During the White House’s daily press conference yesterday (Dec. 6), a journalist asked press secretary Jen Psaki about rapid testing for the coronavirus. Although the US government has announced plans to make at-home rapid testing for covid-19 more widely available, they are still far from ubiquitous. Unlike Germany, the UK, or South Korea, where tests are available in abundance and distributed for free or at a nominal price anywhere from libraries to airports, American at-home tests are expensive ($10 or more each) and not so easy to find, the journalist noted.
Why can’t the US do the same?
While Psaki didn’t exactly provide an answer to that, she did seem to find the very idea that the US might give out free testing to everyone somewhat absurd. “Should we just send one [test] to every American?” she asked the journalist sarcastically.
But the answer to that question is, yes—the US government most definitely should send a free test to every American. In fact, it should send more than one, as the UK and other countries do.
In her spelling out the elements that make the US rapid-test response sufficient, Psaki did the opposite, showing just how far the current situation is from where it should be.
In her answer, the first thing that Psaki noted was that the Food and Drug Administration (FDA) approved a test, which she refers to as the “gold standard,” and that the tests available in other countries might not meet the same requirements. This is true: The FDA’s standards for authorization are higher than Europe’s, for instance, which guarantees specific product standards and reliability. The consequence is fewer tests are available on the market, and authorized makers have more power to set the price.
But the tests aren’t more expensive because they are better. Cheaper, accurate tests could be produced in large quantities if the US government were investing in them enough to create a market large enough that approved makers could produce at scale.
Further, the same tests approved in the US, such as the Abbott BinaxNOW that Psaki calls the “golden standard,” are available in other countries at a much lower cost, or for free, because the price is subsidized by the government.
The White House plan, Psaki says, is to “continue to increase accessibility and decrease cost over the course of time.” But the gradual increase might not get enough tests where they need to be, and it definitely won’t get them there in time.
Psaki’s added that the White House has quadrupled the size of the testing plan. But this doesn’t mean the actual availability is quadrupled, notes Michael Mina, an epidemiologist who has long been advocating for improved testing.
The need for tests is huge now—not in the future. States such as Colorado or New Hampshire, which distributed free tests to their populations, ran out of stock very quickly.
One of the few active measures the White House has announced as part of the testing plan is that private insurers will reimburse at-home tests. This, according to Psaki, will give 150 million Americans free testing. It is, at best, wishful thinking: The very prospect of dealing with insurance billing and reimbursement can deter purchases.
The White House said 50 million tests will be available for uninsured patients, especially in rural areas, but it is yet unclear whether patients with Medicare or Medicaid will also be reimbursed, or if there are limits to the number of rapid tests covered in full.
Another element that Psaki mentioned is the price of sending a test to each American home. This, too, is a weak argument.
Of course, if the government bought enough tests to send to each home, it would get a better price than the one paid by the end consumer. And even if it did, the price tag would be less than $4 billion—a steal compared to the social, medical, and personal costs that could be reduced thanks to the tests. This calculation alone should be enough to convince the White House to send not one test per person—but several, and whenever needed.