Single-payer supporters, myself included, have argued that the coronavirus pandemic demonstrates the flaws of America’s private insurance system, and that this system is hampering the nation’s ability to fight the virus. Conversely, single-payer opponents like Joe Biden have repeatedly argued that single-payer will not “solve” the coronavirus pandemic. On Twitter, the president of the Center for American Progress, Neera Tanden, recently admonished a pro-Medicare for All commenter: “You might want to check out the death rate in France before you think the form of health system is the answer here.” In another tweet, Tanden said she doesn’t “think the health care payment system and the ways a country fight [sic] the virus is correlated.”

This is exactly the sort of hand-waving deflection you would expect from people whose campaigns or careers depend on defeating single-payer and the politicians who support dramatically reforming our own broken system. It’s true that it’s hard to see direct correlations between a country’s health care payment system and its success in fighting a virus, in part because the United States’ health care system is so uniquely insane and unequal among developed nations. You can certainly say that single-payer wouldn’t by itself ensure that the United States’ coronavirus response was adequate, since there are other factors that are just as important. Social distancing measures have proven to be a vital part of the coronavirus mitigation strategy, as have testing regimes and broader questions of pandemic preparedness. Perhaps having Donald Trump as your head of state renders any best practice moot.



Nevertheless, it is hard to argue that ensuring universal coverage, something that Biden’s plan explicitly does not ensure, would not improve our ability to respond to this crisis, if for no other reason than the fact that it would provide the means by which a gravely sick person could go to a doctor or a hospital emergency room to get treatment without going into bankruptcy. The same could be said of a health care system that would have broadly assured that people could receive comprehensive treatment for any of the number of pre-existing medical conditions that exacerbate Covid-19 without encountering roadblocks, like the high deductibles that perversely incentivize consumers to not seek medical advice. It would have improved our response to the pandemic, as well as society more broadly, if these barriers—which are for all intents and purposes additional taxes on the working and middle classes—did not exist.



Single-payer advocates would indeed be hard-pressed to argue that such a reform would be some sort of silver bullet against the coronavirus. Similarly, paid sick leave would be similarly unable to “fix” the coronavirus pandemic on its own—yet you don’t see liberals offering the same resistance. The two policies share this in common, however: There is no reason to think things would not have been vastly better had they been in place before all this happened.

Part of the problem of comparing America’s experience to other countries, like France, is that it’s quite difficult to find a developed country that does health care as poorly as the United States, including both countries that have handled coronavirus well and those that have handled it poorly. Germany, a country with a multi-payer system but where only 11 percent of the populace has private insurance, has one of the lowest fatality rates. Italy has a health system where most are covered by government insurance, but the crisis has been particularly dire as hospitals in its wealthier northern regions have been absolutely crippled by the virus. South Korea, meanwhile, has a single-payer system and swiftly implemented some of the most aggressive and successful testing measures anywhere in the world, limiting the virus’ spread and yielding low fatality rates. Overall, Western Europe is a couple weeks ahead of the U.S. in its outbreak, but we appear to be faring worse than they were at this stage.

