Viewpoint: Pandemic underscores urgent need for universal health care

Karen Rubin
Karen Rubin, Columnist

What frightens Republicans – the party of privilege, entitlement and white supremacy – about the very idea of universal health care is that they will have to stand in line like everyone else for the COVID-19 vaccination and other shots. The zero-sum mindset is if “they” have health care, I won’t. Hence the “death panels.”

Well, this coronavirus pandemic has shown us Republican death panels, with an overwhelmed or nonexistent public health system that results from a for-profit model of health care and health insurance tied to employers (creating a system akin to indentured servitude).

January was the deadliest month so far, with 95,000 COVID-19 dead in the United States as the number of infected hit 26 million – that’s 26 million on top of the 100 million with “pre-existing conditions.” Even if 80 percent had only slight cases, that leaves 5 million with severe illness and very possibly millions of “long-haulers” with serious, ongoing health issues that likely hurt their productivity and their ability to earn a living. Who will pay for their health care? Who can afford it?

And even though it will probably be many months before there is an all-clear from this pandemic, the likelihood is it will not be a century, not even a decade before the next one.

So we need a real public health system, pandemic preparedness, true universal health care and beyond that a new emphasis on prevention and wellness.

Among the first executive actions President Biden took was to start to undo Trump’s sabotage of the Affordable Care Act. Biden ordered the reopening of enrollment in the health law’s marketplaces and a re-examination of Trump administration policies that undermined protections for people with pre-existing medical conditions.

But so much more needs to be done.

It is time for true universal health care – it can start with adding a public option to Obamacare or go whole hog and introduce universal Medicare. That just means expanding Medicare to all – it can be gradual by expanding the age to buy in (realizing that 80 percent of health care spending hit in the last few years of life), but it is probably preferable to make Medicare the rule and private, employer-based health insurance the exception.

Eliminating the totally non-productive, bean-counting, for-profit insurance middleman would save some 20 percent from the cost of health care, which now amounts to 19 percent of Gross Domestic Product and as much as 20 percent of a family’s household budget.

Take the best of universal health care systems provided by every other industrialized nation – you don’t have to replicate them – and create a hybrid between private and socialized system (as it already is now). You can keep a private health care system (likely alongside public hospitals, clinics and doctors), but fees and charges not just for doctors and hospitals but also drug companies should be regulated, rationalized, capped as a public utility. That would provide true equity.

To solve the problem of health equity and the fear about “rationing” care, increase the number of doctors, nurses, physician assistants; open new healthcare categories of restricted specialties that take less time and cost to train; open more community clinics and expand telemedicine. Provide tuition forgiveness for serving in clinics in communities most in need of care.

Invest in research to develop precision medicine and drug techniques that are more effective and efficient.

Address the epidemic of Alzheimer’s, the most expensive disease in America and the fifth leading cause of death in adults over 65 years. Alzheimer’s affects 5.8 million Americans and cost $305 billion in 2020. The cost is expected to increase to $1 trillion as the population ages and the number of people with Alzheimer’s triples to 16 million by 2050, according to the American Journal of Managed Care ( Invest in research to develop early diagnosis and treatment. (See

Breathe new life into public health systems which have been shortchanged, starved to death under Republican anti-government policies for the past 40 years. Public health should apply to all, including undocumented immigrants who have the same vulnerability to disease and ability to spread it. Indeed, there shouldn’t be undocumented anyone – fix the broken immigration system to make society healthier, more productive and prosperous.

Critically, with the advances in medicine and medical technology, the health care system should be as much focused on prevention and wellness as illness – models that are discouraged in a for-profit health and Big Pharma system.

Imagine this: Science has the capability of keeping people alive to 120, but consider the cost if they are on dialysis for 55 years, or needing regular heart or organ transplants (they are working to create artificial ones that can be manufactured with a 3-D printer). How does society support one third of the population retired, needing expensive, ongoing medical care for decades?

We need to achieve true health care equity, but we almost must build in wellness more robustly: free annual wellness checkup, free vaccinations, full coverage for mental illness on par with physical illness, assistance or even incentives for physical and mental wellness – nutrition, exercise, yoga, shelter, living wage, education.

The Global Wellness Institute, which mounts an annual summit, has launched a “Wellness Moonshot Challenge” dedicated to eradicating preventable illness. Imagine that! People living their lives with the most important quality-of-life ingredient of all, health, rather than years and years of suffering with debilitating pain.

“In 2020, we experienced a global pandemic, economic meltdown, racial injustice, polarizing politics, and a mental wellness crisis that changed every aspect of human life¬¬. The pandemic made wellness radically more important to people overnight, while the coronavirus exposed the terrible human cost for not controlling chronic, underlying conditions, radically strengthening the case for preventative wellness,” said GWI CEO Susie Ellis at this year’s Global Wellness Summit (

GWI cites the Centers for Disease Control and Prevention estimate that 69 percent of all deaths globally each year are the result of preventable diseases and that the global cost of largely preventable chronic diseases (cardiovascular disease, chronic respiratory disease, diabetes and more) could reach $47 trillion by 2030 (World Economic Forum, 2017).

“Never in my lifetime has there been a more critical moment to stand up and take action to raise awareness of the importance of largely preventable chronic diseases. We are calling on companies large and small, private and public foundations, universities and individuals to sound the clarion call and unite in this crucial mission,” Ellis declared.

Government also needs to partner in this Global Wellness Moonshot.

About the author

Karen Rubin

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