| Sometime in the months ahead, the U.S. will have to decide how prepare for future infectious threats. The nation will have to choose how to fund and equip public-health agencies, hospital capacity, stockpiles of protective gear and other infrastructure we'll need in future surges of Covid-19 and pandemics yet unknown. Public health, long neglected, will be competing with every other budget priority for a shrinking stream of tax dollars. Making the case for investing in public health has never been easy in the U.S. It goes against Americans' libertarian streak—a skepticism of government, belief in individual liberty and distrust of central authority that's deeply rooted in our history and culture.  The case for investing in public health has never been easy in the U.S. So what happens next? Photographer: Mark Kauzlarich/Bloomberg The debate is further complicated by how much America already spends on health care—at 18% of gross domestic product, more than any other country. That spending has long been a drain on governments, employers, and households, even as the U.S. lags other countries in health measures like life expectancy and infant mortality. Our richly funded medical care didn't prevent the country from recording the highest number of Covid-19 cases and deaths in the world so far. Just a sliver of our health spending—less than 3 cents on the dollar—goes to public health. Five large health insurers returned more money to shareholders in dividends and stock buybacks than the entire budget for the Centers for Disease Control and Prevention. When it works, public health is invisible. Now the world has seen the consequences when it doesn't work. The question for Americans is, will that change our minds?—John Tozzi | 
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