One takeaway from the COVID pandemic must be the recognition that a market based approach to public health is a disaster. Even the terms imply the priorities. Public health puts people first. It is a necessary and worthy investment. 1/

Though government is often thought of as inefficient, the efficiencies from a national, coordinated effort would‘be kept disease rates lower and saved lives. Free enterprise is free but supports enterprise, not people. It is also not motivated to provide urgent help to people 2/

When will Americans realize that provision of care by a profit- based system can never be the most efficient approach. Why? Because there is always a cut of money going to shareholders instead of patients or research. Decisions are made to protect profits and not people. 3/

Currently, high quality care that is invested in long term health of patients is incompatible with profit-based care. Any attempts to reconcile these two must better incentivize the health of people, both their immediate health and long term implications of current decisions. 4/

Thought experiment: what would fire departments look like if they were private and for-profit? Public health is similar. So what did we ignore/dismiss/undercut the proper response mechanism for this pandemic? 5/

America’s house is on fire and we told the FD to stay home, and waited for the economy to come up with some viable ways to address the flames. /end