It’s Time to Expand the COVID-19 Exception to All American Health Care
Yves here. In theory, spending more money on other US health care priorities, as we have with some elements of Covid response, would be desirable. But in a saying attributed to Yogi Berra, “In theory, there is no difference between theory and practice. In practice, there is.”
We have a bloated and fabulously inefficient health care system. There’s every reason to think that more generous funding of health care priorities, like tackling cancer or autoimmune diseases, would largely go to private equity and health care executive pay packages.
The biggest thing the Feds could do is use government buying power to negotiate drug prices, as every country in the world except the US does. Stopping the price gouging on insulin (and tons of other meds like Sovaldi, Zolgensma, Acthar Gel, and Isuprel which saw huge price increases) would do more to help Americans than long-term initiatives to tackle Big Ailments, given not just the uncertainty of results but questions about whether the effort could be sustained and how to prevent it from becoming the medical version of the F-35.
I wish I had a better answer. But the fact that the US has no good data about any aspect of Covid: how many have had it and what variant if so, how many have died and been hospitalized, how many have been vaccinated, and has made messaging more important than results says we aren’t capable of running large projects, even when the health of citizens and the economy depends on them.
And I have to cringe when I hear people who have not encountered Medicare depicting it as a paragon. It’s a public-private program with lots of gaps and insane complexity. Yes, it’s better than not having insurance, but treating it as some sort of nirvana is wildly naive.
By Sonali Kolhatkar, the founder, host and executive producer of “Rising Up With Sonali,” a television and radio show that airs on Free Speech TV and Pacifica stations. She is a writing fellow for the Economy for All project at the Independent Media Institute. Produced by Economy for Alla project of the Independent Media Institute
There has been a Jekyll-and-Hyde quality to American health care over the past two years. The federal government under the previous administration of Donald Trump, as well as the current one of Joe Biden, has carved out what can be characterized as the “COVID-19 exception,” inconsistently intervening to help people avoid the virus or recover from it, while standing by as Americans struggle with other ailments. In doing so, it has exposed the vast fissures of a broken system into which millions of Americans routinely fall some, never to emerge.
For example, the Biden administration is now taking action—albeit a year late—to ensure that Americans have a small measure of access to COVID-19 rapid antigen at-home test kits. Without requiring congressional approval, the government launched a centralized and straightforward website for people to order free antigen testing kits. The site is stunningly easy to use, does not require any other information besides a name and address, and relies on the US Postal Service for distribution.
That effort came on the heels of an announcement that private health insurance companies would now be required to reimburse their patients for the cost of such purchased tests out-of-pocket.
Although these policies are being enacted nearly two years into the pandemic, they are certainly better late than never. They signal that the federal government tacitly recognizes the prohibitive cost of protecting oneself from a rapidly mutating and increasingly transmissible virus for low-income Americans.
The government is also providing free masks—finally. Experts recently dismissed as insufficient the now-ubiquitous reusable cloth masks, in the face of the Omicron variant. The Centers for Disease Control and Prevention (CDC) has instead recommended high-quality medical disposable masks such as N95 masks, which are very difficult to come by, or similarly protective KN95 masks, which run upward of $1 a mask. In response, the White House has announced a program to make 400 million N95 masks from the strategic national stockpile available to Americans for free through local drug store chains.
Commentators are pointing out that it’s past time that the government offer free at-home tests and masks—as if inaction on health care wasn’t a standard feature. The Washington Post compared the US to other nations that made such protective materials available to their citizens for free far earlier in the pandemic, and pointed out that the United States’ “lack of universal health-care coverage contrasts sharply with other nations.”
In spite of arriving late to offering masks and at-home tests for free, the federal government has adopted more of an interventionist posture on COVID-19 than any other health care front, ensuring that vaccines, most testing, and treatment remain largely free of charge to Americans. Insurance companies are mandated to cover COVID-19-related costs regardless of the contours of individual plans. And, the uninsured have their costs covered by the government.
The flip side of this commendable government approach to the pandemic is that it ignores those who are unlucky enough to be uninsured or underinsured and struck by any other ailment besides COVID-19.
Take canceran illness that affects 1.6 million Americans each year and is the second leading cause of death in the nation. Studies show that cancer-related death rates are higher for those who lack private health insurance compared to the insured. Might such disparities vanish if the government considered cancer to be as worthy of intervention as the coronavirus?
Peter Arno and Philip Caper, writing for Physicians for a National Health Programasked this critical question in another way: “will our first-hand experience of the federal response to the pandemic (delayed though it was) dispel the usual objections to single-payer health care? Or will most Americans conclude that the public health crisis caused by this pandemic is a one-off exception?”
Although the COVID-19 exception is a promising step toward federal intervention in health care, the programs to distribute vaccines, tests, and masks are still woefully insufficient or disorganized—precisely because the United States lacks a centralized universal health care system through which to enact such efforts. Last year’s COVID-19 vaccine rollout was chaotic precisely because the federal government had to rely on a patchwork system of private and public health care, private for-profit drug store chains and smaller nonprofit organizations.
According to Public Citizen“Countries with a more unified system are better able to roll out testing, track the spread and intervene appropriately, as they aren’t forced to negotiate with numerous private insurers, issue regulations or orders for multiple public insurance programs, or figure out how [to] handle testing and treatment for the uninsured.”
The United States is a global embarrassment when it comes to health care. The Economist magazine once described the US as, “The only large rich country without universal health care.” The US joins extremely poor nations like Afghanistan and Yemen on the list of 10 notable countries without a universal government-run health care system.
According to a recent Federal Reserve report“[s]eventeen percent of adults had major, unexpected medical expenses in the prior 12 months, with the median amount between $1,000 and $1,999.” The report also found that “[t]wenty-three percent of adults went without medical care due to an inability to pay.” These statistics are startling and yet, not shocking enough for the government to either expand the COVID-19 exception to cover all illnesses, or expand the Medicare program to cover all Americans. Either step would ensure that no Americans would forgo health care due to an inability to pay.
This depressing status quo is the direct outcome of a well-funded propaganda war by corporate profiteers against expanding the existing Medicare program to all Americans. They include health insurance companies, the private hospital industry, and pharmaceutical corporations.
Interestingly, the standard critics of government-funded health care are stunningly silent on the COVID-19 exception—perhaps because they understand just how shameful it is to deny people care for a pandemic that has eclipsed normalcy and claimed over 800,000 American lives. There is a silent acceptance of the government taking responsibility for ensuring protection from COVID-19, but not from cancer, diabetes, or any other illness.
The naysayers against Medicare for All are relying on Americans simply not noticing the COVID-19 exception.