At a White House briefing earlier this week, Joe Biden’s press secretary Jen Psaki was asked an extremely straightforward question by NPR’s Mara Liasson: Why doesn’t the United States government simply make COVID-19 testing free or even mail tests to every American household?
It was perfectly reasonable to ask considering that extensive free testing is already underway in several countries throughout the world — and still more reasonable given the plan announced by the Biden administration last week, which will allow people to get reimbursed for tests through their private insurance plans.
It’s as convoluted and as quintessentially American a solution as one could possibly imagine. Rather than simply offering tests for free from a government website (something the UK has done with no trouble), the administration’s model will instead force people to purchase them from pharmacies at market prices, obtaining reimbursement through bureaucratized health insurance schemes that an estimated 28 million Americans (or nearly 9 percent of the population) don’t even have. Though some at-home tests will be set aside for those without insurance, it’s as yet unclear whether there will be adequate supply and merely underscores, yet again, the absurdity of tying health insurance to employment.
Though Liasson put several of these very points to Psaki, her queries were greeted with a mixture of exasperated sarcasm and American exceptionalism:
Liasson: There are still a lot of countries like Germany and the UK and South Korea that basically have massive testing free of charge or for a nominal fee. Why can’t that be done in the United States?
Psaki: I would say, first, we have eight tests that have been approved by the FDA here. We see that as the gold standard. Whether or not all those tests would meet that standard is a question for the scientists and medical experts, but I don’t suspect they would. Our objective is to increase accessibility and decrease costs. And if you look at what we’ve done over the course of time, we’ve quadrupled the size of our testing plan, we’ve cut the cost significantly over the past few months — and this effort to ensure insurers are able to get your tests funded means 150 million Americans will get free tests.
Liasson: That’s kind of complicated though. Why not just make them free and give them out and have them available everywhere?
Psaki: Should we just send one to every American?
Liasson: Maybe. I’m just asking you . . . there are other countries . . .
Psaki: Then what happens if every American has one test? How much does that cost, and then what happens after that?
Liasson: All I know is that other countries seem to be making them available in greater quantities for less money.
Psaki: We share the same objective, which is to make them more accessible, right? Every country’s going to do that differently. . . .
For all the talk about how much the liberalism of the Biden era has radically broken with its ideological antecedents in the Barack Obama and Bill Clinton eras, the whole episode is a stark reminder of the kind of thinking that continues to dominate the Democratic Party. Even when facing a world-historic crisis, it seems, the political imaginations of America’s most powerful liberals still default to conservative arguments about cost, the tired rhetoric and trick language of “access” and “affordability,” and, above all, deference to the private sector. The very idea of a simple public good, removed from market considerations entirely, remains anathema.
All told, it’s a testament to the ongoing firmness of neoliberalism’s grip on the Democratic Party, notwithstanding some of the spending measures and social supports that did emerge in response to COVID-19. From economics to health care, the pandemic was as good an occasion as any since 2009 to radically reexamine and reform the very foundations of public policy and question axiomatic assumptions about America’s barebones welfare state or the wisdom of tying health care to employment. Though the administration initially spent big and served up poverty-cutting direct cash payments, it has tended toward the phasing out, watering down, or means testing of benefits rather than making some version of them permanent. On health care reform, meanwhile, Biden’s once touted public option remains totally missing in action.
Despite months of chatter about the dawning of a new progressive era, the outer limits of liberal thinking, even in a crisis, still include fiscal restraint, the involvement of private insurance companies, and exasperated condescension at the idea there might be any alternative.