Viruses, Health Care, and Communal Provision

Marc Stier |

A few years ago, I wrote a piece that explained why health care has to be provided communally. I showed that without extensive communal provision through both direct investment and the subsidy of insurance that pays for medical care, we would have far fewer well-trained doctors, far fewer major medical centers, far less knowledge about and treatment for all but the most common illnesses, and most people with pre-existing conditions—that is pretty much all of us sixty years or older and many of us far younger—would not have affordable insurance for those conditions.

We are now seeing one more reason why health care must be provided communally and why everyone must have not only health insurance but protection against the economic ravages of unemployment and underemployment. When we are fighting an infectious disease like COVID-19, one that spreads rapidly and is acutely dangerous, it is absolutely critical that those who are sick or might be sick know whether they are suffering from the infectious disease and get the health care they need if they do have it; that those who are suffering from other diseases that make them more vulnerable to becoming sick with COVID-19 get treatment; and that we all are able to take off from work if we are suffering from the infectious disease.

Why are all these measures so important? Because whether we become sick and whether there are enough medical resources to treat us, is not an individual problem but a collective problem. None of us can protect ourselves from the coronavirus by ourselves. None of us can ensure that medical resources will be available for us if we get sick through our own efforts. We need our fellow citizens to get tested and keep their distance—which means to take off from work— to slow the spread of the disease both to reduce our likelihood of getting and to ensure that the number of us who suffer from it at any one time does not overwhelm the medical resources available in the country. And, of course, if not for extensive public investment in the doctors, hospitals, and medical knowledge, the resources to test for and treat not only COVID-19 but other diseases that make it worse would not exist.

Health care is not an individual good. It is a good we can only secure through common effort paid for by all of us. We largely do provide health care in that way but too many of us who pay taxes for our extensive common provision of health care do not receive the benefits because they don’t have the resources to secure care for themselves. And that is not only grotesquely unfair to those people but ultimately self-defeating for the rest of us.