The United States is virtually certain to suffer the worst epidemic of novel coronavirus in the rich world, and maybe anywhere. We are far behind the measures South Korea has taken to control its outbreak, and not even particularly close to what Italy is doing, where the carnage is horrible and accelerating. The resulting disruptions are creating an incipient economic recession which looks to be just as bad as the one in 2008, if not worse.

There is one presidential candidate whose political proposals match the scale of this crisis: Senator Bernie Sanders.

This was clear in the Democratic debate on Sunday. Former Vice President Joe Biden scoffed at Sanders' talk of revolution, and insisted that Medicare-for-all would do nothing to address the crisis. "With all due respect to Medicare-for-all, you have a single-payer system in Italy. It doesn't work there. It has nothing to do with Medicare-for-all," he said. Instead, Biden insisted, the government should pay for any coronavirus testing and treatment only.

Sanders responded that this sort of jury-rigged Medicare-for-all-who-have-COVID-19 policy would be insufficient — suppose you need some treatment as a result of your family getting sick, but aren't infected yourself? — but he didn't go far enough. At bottom, it is absolutely the case that America's crap medical system is a major reason why we are so vulnerable to pandemics in the first place. Without universal coverage, it is very difficult to contain an incipient virus outbreak, because if it infects an uninsured or underinsured person, they may avoid getting tested or quarantined due to costs. One single person can create a "super-spreader" event that seeds an out-of-control epidemic. Biden's own insurance reform plan, by the way, does not even aim to achieve universal coverage. Ten million people will be left uninsured by his own estimate.

Biden was correct that once an outbreak gets out of hand, one needs an additional crash mobilization of medical resources. But that can't help but be built on top of the existing system — in the case of the U.S., a hideously expensive, dysfunctional, Kafkaesque bureaucratic tangle of ruthless insurance companies and profiteering medical providers. It would be far easier to coordinate an emergency outbreak response if we did not have to worry about basic payment for and access to medical care that other countries figured out 50-100 years ago.

Biden's goofy posture on universal health care was reflected in his general stance towards Sanders' proposed "political revolution." Biden said it was not necessary because the problems are too serious. "We have problems we have to solve now. Now." Er, what? That's like saying that because you have a broken leg, it would be unrealistic to go to the emergency room. He further breezily promised that his milquetoast public option plan would get through Congress, but as Eric Levitz notes at New York, there is little prospect that will be any easier to pass than Sanders' Medicare-for-all bill. Big Medical has already come out guns blazing against the Biden plan.

Moreover, Biden suggested that the United States may not be able to spend too much because the national debt is too high. "We've eaten a lot of our seed corn here. The ability for us to use levers that were available before have been used up by this godawful tax cut of $1.9 trillion." This is the logic that pushed the Obama administration into austerity in 2010, and it is categorically false. The government can borrow without limit so long as the economy is in recession — interest rates on government bonds are virtually zero at the moment. Biden seemingly has learned nothing from the past 12 years of economic history.

Sanders, by contrast, is not fussing about nonexistent deficit concerns in his coronavirus response plan, which would drastically expand testing, directly purchase additional medical equipment, prevent price-gouging from pharmaceutical companies, and more. The rest of his program includes many trillions of dollars in new programs: Medicare-for-all, paid family and sick leave, a Green New Deal to tackle climate change, increased disability and unemployment insurance, and much more. That's the kind of thing needed not just to stop the current pandemic, but also to make America much more resistant to the next one. As we are learning once again, gigantic crises and recessions are hugely wasteful — keeping the status quo would be more expensive in the long run than following the Sanders agenda.

Biden, however, is not the only 2020 candidate who is not taking the coronavirus outbreak seriously enough. President Trump, of course, horrifically botched the response, and continues to do so. He needed to be taking drastic action to limit the spread of infection starting in January at the latest, but he continues to bungle things to a jaw-dropping degree. As just one example, on Wednesday last week, in a scripted primetime address, Trump wrongly told Americans in Europe that they would be unable to get home starting Friday. Then he failed to boost up customs and security staffing, which created gigantic crowds of travelers — coming from infected countries, remember — trying to get back home at airports across the country. Every one of those was possibly a super-spreader event.

There will surely be whole books written on how Trump failed to even mitigate this epidemic. But while Biden's proposed response is head and shoulders above Trump's, he is still raising ridiculous fears about borrowing, and failing to understand that America's ratty safety net (which long pre-dates the current administration) is a huge vulnerability. At bottom, his instincts are conservative and timid.

It is troubling indeed that fading, washed-up leaders like this are the ones leading the country. It would be much wiser to follow the lead of a sensible policy expert like Bernie Sanders.

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