As some asshole with a blog has mentioned many times, we need a universal healthcare system. Forget for a moment the discussion we had during the presidential primary season about exactly what that system would look like and WHO WILL PAY FOR IT?!? Having been around and in public health and infectious disease for many moons, it is obvious that we need a universal healthcare system–not necessarily a universal health insurance system (we’ll return to that in a bit). This is prompted by something Jen Gunter recently wrote on the Twitter machine:
If we had a unified healthcare system*, we would have the possibility of being able to track not only influenza-negative ICU admissions, but things like reported COVID-19 symptoms, even if testing hadn’t been available (and a national patient identifier would prevent ‘double reporting’–someone whose doctor reports symptoms, and then checks into the hospital wouldn’t be counted twice). And state by state differences in reporting wouldn’t be an issue either.
It would not be trivial to build this on the fly, but it could be done in a universal system. Right now, we have no way of tracking these data. There would be, at least, the potential to do that tracking. But in our balkanized healthcare system (and that’s an insult to the Balkans), we just can’t, expect in a few places, where consolidation has led to some private systems that could pull these data semi-regionally. We also have multiple reporting system and LIMS, and there’s no easy way to report or get these data–if at all.
Realistically, in the U.S., the only political program with the heft to build such a system is the Medicare-for-All movement. Despite pundits like Bill Scher arguing otherwise, none of the other options have the potential to get us there (and, please, the ACA tried, and utterly, utterly failed. Just don’t with that). Sure, a handful of economists can engage in fantasy discussions about a hybrid Japanese-Dutch decaf system with a lemon twist, but, within the context of U.S. politics and existing legislative infrastructure, Medicare**-for-All is the only way to get to this unified system.
*Arguably, an administration that built a unified healthcare system also would have had a much better public health response, so this might have been redundant. Better redundant though, than dead.
**Though the Medicare-for-All proposals actually resemble Medicaid for All much more.