Biden Has a COVID Plan, But Won’t Learn Deeper Health Care Lessons

    Donald Trump, the corrupt, narcissistic demagogue, has left the Whitehouse in the midst of a pandemic that killed 400,000 people on his watch, with no end yet in sight. His successor, Joe Biden, has a COVID plan. But nothing about him suggests that he will learn the deeper lessons of this preventable catastrophe.

    From the start, Trump dismissed the threat of COVID-19. His administration wouldn’t implement a unified, national strategy, instead leaving 50 state governors to figure out a response. Trump refused to marshal the vast  resources of the federal government to coordinate the production or distribution of personal protective equipment to hospitals overwhelmed by coronavirus, putting staff at great risk. He defiantly refused to wear a face mask and mocked those who did. In September, he held a superspreader event in the Rose Garden that infected his staff and family. Trump himself was infected and downplayed its severity. At every turn, the former president rejected evidence and science, obstructing the nation’s ability to control the spread of the coronavirus.

    Donald Trump’s actions and inactions are directly responsible for not preventing the sickening and death of millions of Americans. He has blood on his hands and must be held accountable.

    The Biden administration has inherited a Trumpian dystopia: A new wave is crashing over the country, the vaccine rollout is a disaster and a skeptical and scared public doesn’t believe the federal government can do anything right.

    To take on the pandemic, Biden announced a three-point plan that includes the distribution of 100 million vaccine shots in his first 100 days in office—enough to cover 50 million people—a face mask mandate and efforts to reopen schools safely. Moreover, Biden said he’ll use the Defense Production Act to ramp up production of materials necessary to roll out the vaccine.

    “My first 100 days won’t end the COVID-19 virus. I can’t promise that,” Biden said. “But we did not get into this mess quickly. We’re not going to get out of it quickly.”

    The pandemic has brutally exposed how our dysfunctional, for-profit insurance system cannot adequately respond to a public health crisis on this scale.

    The Biden administration actually believes in following the science around the coronavirus and the highly respected Dr. Anthony Fauci will be his chief medical advisor, meeting with the COVID-19 pandemic response team.

    Yet scientific literacy and mass vaccination, while necessary, are not sufficient. Because with each passing month, the COVID-19 pandemic has brutally exposed how our dysfunctional, for-profit insurance system cannot adequately respond to a public health crisis on this scale.

    Economically, the pandemic caused a massive recession and historic levels of job loss. But health coverage in the United States is tied to employment status. It’s estimated that over 26 million people have lost employer-sponsored coverage during the pandemic. It’s clear now, if it wasn’t before, how illogical it is to link insurance to employment. And it’s dangerous. The uninsured often delay testing and treatment, fearing the cost, and that is deadly in the era of COVID-19—as it always has been with other health crises.

    “How is this going to play out in the next year and how will we control the pandemic if people fear getting charged for a test?” asked Sara Collins, vice president for health care coverage and access at the Commonwealth Fund. People without insurance and even those who do have coverage face staggering medical bills if they are sickened by the coronavirus, which have left the gravely ill on ventilators in intensive care units for weeks, even months. The charges can run anywhere from hundreds to tens of thousands of dollars. Americans are receiving “surprise bills” for outrageous amounts for care connected with COVID-19. Collection agencies and medical bankruptcy await thousands of coronavirus survivors.

    Our profit-driven, multi-payer model of insurance is expensive, complex, offers limited coverage and leaves millions uninsured. It has always failed—above all for the marginalized populations devastated by previous and ongoing health crises like HIV/AIDS and overdose. But it has failed spectacularly and visibly, in a way that has dominated national attention like never before, in the face of the mutating coronavirus.

    Shamefully, the United States is alone among rich-world countries in not providing healthcare to its entire population. Countries in Europe and Asia—like Taiwan, for example—that have universal coverage and extensive public health infrastructure were able to coordinate rapid, national responses. Even the UK, where the government is guilty of many pandemic failures, has rolled out vaccinations far more efficiently than the US thanks to its centralized, taxpayer-funded National Health Service.

    What is desperately needed in the US is Medicare for All. Rep. Pramila Jayapal (D-Wash.) is the sponsor of legislation that would abolish the private insurance industry, creating a single-payer, national health insurance system that guarantees universal care. No cost-sharing, no deductibles, no coinsurance or copayments. It’s popular, too: 70 percent of people polled support Medicare for All, as do 120 House members–a majority of Democrats. Even Warren Buffett, Al Gore and Jimmy Carter are on board for single-payer. But there is one very powerful Democrat who is not: President Joseph R. Biden Jr.

    In a video on Biden’s website he explains, “In the Democratic debate in Miami, the question was asked if we support eliminating private health insurance. Some said yes, I said absolutely not. I believe we have to protect and build on Obamacare … I’m not for getting rid of Obamacare.”

     

    Expanding ACA Falls Far Short

    The Affordable Care Act (ACA, commonly called Obamacare) was passed in 2010. Biden has a personal stake in retaining the ACA because he played a major role in its fraught passage. During the signing ceremony, a microphone recorded him whispering loudly in Obama’s ear, “This is a big fucking deal!”

    The two most important aspects of the ACA were the expansion of Medicaid—although 12 states refused—and the fact that health insurance companies can no longer deny coverage or charge more because of a “pre-existing condition.”

    How can you defend a health care reform that is unaffordable and abandons millions of people?

    But almost 11 years in, it’s clear that Obamacare has failed. In 2019, 73 percent of uninsured adults said that they were uninsured because the cost of coverage was too expensive. Another widespread problem is health insurer claim denial. Nearly one in five claims for in-network care by patients with ACA plans are denied and some insurers reject about 40 percent of claims. To be sure, the ACA lowered the number of uninsured, but 28.9 million still have no access to care. How can you defend a health care reform that is unaffordable and abandons millions of people? Especially during an unprecedented pandemic!

    The new president’s approach to the healthcare crisis amounts to more piecemeal reforms that won’t contain costs and won’t cover everyone. Biden wants to shore up the ACA by increasing subsidies for people to buy private health coverage on the state marketplace exchanges. That funnels yet more public money into the coffers of private insurance companies at a moment when these corporations’ profits are skyrocketing. Pandemic profiteers UnitedHealth reported net earnings of $6.7 billion in the second quarter of 2020, compared to $3.4 billion for the same period in 2019. Anthem’s net income for those periods increased from $1.1 billion to $2.3 billion.

    Biden, too, is on the take. By mid-2019, he had accepted almost $100,000 from the insurance and pharmaceutical industries to fund his 2020 presidential run—more than any other Democratic candidate. One of his top fundraisers is Michael F. Neidorff, the CEO of Centene—a health insurance corporation that is heavily invested in the prison healthcare market.

    On the campaign trail, Biden announced that he would create a government-run health plan, similar to Medicare, called the “public option.” People would have to pay for insurance under this plan, as an alternative to buying it from private companies. Insurance companies successfully rallied opposition to this option when it was introduced during the health care reform debates in 2009, and they will try again. Biden also wants to lower the eligibility age for Medicare from 65 to 60.

    The system needs to be completely rebuilt on the principles of patients not profits, and healthcare as a human right.

    Both of these reforms are an attempt to shut down the movement for Medicare for All. Even if enacted, they represent small fixes to an inhumane healthcare system—a system that needs to be completely rebuilt on the principles of patients not profits and healthcare as a human right, not a commodity. Medicare for All embodies those vital principles. Biden’s proposals to build on Obamacare do not.

    During a presidential debate about health care last March, Biden said, “With all due respect for Medicare for All, you have a single-payer system in Italy—it doesn’t work there.”

    This was in response to Senator Bernie Sanders’ comment: “One of the reasons we are unprepared [for the pandemic] is we don’t have a system. We’ve got thousands of private insurance plans. That is not a system.” Sanders added that the coronavirus exposes the “incredible weakness” of  US healthcare, in part because millions of Americans are uninsured or underinsured.

    So with all due respect to President Biden, no one in Italy is ever uninsured. The concept does not exist. No Italian will ever get a surprise medical bill for $500,000, be forced into medical bankruptcy, not fill a prescription because it costs too much money, or ask right before being placed on a ventilator in order to breathe, “Who’s going to pay for it?”

     


     

    Photograph of COVID-19 vaccinations in New York City by Helen Redmond

    • Helen Redmond

      Helen is the senior editor of Filter. She has written about nicotine, mental health and drug policy for publications including Al Jazeera, AlterNet, Harper’s and The Influence. As an LCSW, she works with drug users in medical and community mental health settings. An expert on tobacco harm reduction, she provides training and consultation on mental health, nicotine use and THR, and in 2016 organized the first Tobacco Harm Reduction Conference in the US. Helen is also a documentary filmmaker.

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