Public Health v. Private Health

In the most recent debate between Joe Biden and Bernie Sanders, the topic of health care in the age of Covid-19 was batted around. Bernie, of course, claimed that Covid-19 proves the importance of passing Medicare for All. Biden countered that everyone in Italy is covered, yet their insurance scheme failed to protect them from this new virus. While I really do want to get all Americans covered, I give this debate point to Biden.

Bernie might actually understand that a health insurance scheme that covers everyone for their individual health concerns is a totally different beast from a public health system that strives to protect us all from preventable catastrophes. To me, it’s beyond annoying that he can’t divert from Medicare for All for even a minute to acknowledge this in a debate. His version of M4A is not a cure all for every ill in our society. 

Public health systems focus on safe drinking water, waste water treatment, minimizing transmission of communicable diseases, addressing addictions, violence, preventable injuries, and more. Just check the list of programs under the auspices of Public Health – Seattle and King County and you’ll quickly see the difference between an insurance scheme for individuals and the mission of public health agencies. Strong public health systems are vital components of our communities today.

Covid-19 certainly makes the gaps in our individual safety net conspicuous. Congress is trying to cover these insurance gaps in a piecemeal fashion by covering Covid-19 related testing and care. But accidents will happen, cancer will happen, hearts will get attacked, so our Swiss cheese insurance scheme will continue to wreak havoc with those with other health problems – and those affected by our economic meltdown.

Covid-19 also exposes our short-sightedness regarding public health funding and contingency plans for contagious diseases. Perhaps we don’t need to have a billion items of personal protective equipment on hand, but we clearly need to have a plan to produce them quickly when the need arises. If planning efforts reveal reliance on unreliable allies, then we’d better think ahead about that pitfall as well. 

Anyone who says that this could not have been predicted is just wrong, and yes, Donald, I’m thinking of you. Once we come through this, we’ll have an opportunity to plan for a future virus. Unfortunately, preparing for rainy days is difficult when we put so much pressure on politicians to give us goodies now, the future be damned. After this, if no one is in a mood for sacrifice, we could pass up the opportunity to prepare for the next pandemic. Of course there will be another one. Guaranteed. Learning from this one to prepare for the next one? Not guaranteed.

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