On Monday, Jen Psaki, the White House press secretary, boasted about the Biden administration’s coronavirus testing apparatus. “We’ve quadrupled the size of our testing plan. We’ve cut the cost significantly over the last few months,” Psaki told reporters, noting Americans will now be able to get the costs of tests reimbursed by their private insurers.

“Why not make them free and give them out everywhere?” a reporter asked.

“Should we just send one to every American?” Psaki asked, beginning to smile. When the reporter answered “maybe”, the press secretary dug in. “What happens if every American has one test? How much does that cost and what happens after that?”

Psaki was straining to make the question seem absurd. There are more than 300 million Americans. How can the United States government just mail a test to every person?

Her sarcasm revealed a dismal truth: if America is no longer unique in struggling through the pandemic, adequate testing remains in woefully short supply. The Biden administration has failed, like the Trump administration, to make free tests available everywhere. And in that failure, America has fallen behind the rest of the world.

In Boris Johnson’s United Kingdom, free packs of Covid-19 rapid lateral tests are available to order daily. Germany has reintroduced free testing as cases continue to surge. South Korea, long a global leader when it comes to aggressively testing for coronavirus, even has free tests for pets.

Meanwhile, in the United States, testing varies widely by city, county and state. New York City, battered by the original wave of coronavirus, now has free and easily accessible testing sites in most neighborhoods, where results can be learned within the hour. Other localities are still charging money and taking days to return tests. In rural areas, it can be especially difficult to get tested quickly for Covid-19.

At-home tests are now available in most large pharmacies like CVS and Walgreens. A package can cost more than $20. For many Americans, wrangling with a test that can outstrip the cost of dinner is just not worth it.

The new Biden plan is convoluted. Instead of subsidizing the cost of tests so they are freely available in stores or following the New York model of paying for testing sites in underserved areas, the Biden administration will compel private health insurers to reimburse people who buy over the counter, at-home rapid tests. Ultimately, this puts the onus on the individual to wade through paperwork or battle with an insurance company to receive a proper reimbursement. There will be Americans who won’t even bother.

For those who lack health insurance, Biden’s initiative offers little. The federal government will buy another 25m tests to give to community health centers and rural clinics, a decent gesture that doesn’t account for those who either don’t live close enough to such places or may be passed over if the tests don’t happen to reach their facilities.

The plan, ultimately, is frustratingly piecemeal and reflects the byzantine approach to healthcare the American government continues to take. Instead of a universal provider akin to the United Kingdom’s National Health Service or Canada’s single-payer system, America’s healthcare regime remains a predatory patchwork.

Private insurance is expensive and inefficient. Comprehensive public insurance is open only to those who are very poor, old, or work for the government. The ailing American healthcare system has been on full display during the pandemic, with those who survive hospital stays sometimes returning home with enormous medical bills. Other Americans, fearing costs, avoid medical visits altogether.

A well-funded rapid testing regime could help, along with vaccination and anti-viral treatments, restore normalcy. Coronavirus, as we now know, can still spread among the vaccinated, and the Omicron variant might increase the number of breakthrough cases. This new reality will require a much greater degree of testing than we now have and force the Biden administration, Psaki included, to take it all a lot more seriously. Rapid, accurate testing can make indoor gatherings safer and ensure those with Covid don’t readily infect others. The misery we all have lived through may begin to subside if the federal government does what it should do and guarantees every American a right to a free, available test.