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Free Tests, Free Vaccines: Remove the Wealth Barriers to Fighting COVID-19

We can’t address a pandemic without eliminating economic hurdles to public health.

John Nichols

March 13, 2020

A congressional aide tapes up a sign with office policies to prevent the spread of the coronavirus in the Rayburn Building.(Tom Williams / CQ Roll Call via AP Images)

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Former Vice President Hubert Humphrey reminded us long ago that “the moral test of government is how that government treats those who are in the dawn of life, the children; those who are in the twilight of life, the elderly; and those who are in the shadows of life, the sick, the needy and the handicapped.”

It is also the practical test—especially during a pandemic such as the one that the United States is now experiencing.

If we commit to provide the very best care and support for those who are most vulnerable, those who are most threatened physically and economically by the coronavirus outbreak, threads of human decency and common sense intersect to the benefit of the whole of society. That means that our responses to the coronavirus must be universal in every sense. If care is too costly, if workers feel pressured to show up for jobs when they feel ill, then this country is not responding realistically or responsibly to the crisis.

That’s why Representative Ayanna Pressley argues, “Coronavirus testing must be made free to the public if we are going to understand the scope of this crisis. Anything less will undermine America’s effort to protect our communities and save lives.”

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And that’s why Representative Pramila Jayapal has written to Vice President Mike Pence to argue, “Coronavirus impacts all of us. Stopping immigrants from seeing the doctor is harmful and downright dangerous during a public health emergency. Putting up barriers to care for some is a public health risk for all. The Trump Administration must immediately suspend its wealth test.”

That’s a reference to the Trump administration’s scheming to block immigrants who might at some point make use of federal safety-net benefits to get by. But the fact is that there are millions of people in the US who cannot afford needed health care and millions more who cannot take a day off work without risking their livelihoods.

The unfolding coronavirus outbreak threatens the stability of the US economy. It threatens to upend the 2020 election campaign, as rallies are canceled and debates are moved. Election turnout could be severely diminished in states that have not fully developed vote-by-mail systems. Yet, the most serious threat is to the health and safety of those millions of Americans who lack access to health care, who lack the resources that are required to pay for that care, and who lack the freedom to take time off when they or family members are ailing.

If society fails to meet everyone’s needs, no matter what their immigration status, and no matter what their ability to pay, then there will be a class divide in our response to the pandemic. And that divide will render the response dangerously inadequate.

Vermont Senator Bernie Sanders has been making this point for weeks, delivering “now is the time for solidarity” speeches and statements that go far beyond merely pointing out that we would all be better off with a single-payer “Medicare for All” health care system.

“We have to make sure that everybody, right now, feels free when you’re sick to go to a doctor, regardless of your income. And you know what? The government will pay that bill,” the Democratic presidential contender said on the Tonight Show Wednesday. “Number two, we are the only major country on Earth not to guarantee paid medical leave. If you can believe it, there are people who are sick today, who may actually believe they have symptoms of the coronavirus, who are going to work because they have no income (if they do not). They’re making $12, $13 an hour, they’ve got to feed their family, they go to work. We have got to do what every other country on Earth does and guarantee paid family and medical leave and do it right now on an emergency basis.”

Paid sick leave can’t be treated as an option anymore. “It’s not just inhumane to force people to work while sick. It’s also a massive threat to public health,” says Wisconsin union activist Randy Bryce. Representative Val Demmings says, “Paid sick leave is required to control coronavirus.”

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Sanders points to a wide range of additional requirements, especially the need for free vaccines.

The senator argues that the Trump administration’s refusal to take steps to eliminate the wealth test for the vaccine that will be developed to prevent the spread of coronavirus is “a crock. That is ridiculous. We have got to make sure that when that vaccine comes out, it is available to everybody in this country, regardless of their income.”

After Alex Azar, the former pharmaceutical corporation executive who serves as Trump’s Secretary of Health and Human Services secretary refused to guarantee in congressional testimony that any coronavirus vaccine or treatment would be affordable for all, Sanders declared, “Under the Trump doctrine, if you are wealthy you can buy a vaccine and not succumb to the sickness. If you are poor or working class, you may have to get sick or even die. That is an outrage. That is unacceptable. We need a vaccine that is available to all.”

Were he in the White House, the senator says he would make the vaccines available for free. “And is that a radical statement?” the senator asks. “That is the most obvious statement anybody could make.”

Obvious, but not assured by any means.

President Trump’s miserable response to the crisis keeps confirming Joe Biden’s observation that “Unfortunately, this virus laid bare the severe shortcomings of the current administration. Public fears are being compounded by pervasive lack of trust in this president.” After Trump delivered a convoluted, error-filled speech on Wednesday regarding the coronavirus outbreak—which emphasized travel bans, tax fixes, and negotiation with the insurance industry—House Democrats offered a sounder response, in the form of their Families First Coronavirus Response Act, which strikes down a few wealth barriers.

The Families First Coronavirus Response Act is focused directly on providing support for America’s families, who must be our first priority in this emergency,” says Pelosi. “We cannot fight coronavirus effectively unless everyone in our country who needs to be tested knows they can get their test free of charge. We cannot slow the coronavirus outbreak when workers are stuck with the terrible choice between staying home to avoid spreading illness and the paycheck their family can’t afford to lose.”

The plan provides for:

  • Free coronavirus testing for everyone who needs a test, including the uninsured;
  • Paid emergency leave with both 14 days of paid sick leave and up to three months of paid family and medical leave;
  • Enhanced Unemployment Insurance, a first step that will extend protections to furloughed workers;
  • Strengthened food security initiatives, including SNAP, student meals, seniors nutrition, and food banks;
  • Clear protections for frontline workers, including health care workers and other workers who are in contact with those who have been exposed or are responsible for cleaning at-risk places;
  • Increased federal funds for Medicaid as states face increased costs.

These are fine first steps, and Americans should demand that the Republican-controlled Senate follow the lead of the Democratic House and take them. But demands for a comprehensive response that provides health care and economic security for all shouldn’t stop there. Representative Alexandria Ocasio-Cortez says the need for “dramatic action now to stave off the worst public health and economic effects” of the coronavirus outbreak requires an exploration of broader initiatives such as debt relief and universal basic income initiatives. “This is not a time for half steps,” says AOC.

She’s right; it’s time to expose the wealth barriers that get in the way of a comprehensive response to the coronavirus outbreak—and to strike them down.

John NicholsTwitterJohn Nichols is the executive editor of The Nation. He previously served as the magazine’s national affairs correspondent and Washington correspondent. Nichols has written, cowritten, or edited over a dozen books on topics ranging from histories of American socialism and the Democratic Party to analyses of US and global media systems. His latest, cowritten with Senator Bernie Sanders, is the New York Times bestseller It's OK to Be Angry About Capitalism.


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