The Centers for Disease Control estimates that anywhere between two million and twenty-two million Americans will be hospitalized with COVID-19 — in a nation that has less than a million hospital beds. It’s not as if those beds are currently empty, either. In fact, America’s hospitals and health care workers are already stretched thin. The coronavirus epidemic threatens to deliver them to the breaking point.

This crisis represents the convergence of multiple preexisting problems. One of these is that the United States’ uncoordinated patchwork of public and private hospitals has been subject for decades to a “lean production” management approach, borrowed from the private manufacturing sector, which purportedly aims to cut waste, trim fat, and improve efficiency.

In reality, what this has meant is that cost-cutting measures have led to shortages in workers, space, and equipment. Our overwhelmed, understaffed, austerity-starved hospital system is already in bad shape. It’s not ready for what’s to come.