The COVID-19 pandemic has brought into sharp focus two undeniable truths: Our healthcare system has structural weaknesses, and the state of our individual health depends on that of our fellow citizens.
Our immediate priorities, of course, are to slow the spread of the virus, ensure that our healthcare delivery system can handle the flood of patients, ensure the protection and well-being of our front-line healthcare providers, and protect workers and businesses from the collapsing economy.
But crises, for all the hardship they bring, also present opportunities for necessary change. What’s needed now is a new social contract between the government and the private sector, between people who receive and pay for healthcare and those who provide it, and between individuals and their communities. Once we’ve stabilized, it will be time to prioritize our collective well-being by strengthening our healthcare system to ensure we’re well-prepared for future crises.
We can do that in the following ways.
First, the current crisis has shown that as a nation, we need to rebuild our public health infrastructure to prevent and respond more quickly and effectively to future epidemics. No longer can we simply rely on market forces to drive investment in needed services and products. The government must play a more active role in the financing and development of vaccines and new drugs and establish smart public policy that creates reserve capacity for hospital beds, supplies and equipment needed in an emergency.
We need to dramatically increase our investment in primary care—including mental health—and build a robust community-based health system foundation. Our country’s emphasis on specialty and hospital-based care likely made us more vulnerable during this crisis. If instead we prioritize prevention, testing and most primary-care services—and remove financial barriers for patients—people will receive care at a much earlier stage and in settings that allow them to avoid our already overcrowded and overburdened hospitals.
It’s also time to finally change the way we finance healthcare so that medical providers are paid to keep us healthy, not just treat us when we’re sick. We’ve known for decades that the way we pay doctors and hospitals has prioritized specialty care and undervalued preventive services that could have been helpful in reducing the number of infections during the COVID-19 crisis. We need to revamp the way we pay providers so that they are rewarded for keeping their patients healthy using the most cost-effective methods to do so.
We need to get serious about building a robust infrastructure for the exchange of healthcare information among all healthcare providers, along with standardized measures that give us a complete picture of the quality and costs of healthcare services. Policymakers must lead the way by establishing minimum requirements for capturing and sharing healthcare data and information essential to guiding good patient care, smart policy and health benefit designs.
Finally, this crisis has demonstrated beyond a doubt the glaring inequities in our country. Social distancing is a luxury; working from home is not an option for most low-wage workers. Those with chronic illnesses are more vulnerable to the worst outcomes of this virus. Communities of color face increased burdens of health and socio-economic disparities, with hotspots for the virus disproportionately among poor and minority communities.
The lack of access to routine healthcare services, due in large part to a lack of affordability, has surely contributed to the coronavirus’ spread in the U.S. The time is long past to debate the benefits of broad coverage; we must expand Medicaid in all states and provide subsidies to low-income individuals who enroll in health insurance plans through the exchanges.
Often, a crisis can stimulate action and enable us to overcome barriers that have stopped progress in the past. We must not let this moment pass.