The Big Fail: What the Pandemic Revealed About Who America Protects and Who It Leaves Behind

In this withering account, The Free Press columnist Nocera and journalist McLean, who previously collaborated on 2010’s All the Devils Are Here, survey the policy decisions, made in some cases decades before 2020, that hampered America’s ability to combat the Covid-19 pandemic. The authors highlight the effects of NAFTA, suggesting that it fueled the globalization of supply chains so that by the time the virus hit the U.S., most hospitals bought PPE on an as-needed basis from China and had few domestic alternatives. The industrialization of American hospitals also proved disastrous, they contend, chronicling how the efforts of Nashville internist Tommy Frist Sr. to privatize and franchise hospitals in the late 1960s heralded a noxious trend of prioritizing profits over patient care, leading hospitals to cut costs by reducing the number of available beds and all but assuring medical facilities didn’t have the capacity to handle waves of patients as Covid swept the country in 2020. Nocera and McLean excel at teasing out how political polarization, private equity’s takeover of nursing homes, and other factors intersected in disastrous fashion during the pandemic, combining first-rate reportage with astute big-picture analysis. It’s among the best reports to date on America’s botched pandemic response. (Oct.)