From universal healthcare to permanent vote-by-mail, the case for making pandemic policy permanent

For humanitarian reasons, the policy changes spurred by this crisis should continue in normal times. Here's why

Published August 16, 2020 2:00PM (EDT)

 A healthcare worker tends to a patient in the Covid-19 Unit at United Memorial Medical Center in Houston, Texas on July 2, 2020. (MARK FELIX/AFP via Getty Images)
A healthcare worker tends to a patient in the Covid-19 Unit at United Memorial Medical Center in Houston, Texas on July 2, 2020. (MARK FELIX/AFP via Getty Images)

The sudden onset of the pandemic prompted governments worldwide to spring into action with emergency policy changes — for instance, the CARES Act in the United States. Most of these emergency measures were humanitarian in nature — related to self-preservation, and protecting the masses. And as many commentators have noted, these kinds of COVID-19-related social measures provide us a prime opportunity to make things better after the pandemic is over.

But how, exactly, and why, should we do so? I want to offer a new answer.

First, I should note that there is broad agreement about the kinds of things that governments (and people) worldwide should be doing — general, obvious humane political measures. Specifically, there are five fundamental things that every country should be doing during the pandemic:

  1. While the virus is raging out of control, non-essential workers should not be allowed to go to work. Instead, we should be supporting them to stay at home.

  2. Nobody should have to pay for healthcare for testing or treatment for the novel coronavirus.

  3. We should put in place postal voting, to ensure that everyone has an opportunity to vote safely at this time.

  4. We should give individuals and small businesses rent breaks or reductions, or prohibit evictions, at this time.

  5. The wealthiest companies should be switching their production lines to things that are so badly needed but in short supply right now.

I hope you will agree that these claims are all highly plausible.

Now, for a surprising claim: the reasons for which we should be doing these things for the sake of most people during the pandemic apply equally in normal times, to assist and protect a significant subset of us (including many poorer citizens and socio-economically disadvantaged). These reasons are exactly the same in kind. If you accept that the former exist, you must also accept that the latter exist.

Start with (1). Why shouldn't non-essential workers be working right now? It is because of the health risks posed to them (as well as to others whom they might infect) by going to work right now. It is unacceptable that these people be exposed to such a risk of severe illness, death, or long-term health complications that might reduce their life quality in the long run or result in early death.

But now, many workers in normal times face equivalent risks from the work they do over the course of their lifetimes. While few face exposure to a killer virus, or even to much of a chance of dying on the job, many have significantly increased risks of illness in the long run. These risks are due to, for example, prolonged standing or sitting, staring at screens, stress, boredom, lack of opportunity for creative expression or autonomy, repeated exposure to contaminants, job insecurity, and so on. The health conditions they face include hypertension, heart disease, cancer, musculoskeletal disorders, and mental illness.

If it is unacceptable to allow most people during the pandemic to risk their health by going to work, then it is also unacceptable to allow so many workers in normal times to face equivalent risks by working their normal jobs.

The solution, of course, is not to keep the latter workers at home in normal times, but simply to improve their working lives—say, by allowing them to work fewer hours for better pay, or in better conditions.

Turn now to (2). Why shouldn't people today have to pay for healthcare due to COVID-19? Part of it is that the virus is so infectious and thus hard to avoid. And part of it is that the treatments are, for most people, prohibitively expensive. If people had to pay for these treatments right now, many wouldn't seek medical care when they should do so. It is clearly inhumane to have a system that deters people from seeking treatment right now because of the high costs involved.

Then, in normal times, when there is no killer virus circulating (at least, not in wealthier countries), there are countless other health conditions that affect people more or less indiscriminately (through no fault of their own) and which are for many people prohibitively expensive to treat. It follows that in normal times, we should be providing free healthcare to people for these conditions. To fail to do so is inhumane in precisely the same way that it is inhumane not to treat people who are sickened with COVID-19.

Turn now to (3). Why should everyone have access to vote-by-mail ballots at this time? It is because it is unacceptably burdensome right now to go to polling stations.

But this is exactly the same sort of situation that a large subset of the citizens (in countries like the US, at least) face with respect to voting in normal times. They have to work, or look after children, or cannot drive, etc. So, in normal times, for the exact same reason, we should be making voting far easier for these people than it is—say, by increasing the number of polling stations, helping to drive people to stations, or improving access to postal ballots.

Turn now to (4). Why should we give rent breaks or prohibit evictions during the pandemic? It is because the reason so many people cannot pay rent is that they have suffered job losses or illness through no fault of their own.

But now, in normal times, it is also often the case that people cannot pay rent because of job losses or illness that is no fault of their own. We should assist them, too, then. This is not to say they should be allowed to stay on, rent-free, indefinitely. But greater assistance should be given.

Turn now to (5). Why must companies help out in this time? It is because of the dire threats people are facing.

But, as I've noted, many people in normal times are facing equivalently dire threats. These threats are partly workplace-related over the course of their lifetimes. But they go beyond this. People on low incomes are much less able to afford healthy food, housing that is near to green spaces, leisure time or holidays, good quality healthcare that allows them to get early diagnoses or treatments for health conditions, and so on. All of these things greatly increase one's chance of bad health problems later in life.

Just as large private companies should be marshalling their resources now during the pandemic to contribute to preventing bad health outcomes for people, they should be doing much more in normal times to do so as well. How? Simply by paying more taxes to help reduce poverty.

In summary: in normal times, life is, for a subset of the population, relevantly like how the pandemic is for most people today. In a pandemic, it is easy to see that governments and big companies should be protecting and assisting those who are experiencing great hardship. This helps us to see that they should be doing so in normal times as well, given that the reasons to do so are of the exact same kind.

If we do not improve the status quo post-pandemic, then we escape the pandemic only to leave many of our people still trapped within something like it.

By Ben Bramble

Ben Bramble is a philosophy academic based at Princeton University and the Australian National University. Bramble’s monograph on the ethics of the pandemic, titled “Pandemic Ethics: 8 Big Questions of COVID-19,” will be published in August 2020.

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Business Commentary Pandemic Philosophy Rent Controls Universal Healthcare Vote By Mail