The current COVID-19 crisis really shows us the deficiencies in our current health care “system” – which is not really a system at all but a disorganized patchwork of payers, public and private hospitals, and providers that evolved over time.

One issue that is now obvious is that health insurance should not be tied to employment. This was an accident of history, as wages were frozen after World War II to stabilize the economy, and employer-based health insurance was made free from taxation in 1943.

As a result, getting insurance through an employer became the most affordable option, and this became our default method of providing health coverage in the United States. Three large groups that were left out of this system were the elderly (needing Medicare), the poor (needing Medicaid and free care) and the disabled (mix). In those days most people had stable lifelong employment, not only with health benefits but pensions. The economy has changed so much since then, with the near elimination of pensions and the expansion of part-time and gig work, as well as more service-sector jobs and fewer manufacturing jobs.

Some service sector jobs may not pay health insurance at all and instead force their employees onto Medicaid.

Another big change in the economy is that it is now rare for someone to stay with an employer for their whole career, and therefore most people will have to make sure that between jobs that they do not lose health insurance even temporarily. Why?

One of the reasons that our health care system is so costly and that rural hospitals are at high risk for closing is the cost of dealing with our public-private patchwork of payers. One of the main functions of an electronic medical record is billing and coding, and this is a big factor leading to physician job dissatisfaction and burn out.

High co-pay and high deductible plans also stress hospital systems and patients with the need for hospitals to collect from the insurer and then bill the patient, many times with the patient paying the bulk of the bill despite being “insured.”

Whether you are an advocate for single-payer or some other type of universal coverage, which in other more advanced countries can include private insurance, we all know in our hearts that health care is a basic human right. You can’t have life, liberty and the pursuit of happiness if you have no access to, or a disincentive to use, health care.

America, we can still do great things – and we can definitely do a better job providing health care to all of us regardless of wealth and status.

As we have now come to realize, we are all in this together.

(Michael F. Dowe lives in Gilford.)