I’ve been reflecting a bit on what government officials & policymakers should learn from the Covid-19 crisis. While history, with the benefit of hindsight and data, will be the ultimate judge, a few things jump out to me as obvious:
- A few decades lucky streak of no major pandemic should not make anyone complacent on the importance of public health. Many Americans, at the onset of the crisis, simply assumed that pandemics were like the bubonic plague or ebola: concerns for a faraway time and place. But the unpleasant reality is infections have been with us since before civilization and will continue long after the current crisis ends. All our modern conveniences and sophistication don’t mean a damn to a microbe. As a result, making sure public health leadership and infrastructure is in place and has the emergency powers and resources it needs when crisis hits is absolutely vital.
- I think there are very good reasons to want a single payer healthcare system, and plenty of reasons to be wary of one. But, despite the efforts of pundits, I think Covid-19 is largely irrelevant to this debate. The practical reality is many countries with single payer systems (like those in Europe) appear to have been completely incapable of managing this while some without it (ie China) have. This is not to say China did everything perfectly (obviously they didn’t and I pray they’ve learned this time to permanently shut down wildlife wet markets) nor that single payer systems are to blame for whats happening in places like Italy (it’s not). But even holding aside how the term “single payer” papers over important nuances about how different “single payer” systems mix different levels of private coverage in, the truth of the matter is that countries that have been able to control and contain the disease share more around bold actions by public health officials than they do around how exactly healthcare is provisioned. The “Medicare for all” debate needs to be had and resolved — I’m not cheapening that — but I just don’t think Covid-19 is particularly relevant for either side of it.
- Sick leave is critical for public health. People who are sick need to feel like they can stay home and not jeopardize their financial well being. Otherwise economic activity (which we can’t all avoid: everyone eventually needs food even when locked down on quarantine) becomes increasingly the domain of those who are sick but forced to be working from economic desperation.
- Confused and contradictory messaging from government officials is NOT helpful. When different officials give wildly different responses (see Devin Nunes encouraging people to go out for dinner earlier Sunday vs. the Director of NIAID advocating for a national lockdown), is it any wonder that the public can’t tell how seriously to take this? On the one hand, we have toilet paper shortages at stores and on the other hand people in this club in Nashville last night are partying as if nothing was happening).
- I’ve had a number of conversations with smart people I respect who have commented on the difference in reaction to the crisis in “the West” (US, UK, Europe) vs “the East” (China, Japan, Korea, Taiwan, Singapore). Its hard to have this sort of conversation without racial undertones creeping in, but its also hard to ignore the chorus of commentators who believe that East Asian countries were able to more quickly implement systems and policies many in the West initially thought were harsh and excessive because they have the type of governance systems & culture to support it — individual rights and preferences be damned. I’m sure a big part of this is that these governments had “practice” with SARS at the turn of the century, but I think we’ll need to think long and hard about some of the tradeoffs a highly federated governance system oriented around the rights of the individual have.
- The internet may not have been this before but its certainly now a utility that is necessary for education and the modern workforce. We should act accordingly as it pertains to increasing access and maintaining it as an open platform for all.
Stay safe everyone — here’s to being able to pontificate more with you all (online or in-person when the crisis is over)! 🍸