Capitalism will take over COVID-19 testing if the government allows

Last month, the Food and Drug Administration (FDA) announced the authorization of the first at-home COVID-19 test. While the test guarantees a result in 30 minutes, it is likely not available until the spring. This test will be available to those who can afford it — the latest example of disease-driven dividends.

The rich can get an excess of testing, but the poor can’t get enough. Rapid testing has become the new velvet rope. Some are paying for rapid COVID-19 tests to get into parties in the Hamptons. Others in Long Island, N.Y., are renting mansions without testing. At the White House, masks are encouraged but not required. Capitalism has found its way into medicine. Life-saving technology, and the privilege to make risky decisions, both favor the wealthy.

Wealth shouldn’t determine testing availability. The federal government must step in to ensure all Americans are able to test; that’s as important as the vaccine.

There’s no question that testing saves lives, so much so that COVID-19 testing is crucial to opening up our economy. A positive test is also vital so that others can isolate themselves if sick and reduce the possibility of infecting others.

President Trump has claimed doctors were profiteering off of the pandemic. While he was correct about profits, he was wrong to assign the gains to physicians. Instead, corporations are the ones driving up revenues profiting from testing. Companies are all investing in testing, and it is paying. This is what a pandemic looks like in an oligarchy where the rich can buy their tests and sell them too.

The Trump administration promised free testing and antibody treatments, but that hasn’t happened. Anyone who wants a test is instead directed to pay out of pocket or to purchase a test, have one delivered by drone, or order one from several online stores. They cannot, however, get a test for free in most places. 

Some state governments are trying to step in, responding with their mandates and systems. New York state-mandated free testing, Massachusetts and Maine have sites where people can be tested without concern for symptomatology. While these state policies are encouraging, they’re further evidence of a patchwork system — and a broken federal promise. 

As cases mount, experts are worried that test costs may be a barrier for tens of millions who are underinsured. 

An average American, after possible exposure, may still worry that they have COVID-19 even when asymptomatic. This is because asymptomatic individuals can be infectious. One might then have to lie to have insurance cover a test despite the Centers for Disease Control and Prevention (CDC) recommendation that asymptomatic persons be tested for the presence of COVID-19. Even if she lied, her insurance might not follow federally mandated rules, and instead, she could be like many others and walk out with thousands of dollars in medical bills.

Here’s the rub: in the background of this testing scarcity, plenty of COVID-19 tests are going unused; it’s not the tests at your local hospital, pharmacy or provider that’s going untouched. It’s the ones waiting for some well-employed person to pay $150 for them, while the uninsured person who’s lying in bed, struggling to breathe, can’t get a test at their local health center. The wealthy can test, creating an incentive to supply more tests that lie on a shelf for retail rather than a clinic.

If the federal government provided free testing, companies wouldn’t be selling tests. The federal government cannot ban them from selling tests, but they can expand access to tests.

According to HHS, The Families First Coronavirus Response Act ensures that COVID-19 testing is free to anyone in the U.S., including the uninsured. However, loopholes are everywhere. Rather than enact emergency measures or policies, the Trump administration has issued guidance that insurers should waIve costs for “medically appropriate” tests only. It made clear that insurers do not need to wave costs for COVID-19 screening.

To be sure, I am not calling for a whole-market change or moving away from a free-market approach, but instead, this is part of a more comprehensive public health approach. Many people on the right are calling President-elect Joe Biden a “Socialist.” This is not socialism; this is part of a healthy capitalistic market. This is an initiative to ensure the market stays alive, so independent companies can stay alive as well.

The solution is simple; the incoming Biden administration invokes the Defense Production Act (DPA) for tests, not just personal protective equipment (PPE), as he’s promised. The current White House has yet to invoke the DPA in a meaningful way to impel industries to make enough tests to match the needs of the nation. The DPA has been used routinely and has mobilized sectors of the economy. If Biden is willing to initiate the DPA for PPE, he can do the same for tests.

While we all may want to be able to buy whatever we want, this comes at a cost to others. Instead, the federal government must redistribute unused tests and force the production of new tests to increase our testing capacity. Large-scale proactive testing will allow us to suppress the virus and return to the new normal, allowing us to save lives.

This pandemic is highlighting stark cracks that free-market pharmaceuticals will not fix. Instead, it’s time for the federal government to step in with a unified approach. The Biden administration must not only respond to this moment but act in a way that begins to dismantle the ability of corporations to profit off of our suffering and put health before profits.

Dallas Ducar, NP, is the chief executive officer of Transhealth Northampton. She is also a Public Voices Fellow with The OpEd Project.