During the March 15 Democratic presidential debate between Joe Biden and Bernie Sanders, moderator Jake Tapper of CNN asked how to avoid a situation like that in Italy, where in some areas doctors are forced to decide who gets urgent treatment and who does not to survive the coronavirus. When it was Biden’s turn to answer, he said “With all due respect for Medicare for all, you have a single-payer system in Italy. It doesn’t work there…That would not solve the problem at all.”
Biden then promptly called for guaranteeing treatment for everyone irrespective of cost, precisely the premise of a single-payer system: “We can take care of that right now by making sure that no one has to pay for treatment, period, because of the crisis. No one has to pay for whatever drugs are needed, period, because of the crisis.”
So, in “normal” times Biden doesn’t think it’s necessary to provide a guarantee of universal coverage. In an emergency, however, “We just pass a law saying that you do not have to pay for any of this, period.”
Apparently, health problems for people who don’t have insurance aren’t an emergency until they threaten others.
Sanders missed the opportunity to call Biden on this glaring contradiction, and also failed to directly answer the charge that a single-payer system like Italy’s is failing the test posed by the crisis. He focused instead on the U.S. system’s failure to provide healthcare to all people, stressing that the current crisis “is only making a bad situation worse.”
Biden suggested that the situation in Italy proves that a public system doesn’t work. Sanders, on the other hand, said he wanted to eliminate private insurance completely, on principle. Neither of these ideological positions reflects how the health system actually functions in Italy. While Sanders’ call for a public guarantee of care reflects a fundamental goal to be pursued, it is essential to also identify the short-term financial mentality that has pervaded healthcare in both public and private systems in recent decades.
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8. April 2020 at 6:25 pm
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