A counterintuitive thing about crises is that they can make very complex issues become very simple, very fast. Physics, for example, is very complex. But when someone throws a brick at your head, you duck. Simple. Likewise, providing health care to an entire country is very complex. But when there is a global pandemic that threatens to kill millions of people at the same time that everyone is losing their jobs, it is clear that you have to just give everyone health care. Any other path is lunacy. You don’t have to be a brilliant health care expert to understand this. You just have to not be owned.
Since the coronavirus crisis began in earnest — since schools and businesses were shuttered across the nation, and sports seasons and concert tours and public events were canceled, and wildcat strikes took place, and major hospitals faced dire equipment shortages, and thousands began to sicken and die, and 10 million people became unemployed in two weeks — not a single major politician has stood up and said, “In light of all this, I now support Medicare For All.” Not a single Republican, of course. But also not a single prominent Democrat. On the contrary, the likely Democratic presidential nominee stood up two days ago and affirmed that he is still opposed to Medicare For All, because “it will not solve” this crisis “at all.” As horrific, unprecedented unemployment figures were released today, the most that Joe Biden could muster was a statement calling for open enrollment in Obamacare.
Americans, with no jobs and no money and the very real threat of imminent death, should be legally permitted to purchase bad and inadequate private health insurance that they cannot afford. That is the position of the party that represents the progressive side of American politics. The other party is just trying to source enough body bags.
The inability of elected leaders to embrace a concept that was previously considered radical but that reality has proven to be necessary is not an ideological problem. It is a problem that is inherent in the existence of an entrenched power structure, which has the effect of narrowing the agreed-upon scope of possibility down to range that can prove to be absurd when times change. It is not as though politicians wake up every morning, check the news and the infection numbers and the economic statistics, and then evaluate the political position “Medicare For All is a bad idea” based upon the new reality of the day. That position is one that was forged over decades by a world order and a set of economic relationships that is being swept away in a matter of weeks. Politicians cannot adapt to that, because achieving their own positions of power has depended on the fact that they can be relied on not to change their positions in a matter of weeks. The only way to get us on the path to where we actually need to go may be to sweep away the politicians themselves.
This is what “The Black Swan” is all about — not the simple idea that unexpected things happen, but the fact that we build entire systems of belief and prediction that do not take into account the fact that unexpected things happen. Then when they do, our beliefs are revealed to be foolish. Politicians who consider themselves to be “moderate” because they support Obamacare rather than Medicare For All are like people who consider themselves safe because they install a security system in their home, without taking into account the fact that they built their home right beneath a volcano that just erupted. Suddenly, the perspective has changed. What could have been justified as a safe and moderate choice is revealed to be awfully short of what is in fact necessary.
This is going to be a transformative moment in American politics, by necessity. Not because the inadequate leaders who currently hold power will be convinced overnight to change the views that got them power in the first place, but because a huge number of Americans are going to get sick and die and lose their livelihoods and be broke and unable to buy the things they need. Millions of lives are going to be destroyed in large part because of the health care system we have built, which links health insurance to your job. Common sense can tell you this was always a bad idea. It has always been a disaster for a certain number of people, but that number was small enough for politicians to ignore. Now, that is no longer the case. Obamacare, a classic example of the Democratic strategy of splitting the difference between what is right and what the Republicans want, is not going to be up to the task when ten million people lose their jobs in two weeks, with millions more on the way. It is not built for that. It is an approach that, in retrospect, was not designed with the full range of possible problems in mind. The volcano is erupting right now. The alarm going off in your home security system is not going to save you.
The universal and instantaneous agreement by almost all Americans that health care for those with coronavirus should be free has not been enough to convince any prominent Democrats to simply say, “I guess that should be true for all sick people, period.” Think about how strongly attached you must be to a bad idea in order for that to be true. If ever there were a time to admit that no one should die because they can’t afford health care, it is now. If ever there were a time to admit that tying health insurance to employment was a fundamentally flawed idea, it is now. If ever there were a time to admit that Obamacare was a half-measure that is no longer enough, it is now. Every day and with every successive piece of awful news I expect to hear members of Congress change their tune. Every day I am disappointed. More disappointed are the 10 million newly unemployed Americans, and the millions of Americans who have been and will be stricken with this disease while unemployed. I hope that their disappointment turns to rage. And I hope they turn that rage on the leaders elected to take care of them. They are failing at a time when failure means death.