The plagues had another major impact. It gradually became clear that the petulance was spread by poor housing, sanitation, hygiene, and polluted water. But no one was safe from contagion, and so the health of the wealthy was dependent on the health of the general populace.

So there were massive structural reforms - sewers, clean water supplies, and medical advances based on science rather than superstition. These had to be made available to all to benefit the few. "Herd immunity" is only achieved if the vast majority are immunised. Health care was understood as a communal good.

But in more recent times, and especially in the USA, healthcare has come to be seen as a private good to be bought by those who can afford it - either directly or through insurance. Public healthcare, sanitation and clean water has been systematically defunded. The lack of adequate sick pay or social welfare forces the sick to go to work and spread contagion.

The rich will have to learn, all over again, that healthcare is a communal good. Your health is not safe unless every-ones health is safeguarded, and that requires good public healthcare and social welfare systems. Welcome to the late middle ages...

Index of Frank's Diaries