When this whole mess is over I want to remember the shortages of masks for medical workers.

At the moment when it looks like cases of COVID-19 are going to explode and overwhelm some medical systems, Forbes Magazine has printed directions for volunteers to sew masks for frontline medical workers. A local nurses’ association is organizing an N95 mask donation drive. Last night my spouse spent hours trying to negotiate transnational supply relationships to locate sources of masks even at high prices.

Meanwhile, the CDC suggests that frontline workers could use bandannas or scarfs–as if our medical professionals are working in Civil War field hospitals.

These past few days I have been thinking of how much Americans love our specialized gear and our shiny technology. We love our California Design, our startups, and our pickups. Our organizations have been optimized over decades by rewarding the discoverers of profitable efficiencies at the expense of dependable redundancies. We all know that American workers are among the most efficient in the world. Up until this past week, if America had a sound it might be a Cummins engine.

We have been told we have the best healthcare system in the world and some have believed it. They have believed it despite the high premiums, despite the high deductibles, despite the lines and waits, despite the GoFundMe campaigns and despite the fact it doesn’t cover everyone.

Our healthcare system is among the most expensive, bureaucratic and profit-generating healthcare systems of the overdeveloped world. It’s supply lines, digital networks and and managerial protocols stretch across the country and snake off into the world.

And yet, I want to remember that despite its power and its billions, at the moment we need it most, the system cannot deliver the most basic thing: a simple face mask—layers of filter paper held together by rubber bands. Instead hospitals have been forced to turn to the people that have been paying so much for healthcare, some of whom have not been going to the doctor because they fear the financial consequences.

For years whenever reforms in America’s broken healthcare system were discussed the conservative Right scared people with the idea of rationing care–“death panels” where someone would decide who lives and who dies.

If this gets much worse those decisions will be coming. They will be made by doctors who might not even have masks.