COVID-19 has exposed the true cost of underinvestment in public health

As much of the world has seen their COVID-19 numbers plummet and some return to a semblance of normal life, the pandemic still rages across America. One reason is the unforgivable vacuum of leadership and strategy at the national level. Another cause is the longtime neglect of our healthcare infrastructure.

In Colorado, our local health agencies have been underfunded by as much as 40% year after year. This is broadly true nationwide, where longtime underinvestment and bad federal policy have combined to give America one of the highest rates of people who are uninsured, endure chronic conditions, or lack access to routine, preventive care. The pandemic has cruelly exploited these conditions and brought the cost of our underinvestment into deadly focus.

After decades of neglect, our healthcare system cannot conjure epidemiologists or contact tracers from thin air to address a pandemic. It cannot magically conduct massive public outreach, provide sustained support for vulnerable populations, and, eventually, administer hundreds of millions of vaccine doses without sufficient personnel and resources in place.

As long as this remains true, the virus will continue to spread, claiming lives, keeping kids from school, straining mental health, and pushing millions of small businesses to the brink of closure. We cannot allow this to happen again. Although Congress has provided some support for hospitals and other providers since February, far more is required.

America has to decide whether we want to manage the virus or allow the virus to manage us. To manage the virus, we need a dramatic investment to expand our public health capacity at every level and lay the foundation for a more resilient healthcare infrastructure going forward.

That is why Sen. Kirsten Gillibrand (D-N.Y.) and I have proposed creating a national Health Force, a bold initiative modeled after Great Depression-era programs like the Civilian Conservation Corps that would provide hundreds of thousands of jobs to support state and local public health efforts nationwide. Health Force members would work in communities nationwide under the supervision of local health officials to help with vital tasks such as contact tracing, community outreach, meal delivery for seniors and other immunocompromised people stuck at home, and, hopefully soon, vaccine administration.

The Health Force is not only a proposal to keep Americans safe. It is also about putting us in a position to reopen our small businesses and schools and allow them to stay open. As any teacher or shop owner will tell you, the worst thing we can do is fall into a vicious cycle of opening and closing. That has already happened this fall at many schools and universities. To stop that cycle, we need a robust investment in health infrastructure so that communities nationwide can react swiftly and effectively when new cases arise.

The Health Force is just one of many steps we should take to build a more resilient healthcare infrastructure for the 21st century. For example, we should finally join other developed nations by achieving universal healthcare through an affordable public option. We should unshackle Medicare to negotiate for lower drug prices and share those cost savings with the American people. We should increase transparency and embrace value-based care across the healthcare system, while continuing to increase investment in breakthrough research and technologies. Finally, we should confront the pernicious and long-standing inequities throughout healthcare that have allowed the virus to prey disproportionately on America’s immigrants and communities of color.

To be sure, all of this will require significant and sustained investment. But if we have learned anything over the last few months, it is that the cost of underinvesting in America’s healthcare system is far greater.

The 116th Congress: Policymaking Amid the Pandemic