NEWSWEEK.COM 25
PUBLIC HEALTHhealth and healthcare—would take a huge invest-
ment and require the political will for massive
change. According to a KFF Health Tracking poll, 48
percent of U.S. adults want Biden and Congress to
build on the ACA, including three in four Democrats,
rather than scale it back or eliminate it.
If it’s possible to fix American healthcare, now
would be the time. Americans are more attuned to
health and the nation’s health system than they’ve
been for at least a century. Biden may have a unique
opportunity to repair and expand Obamacare and,
in doing so, rescue public health—if he can over-
come the inevitable resistance from Republicans and
entrenched healthcare interests.
“This is the moment where we can address our
health problems and make transformational chang-
es,” says Democratic Congresswoman Rosa DeLauro,
who heads the House Appropriations Committee.
“But in Washington when windows like this open,
they close quickly.”Low Marks on All Counts
the pandemic cast an ugly light on america’s
health infrastructure. The country still does nothave a good COVID-19 testing program and has yet
to develop any sort of wide-ranging contact-tracing
system; both are considered essential to successful
efforts to combat the pandemic, as demonstrated in
numerous other countries. Mask-wearing and social
distancing, the two main tools of pandemic contain-
ment, have been spotty at best in the U.S., and short-
ages of protective equipment for healthcare workers
and others still haven’t fully eased. The U.S. played a
big role in pushing the historically fast vaccine devel-
opment, but then followed up with a disorganized,
slow and uneven vaccine distribution effort.
The vaccines, though, are finally being rolled out.
The nation may turn the corner on the pandemic
by this summer, if variants of SARS-CoV-2 don’t act
as spoilers. But at that point it will be well worth
pondering the possibility that the next pandemic is
looming just down the road. In just the past 20 years
the world has experienced five pandemics, including
COVID-19, and experts are watching a range of virus-
es that have a strong potential to suddenly leap into
dangerous prominence.
Will we be any better prepared for the next pan-
demic than we were for this one? The Trump admin-
istration’s missteps in its response disguise the fact
that our health infrastructures simply weren’t up to
this crisis—or any major health crisis, for that mat-
ter. They were inadequate long before Trump took
office, and they still are.
“In the postwar era, there is no point at which
the U.S. has had a public-health commitment com-
mensurate with the dangers we’re now facing,” says
economist Robert Reich, the U.S. secretary of labor
under Clinton and now a public-policy professor at
the University of California Berkeley.
The price Americans pay for troubled public
health and health care systems is written in grim
statistics. U.S. life expectancy has fallen behind that
of 35 countries, including Slovenia and Costa Rica.
Americans lead almost all developed countries in
the incidence of obesity, heart disease and diabetes,
among other chronic diseases, with death rates to
match. The U.S. maternal death rate is not only the
worst among fully developed countries, it also ranks
behind Kazakhstan, Bosnia and many other less-ad-
vanced countries. All of these problems dispropor-
tionately plague Black and Hispanic Americans, but
that’s not to say white Americans are faring well—
they do worse by virtually all measures than theirPOOR HEALTH
America’s public-health
failure in the COVID-1 9
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