prioritize Federal contracts for ventilators. Our negotiations with General Motors regarding its ability to supply ventilators have been productive, but our fight against the virus is too urgent to allow the give-and-take of the contracting process to continue to run its normal course. General Motors was wasting time. Today’s action will help ensure the quick production of ventilators that will save American lives.
The Defense Production Act of 1950 authorizes the President to require businesses to sign contracts and fulfill orders deemed necessary for defense, but it has also been invoked occasionally in non-military emergencies. Democrats in Congress were urging him to invoke it in the current crisis. Trump was under pressure from corporate CEOs and the Chamber of Commerce not to do so.
Trump then fired off tweets to General Motors and Ford, which was working on its own plan to adapt car parts for ventilators, declaring that they ‘MUST START MAKING VENTILATORS NOW!!!!!!’ (yes, in capitals and followed by six exclamation points).
What is going on here?
My answer is – a sterile interaction of three main forces:
- Trump
- his Republican Party colleagues in government and in Congress
- corporate capitalism
I consider Trump separately from his colleagues because he is not just another Republican politician. He is one of a kind. He is influenced by the same ideology as his colleagues but less consistently, as shown by his attempt (however inept and futile) to dictate to the CEOs of General Motors and Ford instead of acting as an obedient executor of their will.
Continually changing his mind, Trump sometimes forgets how capitalism works, even though most of the time he understands this very well. How else could he fondly imagine that a corporation might be induced to satisfy a human need, irrespective of whether doing so is made commercially viable – that is, profitable? He does not blame capitalism, of course, choosing instead to blame individuals, such as Mary Barra, current CEO of General Motors, who – according to Trump – makes a mess of everything in which she is involved. In sharp contrast to the ‘very stable genius’ standing at the country’s helm.
As of this writing (March 30), no new facility for the production of ventilators is yet in operation in the United States.
Note
[1] This account relies mainly on three articles published in the Daily Kos on March 27: here and here and here.
Stephen Shenfield
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