In this March 31, 2020, file photo, President Donald Trump speaks about the coronavirus in the James Brady Press Briefing Room of the White House in Washington. Credit: Alex Brandon / AP

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This fall, we can turn the political page and make a public commitment to health care.

Our country still struggles with a pandemic worsened by Donald Trump’s mismanagement and, as seen in his comments to journalist Bob Woodward, his purposeful dishonesty about COVID-19’s risks.

The disease has killed about 200,000 Americans so far. With around 1,000 now dying each day, Dr. Anthony Fauci worries about a surge in colder weather. Some who survived COVID-19 are left with a foggy brain, painful joints or damage to their hearts, lungs or kidneys. Our schools are closed or partly opened.

Workers, employers and state and local governments are stressed and their economic struggles will undermine them for years.

Unlike any other administration, Trump’s political operatives at the Centers for Disease Control and Prevention shaped experts’ reports to make the situation sound rosier than it is.

But this election is not just about whether Trump continues as president or even about how we can repair the damage he’s done to our health, economy and democracy.

It’s hard to have hope in these terribly difficult circumstances, but there is potential for real change in 2021, with health care a key area of opportunity.

Unfortunately, some asking for Mainers’ votes offer far too little.

Republican Dale Crafts, who is challenging Rep. Jared Golden in Maine’s 2nd Congressional District, suggested in a call-in show that a stronger economy would bring more jobs with health insurance, but that doesn’t help people who are unemployed, have jobs without coverage or whose plans have high copays. Crafts also advised shopping around for lower prices.

Crafts voted against MaineCare expansion multiple times while he was in the state Legislature and his campaign website mentions “free-market based health care options,” an amorphous phrase that suggests you’re on your own.

As for Susan Collins, anyone looking for information on her campaign website about what she wants to do about health care won’t find anything, because there is no section on issues. Regarding the Affordable Care Act, Collins voted against its enactment and to repeal it multiple times, then voted against repealing it in 2017, then for the tax law that’s being used as the basis for a federal lawsuit to overturn the law.

In last week’s debate, Collins expressed one health policy idea for the future: more information about prices. Her campaign tweeted that Collins supported “increasing transparency,” “promoting competition” and “empowering consumers to pay [the] lowest price for medical care.”

Collins’ approach is like Crafts’ advice to shop around — and it has real problems.

Presidents Barack Obama and Trump already set rules to increase price transparency; research shows that it’s hard to compare prices, most people don’t look for it, and available information doesn’t account for out-of-pocket costs. Also people won’t check prices when there is a medical emergency and sometimes quality is more important than cost. And comparing prices doesn’t help people in rural areas where there aren’t a lot of providers.

In contrast, presidential candidate Joe Biden, senatorial candidates Sara Gideon and Lisa Savage and congressional candidate Golden would all expand public efforts, with the first three emphasizing some sort of public option for coverage akin to Medicare. Savage would replace the current system with Medicare for all.

Not only would public programs cover many more people, but most Americans support them. According to a May 2020 survey by the Kaiser Family Foundation, 57 percent of Americans support “a national health plan, sometimes called Medicare-for-all, in which Americans would get their insurance from a single government plan.” Even more popular, backed by 67 percent, is “a government-administered health plan, sometimes called a public option, that would compete with private insurance plans and be available to all Americans.”

Neither public approach would go anywhere if Republicans control the Senate, the House of Representatives or the presidency. Instead they will again try to repeal the Affordable Care Act and tell people to shop around. Democrats passed Medicare, Medicaid and the Affordable Care Act and, if in power, would expand public health care programs.

In our time of crisis, health care is on the ballot in November, with very stark choices.

Amy Fried is chair of the Department of Political Science at the University of Maine. Her views are her own and do not represent those of any group with which she is affiliated.