President-elect Joe Biden’s new COVID relief plan does not adopt existing Democratic legislation to expand government sponsored medical coverage nor does it propose a promised public health insurance option. Instead, it adopts proposals from health insurance lobbying groups’ recent letter to lawmakers demanding lucrative new subsidies for insurance companies, at a moment when those corporations have recorded record profits as millions lose coverage and many face claims denials. Biden’s plan would shovel billions of dollars to private health insurers by providing subsidies for Americans to buy coverage through the Affordable Care Act (ACA) marketplaces, which are far more expensive than government health care programs and have at times been plagued by high rates of claim denials.
Today we face the COVID-19 pandemic, with its resultant economic downturn and systemic racism—the triple crises that have exposed the serious problems of U. S. health care. It is now obvious to most observers that the system is broken, raising the question of how it can be put together through the political process after a hotly contested election season filled with disinformation and confusion about potential reform alternatives. Corporatization, privatization, a shift from not-for-profit to for-profit health care, and the growth of investor-owned corporate health care have been dominant themes in the transformation of U. S. health care since the 1980s.