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Without Medicare for All, We Don’t Have the Tools We Need to Stop Coronavirus

The coronavirus is exposing anew the barbarity of our for-profit health system, which blocks people from getting tested and doles out treatment on the basis of ability to pay. We need Medicare for All, full stop.

Medical personnel take a sample from a person at a drive-thru Coronavirus COVID-19 testing station at a Kaiser Permanente facility on March 12, 2020 in San Francisco, California. Justin Sullivan / Getty

Day-to-day life in the United States is starting to be upended. The coronavirus outbreak is now officially a pandemic. And as the deadly virus spreads, the irrational injustices of our marketized health care system are being exposed and the urgency of Medicare for All laid bare.

We don’t have complete information about the new coronavirus (COVID-19), but it appears to hit hard and fast. Up to 60 percent of adults around the world may become infected within a year. The global mortality rate currently sits at around 3.6 percent. There are no vaccines yet, and no known cures. In the United States, there are now over a thousand confirmed cases and at least thirty-eight deaths. Both numbers are expected to skyrocket: experts say confirmed cases will likely double every six days, which would mean a million cases by the end of April. This is not the flu.

As hospitals, doctors, and nurses are placed under increasing strain, it will only get worse. Severe cases require hospitalization for weeks, but the United States only has an estimated 300,000 unoccupied beds nationwide. Some hospitals are already running out of face masks. Outside of the United States, medical workers have begun triaging care — deciding who gets a bed, who has to sit in the hallway without oxygen, and even who will live and die.

Whatever the eventual scale of the crisis, it will not be a purely natural disaster. More than 120 rural hospitals in the United States have closed in the past decade due to unprofitability. Millions of workers are unable to take time off because the United States, unlike most any other country in the world, still doesn’t guarantee paid sick leave. Millions of people can’t afford to see a doctor (in the last year, half of US adults say they or a family member have put off care due to cost). The 27 million Americans with no insurance at all are especially likely to skip care. As the virus spreads, many will forgo seeking treatment or screenings for fear of the cost. We’re already hearing of steep medical bills from patients getting tested for coronavirus: $3,270 in Miami, $3,918 in Pennsylvania, $983 in Kansas. People will die because of our tattered welfare state.

With unnecessary misery mounting, the crisis could create a new impetus for reform. For decades, mainstream politicians have pushed for more cost-sharing in health care, arguing that free health care would incentivize people to use more services than they needed. Austerity peddlers insisted that we simply could not afford universal health care. Both arguments are collapsing in the face of existential health care needs. Politicians long skeptical of Medicare for All are scrambling to eliminate cost-sharing — and the notion that Medicare for All is a naive, unrealistic dream is vanishing.

For years, California governor Gavin Newsom failed to call on the state legislature to introduce a statewide single-payer bill. Now he’s ordering insurance companies to make coronavirus testing free. The same is happening in states like Washington and New York. Federally, President Donald Trump is following suit.

When Bernie Sanders and the late Minnesota senator Paul Wellstone introduced an amendment in 2000 to regulate the price of drugs developed with public money, Democratic lawmakers (including Joe Biden) voted against it. Now Biden and House speaker Nancy Pelosi are demanding that the coronavirus vaccine be made affordable to everyone.

It turns out that when politicians actually want to remove barriers to care, they can. So let’s push them further. If it makes sense to eliminate cost-sharing for patients with coronavirus, why not do so for patients who are HIV-positive? If life-saving drugs developed with public money should be affordable now, why not socialize the EpiPen? If we can remove co-pays for testing, why not treatment? The Medicare system currently covers the costs of coronavirus testing — why not expand Medicare to everyone?

It is still possible to combat the spread of the coronavirus. According to the head of the World Health Organization, Tedros Adhanom Ghebreyesus, “All countries can still change the course of this pandemic. If countries detect, test, treat, isolate, trace and mobilize their people in the response.”

But right now, our for-profit health care system is gas on the fire, as millions of Americans decide whether to get treated or whether to save the money. In meeting the challenge of the new coronavirus, we must mobilize for reforms that mitigate immediate harm and make the next public health scare less deadly. At the bare minimum, we must demand that everyone in the United States — regardless of citizenship or immigration status — receives free testing and treatment for coronavirus. This would save thousands, perhaps millions, of lives. And it could also lay the foundation for what we really need: Medicare for All.