The pandemic has laid bare the deadly dysfunctions of market competition compelling even centrist Democrats to rethink how health care is delivered and financed. 

New York Governor Andrew Cuomo — a fierce opponent of progressive policies — has merged private and public hospitals into a single, de facto statewide public health system to coordinate patient capacity, equipment, and staff. All of the state’s hospitals are now required to act as a single “network” for admissions, meaning patients can go to any facility without regard to insurance coverage. In order to prevent any one hospital from being overwhelmed, patients are being transferred from New York City to Upstate New York, and doctors and nurses vice versa. In private hospitals, where beds are paid for by patients and insurance, these transfers defy the normal incentive to keep beds full.

When the crisis first hit New York there was no coordinated response, resulting in overcrowding and shortages of staff and equipment. Some hospitals were bursting at the seams with patients, while others had empty beds. Public hospitals were setting up outpatient testing centers, while private ones were not. Staff in some hospitals had plenty of personal protective equipment (PPE), while nurses elsewhere were wearing trash bags for gowns.