Pandemic shows need for Single Payer Health Plan, Paid Leave, Social Insurance

A publicly financed single payer healthcare plan would enable the coordination and supervision of disparate private health providers during this pandemic public health emergency and ensure all receive necessary care.

The pandemic has shown how critical the coordination and distribution of scarce healthcare resources are—from the availability of healthcare personnel, the procurement of masks, gowns, and gloves, to the rationing of ventilators, oxygen supplies, emergency room gurneys, and ICU beds. COVID testing and the federal mass dissemination of vaccines have been free for all at the point of service. We must extend the same logic to the rest of the healthcare system—that scarce caregiving resources be distributed by medical need, not ability to pay.

During the pandemic, testing, reporting of infectious disease, outbreak contact tracing, infection control protocols, and vaccination of patients has been coordinated by local public health authorities.  Federal, state, and local government agencies ran mass testing and vaccination sites. A single source of financing could more efficiently facilitate mass vaccination campaigns.

Private providers already receive compensation from many public sources, including Medicare, Medicaid, community health center grants, as well as state and county subsidies for care for the uninsured. The Affordable Care Act significantly standardized and regulated the employer-based and individual health plan market. Funding for new vaccines and treatments to a large extent comes from federal agencies.

A unified single payer plan would replace disparate provider funding sources with one payer with set rates and care recommendations. With highly transmissible disease variants surging across the country, the need to unify disparate sources of financing to provide free testing, treatment, and vaccination is paramount. Chronic and preexisting conditions worsen COVID symptoms, but many can be prevented with proper care. The lack of ability to pay prevents many patients from managing chronic conditions.

Social Insurance that gives financial help to those in need is necessary to stop the pandemic’s spread. In addition to public health orders to shut down schools and non-essential businesses, mandate masking, and mass testing and vaccination campaigns, public actions this year also included eviction moratoriums, business loans, stimulus checks, and legislation granting the right of workers to take COVID-19 sick leave.

Universal paid family leave is needed now. Contact tracing and isolation of close contacts to a COVID infected patient is less effective without paid leave and right to return to employment for workers following such public health orders. If it means two weeks without pay and potentially the loss of one’s job, patients are less likely to identify whom among their friends did they potentially infect and who must quarantine.

Testing, treatment, and vaccination efforts were hindered by conflicting data management systems in place at different health providers, public health agencies, and state and federal systems. There is a need for data sharing and a national registry for COVID-19 test result and vaccination status. A single payer for health services could standardize fragmented data systems and allow coordination between healthcare providers, government agencies, infection control, and contact tracing teams.

The impact of COVID has been felt disproportionately by Black, Latino, and poor people from areas vulnerable to economic scarcity. High-income neighborhoods avoided COVID-19 in the winter 2020-21 surge because workers had paid sick leave, remote work options, grocery delivery services, and spacious housing to reduce their risk of exposure. Crowded multigenerational housing and family members working in essential occupations with a higher chance of encountering covid positive individuals has made working class communities more vulnerable to COVID-19. Disparities in vaccine uptake signals that at-risk communities remain vulnerable to future COVID surges.

The Unite States government spends enormous amount on national security, but historic disinvestment in public health led to under preparedness in response to the pandemic. The 600,000+ deaths over the past year and a half demand a unified and comprehensive national health plan and public health system.

               The public health emergency is forcing public action. The US can better wrestle with the disparate racial impact of the virus caused by occupational and economic stratification with a single payer health plan and income guarantee that covers sickness, caregiving, and the economic crisis caused by emergency public health measures.

Leave a Reply

This site uses Akismet to reduce spam. Learn how your comment data is processed.