In our lifetime, it has perhaps never been clearer that we need a single, coordinated public healthcare system with equal access for all—a VA for All—oriented around public health needs.
As the COVID-19 pandemic rages on, reports mount of uninsured patients dying for lack of access to care, healthcare workers without protective gear, a critical dearth of ventilators, and the potential for mass hospital closures as health systems postpone lucrative elective surgeries.
Rather than seeking to bail out our existing increasingly expensive and fragmented healthcare sector, we should be inspired by places like Spain and Ireland, which have nationalized private hospitals in order to leverage their full health system capacities in a coordinated way to fight this pandemic. Or, we can look no further than the ideals behind our own Veterans Health Administration, where veterans can get lifelong, integrated care at a network of government-run health facilities with minimal or no copays. Bringing our health sector into long-term public ownership can address the immediate needs of the COVID-19 crisis while also creating the infrastructure for a more efficient and equitable healthcare system with a new bottom line for healthcare: people, not profit.
Reconstituting our health system—insurance and the provision of care—as a public utility, rather than a key engine of a growth economy, opens up numerous opportunities to:
- Enhance planning and coordination, enabling more rapid and effective distribution of supplies and tracking of cases
- Ensure equitable access across geographies
- Re-center primary and preventative care
- Improve data management and continuity of care
- Maximize the public return on investment in healthcare workforce training
- Coordinate across the public sector to ramp-up domestic production and distribution of medical supplies
- Expand physical infrastructure where needed, through construction, upgrades and requisitioning
- Expand telehealth infrastructure, coordinating with other agencies to ensure broadband as a critical public utility
- Develop targeted job pipelines that meet community needs and provide good jobs, from frontline healthcare personnel to sanitation workers
- Democratize healthcare and health services and provide for citizen accountability and oversight.
This vision for what is possible stands in stark contrast with our current reality of high-priced care, unequal access, and many of the worst outcomes among the world’s major economic powers. Instead of subsidizing the existing broken model (at ever-increasing cost), we should invest in a new one.