COVID 19 and the U.S. Health Care System

Blog#20- 3/13/20

By Richard Davis

There may be a bright side to the current COVID 19 pandemic, at least in terms of showing how the current U.S. for-profit health care system fails people when they get sick. In the political debate about a Medicare for All plan the defensive posture is to tell people not to support it because they will have to give up their current health insurance.

Last time I checked I couldn’t find people who tell me they love their current health insurance plan and that they would never give it up. As things stand now for people who have private insurance that they pay for in part, or in whole, contracting a serious case of COVID 19 could mean bills anywhere from $10,000 to one million dollars depending on the type of insurance they have or don’t have.

Those of us who have Medicare and a supplemental policy would, in most cases, have no extra costs for treatment of a case of COVID 19. Now that the Trump administration has allowed the purchase of high deductible policies it means that beneficiaries who tried to save money on premiums would be on the hook for $10,000 before their insurance kicks in. Would you give that up for Medicare for All?

And what about uninsured Americans? Health care in this country is a privilege, not a right, unlike any other country in the industrialized world. According to the Kaiser Family Foundation, “Starting in 2017 and continuing in 2018, the (health insurance) coverage gains stalled. The number of nonelderly uninsured increased for the second straight year in 2018 (to 27.9 million) and the uninsured rate ticked up to 10.4%. The number of uninsured grew by nearly 500,000 from 2017 and by 1.2 million from 2016. The uninsured rate rose by 0.4 percentage points in 2018 from the historic low of 10.0% in 2016.”

These are troubling statistics. Here are some practical implications for the spread and treatment of any communicable disease in the U.S. When people get sick in any European country their first thought is to seek out the best treatment for their problem. Money is never a consideration because in their countries health care is a right of citizenship. Their people have decided that it is worth paying more in taxes to have the peace of mind to have access to health care when they need it.

In the U.S., when people get sick they usually have concerns about the cost of care. If any one of the nearly 30 million uninsured Americans needs to see a doctor they will generally put off care as long as possible because they know they cannot afford the care. You don’t need to be an epidemiologist to realize what that kind of behavior does to the spread of communicable disease.

Front line health care workers will do the best they can for the American people. But because we have such a siloed patchwork of places to receive health care it will be difficult for there to be a coordinated national effort to deal with COVID 19. We have learned over the past few days that the federal government and its attempt at leadership during the outbreak is pretty close to useless. When you couple that with the fact that the current administration has severely cut the budgets of the CDC and NIH over the past few years it is clear a timely disease-fighting effort cannot be mobilized, despite throwing billions of dollars in the till.

Thankfully, the states have stepped up to the plate and governors have realized that they have to take matters into their own hands. They are not spewing the same lies and misinformation that is coming from the White House. It became clear to state leaders that they cannot rely on the federal government to protect their people and they have not let politics, optics and re-election calculations get in the way of doing the work that needs to be done. States may not have all of the resources they need, but they will be able to mobilize forces and maximize their potential for caring to their residents.

I hope that when we return to pre-COVID19 life that there is an objective examination of how things were handled and how our health care non-system and our values and priorities may need to be adjusted.

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