Today’s Response to COVID-19 Must Prepare for Tomorrow’s Health Crises
Policymakers need to maintain a longer-term perspective, as they fight minute by minute to stop the deadly spread of COVID-19, to save American lives, and to keep the economy afloat until Americans can safely return to work. Restoring and maintaining the public health in the here-and-now is of utmost importance and the first critical step to reopening the economy.
But they must also prepare for the health care demands of workers and citizens in an economy that is safely reopening. The post COVID-19 health care system will urgently need restructuring and rebuilding to ensure that we will respond better should we ever again face such a dangerous pathogen.
Immediately, our heroic health care workers, first responders and essential workers urgently require personal protective equipment (PPE), and ventilators for those who are seriously ill. To vanquish the virus now, and to reopen the economy safely and keep it open down the road, we need massively increased availability of testing. We must move beyond scrambling to test the symptomatic to extended testing to find the asymptomatic infected, and to identify the recovered who carry antibodies and are no longer infecting others. Once we can identify the safe, we can begin to restore business activity.
Meeting these important needs requires urgent and aggressive use of the Defense Production Act (DPA). Shortfalls may well be beyond the surge capacity of existing producers, and if so, compulsion will be the least-bad choice.
And this is where we must look beyond the treatment of the sick to rebuilding public health. In the immediate term, improved health care access for individuals will aid economic recovery, stop the virus, and relieve the strain on hospitals. People who lose their jobs also too often lose their health insurance. If the newly uninsured shun medical care, the disaster will be compounded.
We must extend and expand subsidies to continue employer coverage under COBRA, and perhaps through Medicaid, and also through Affordable Care Act exchanges. Health insurers will be squeezed as well, and likely will need risk back up (through risk corridors or reinsurance) to mitigate potentially significant premium increases next year.
But once the virus has stopped ripping through American society, we need a review of the weaknesses in the healthcare system that this pandemic has revealed. This disease is by every indication disproportionally killing Americans of color. A blue-ribbon panel including leaders from the public and private sectors should do a bottom-up review including a national collection of data on the impact of the disease and recommendations as to how to bridge the partisan divide and provide all Americans with access to quality health care.
Furthermore, we need a public health infrastructure that can suppress a renewed outbreak to reopen the economy safely. Beyond widespread testing, we need more trained community health personnel to do contact tracing and the capacity to isolate individuals who may spread the infection. Failing that, if another wave of the disease should come in the fall as is predicted, we risk another broad economic shutdown. This is a huge public health infrastructure investment that reverses past failures and prepares us not only for a rebound, but also for avian influenza viruses we will likely face in the future. South Korea’s and Singapore’s preparation for those viruses prepared them for this attack better than we were. This will be costly, but clearly cost-effective.
Again, looking forward, we must continue heightened private health care and pharmaceutical innovation. The coronavirus is transmitted so easily that it could be passed around the world in multiple cycles. Ultimate safety requires a vaccine, and vaccines take time. We must accelerate the approval process. The FDA, among others, has relaxed a significant number of regulations that should be reviewed closely as to whether they should be eliminated permanently. Building for the long haul requires the we build less vulnerable global supply chains, and create a well-managed national stockpile and domestic just-in-time surge capacity for necessary supplies including pharmaceuticals like the vaccine for this virus. A special bicameral, bipartisan Congressional Task Force that calls on the best advice from the public and private sectors should be established in the near term to address all these important issues.
We must be prepared to continue to lift hospitals’ financial burden from the pandemic. Hospitals have been hit very hard financially from the pandemic. Most cannot undertake the services for which they are normally paid, and instead are saving lives instead of submitting bills.
We cannot ignore the immediate crisis. But today’s response must prepare for the crisis that will arrive next year, or five years beyond that. The cost of lack of preparedness for the novel coronavirus is painfully apparent. The benefit of preparedness for the next public health emergency is now equally obvious.
W. Bowman Cutter is a Senior Fellow and Director of the Next American Economy Project at the Roosevelt Institute. He was Director of the National Economic Council and Deputy Assistant to the President during the Clinton Administration. He is co-chair the Committee for Economic Development of The Conference Board’s Committee on the Public Policy Response to the Economic Impact of COVID-19.
Joseph E. Kasputys is Chairman & CEO of Economic Ventures. He was Assistant Secretary of the US Department of Commerce under the Ford Administration. He is co-chair the Committee for Economic Development of The Conference Board’s Committee on the Public Policy Response to the Economic Impact of COVID-19.