The Rationality of COVID-19

The system of COVID vaccine distribution is giving Americans a taste of what universal healthcare is all about. For obvious reasons, advocates of M4A usually draw attention to the way that universal healthcare solves the problem of the uninsured and the underinsured, not to mention problems of medical bankruptcy and so forth. However, vaccine distribution is also demonstrating that a universal healthcare system is a fundamentally rational system of healthcare while a privatized system is a fundamentally irrational one.

Rather than distributing the vaccine according to wealth, so that the rich get the best care, we're instead distributing the vaccine based on need. As a result, people who are most at risk as well as essential workers are getting the vaccine first, with everyone else receiving it based on their level of risk. And I have yet to hear anyone dispute the rationality of this decision, because distributing the vaccine based on need so obviously makes sense.

However, these types of decisions are impossible to make in a privatized system because such a system does not make decisions based on medical need but based on profit. Granted, at the individual or private level, it seems like our healthcare system is rational, because we each experience our doctors treating whatever conditions we have with what seem like appropriate responses. However, our private experiences of healthcare cannot reveal the way that at a broader country-wide level, the question of who gets what healthcare isn't actually made in a rational manner, but is instead made based solely on questions of profitability.

We might not realize it, but the only reason that those of us with health insurance are able to go to the doctor is because our insurance company and healthcare provider are able to make a profit on our care. If they didn’t, they wouldn’t provide that care. Most of the time, we don’t realize this because our experience of the healthcare system is more individualized—we experience our specific doctors and not the healthcare system at large. But the quality of the care we receive is directly determined by our economic situation, so that the richer we are the better care we get. This shouldn’t be a controversial point because of how obvious it is, but in the United States, it is.

As the COVID vaccine is demonstrating, constructing a healthcare system whose operating principle is profit makes absolutely no sense. Instead, the only governing principle of the healthcare system should be need. Otherwise, we would be allowing a wholly extraneous variable into the question of who gets what kind of healthcare. This would be like distributing food to the hungry not based on hunger but based on their height. Height has absolutely nothing to do with hunger, just as profit has nothing to do with healthcare, but in the case of our healthcare system, we nonetheless allow this totally unrelated variable to govern our access to healthcare.

I don’t have a lot of hope that the COVID vaccine will reveal the irrationality of a for-profit healthcare system or the rationality of a public not-for-profit universal healthcare system. But in this turbulent time, American irrationality is doing its damn best to reveal itself to us. And this seems like a further opportunity for those of us interested in universal healthcare.