The coronavirus pandemic is putting the failings of the U.S. health-care system into sharp relief. 

U.S. citizens already ration medicine, avoid care due to financial stress, and use internet fundraisers to cover health costs. The virus could expose more Americans to that ugly reality. Millions of uninsured and under-insured patients could be vulnerable to big bills if they seek treatment. Hospitals don’t have enough spare capacity and could become overwhelmed. There’s also no single entity in charge of coordinating and paying for the virus response, which has contributed to confusion and testing delays.

The outbreak and the weaknesses it lays bare make a strong case for significant health-care reform, which has been a primary focus of the fight for the Democratic presidential nomination and an issue of key importance to voters. Any of the plans proposed over the course of the campaign — from modest public options to a full-on transition to free government run health care under Bernie Sanders’s “Medicare for All”  — would be an improvement on the status quo. The presumptive nominee, Joe Biden, has a plan on the milder side of that spectrum. As the coronavirus crisis unfolds, it may help build a case for stronger medicine.

Even before COVID-19 hit, health care was a weakness for President Donald Trump. Administration efforts to eliminate the Affordable Care Act and cut Medicaid funding didn’t sit well with many voters; they’re unconscionable now in the face of an epidemic and possible recession. His response to the virus has also been subpar. Under his leadership, testing for COVID-19 has been inadequate and badly behind schedule, while his messaging has at times minimized or distorted the danger. In an Oval Office speech on Wednesday evening, he assured the nation that insurers will cover and eliminate co-payments for tests and treatment, something that wasn’t entirely true. And instead of working toward providing concrete financial protection for Americans threatened by the crisis, he has pushed tax cuts and enacted an ineffectual travel ban, while initially ripping a bill produced by House Democrats that would offer relief. 

Biden’s health plan, while less far-reaching than Sanders’s, would create a new public insurance option that would cover millions and substantially reduce premiums and deductibles for individual coverage. It would still leave significant numbers of Americans uninsured and exposed to significant bills when they fall ill, and in the face of a crisis, might need to be revised to give people the help they need. Notably, Biden seems to have indirectly acknowledged this; his COVID-19 response plan, released Thursday, has a touch of Sanders to it, including a long list of actions to ensure no American faces charges for virus treatment and testing. Medicare for All would do that for every American for any health issue on any day. 

Biden is unlikely to embrace a single payer plan. But both the virus and an eventual need to win over Sanders voters make a case for more ambition. Bigger subsidies for his public option, broader limits on out-of-pocket spending, targeted hospital price caps, and expanded auto-enrollment could all help to protect Americans against both epidemics and common health expenses. 

When there’s a public health crisis, no one wants cost concerns to prevent people from getting the care they need. As Americans watch the health care system and their neighbors struggle with this outbreak, it’s going to create an appetite and opportunity for more substantial reform — not only to deal with epidemics, but also with the thousands of little health crises that strike every day. It shouldn’t be wasted.

To contact the author of this story: Max Nisen at mnisen@bloomberg.net

To contact the editor responsible for this story: Beth Williams at bewilliams@bloomberg.net

This column does not necessarily reflect the opinion of Bloomberg LP and its owners.

Max Nisen is a Bloomberg Opinion columnist covering biotech, pharma and health care. He previously wrote about management and corporate strategy for Quartz and Business Insider.

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