A critical factor accelerating the spread of coronavirus in the United States is our lack of universal health care.
As we debate the costs of providing medical treatment for all, and as the virus tears through the fabric of our society, it’s become clear that many of the factors accelerating the spread of illness and death associated with this new plague are associated with the for-profit nature of our health care system.
Because we have a patchwork medical system whose primary motivating engine is corporate profit, rather than a unified public medical system whose motivating engine is the health of the public, communicable diseases are treated in a mindset of individual outcome. Our system focuses on the immediate needs of insured patients rather than treating the overall disease as a public emergency, thus hampering the containment and treatment of epidemics like these.
Because they have not been profitable, there is no available stock of testing equipment or preventative materials such as masks to be available for the general public. And as a result, our for-profit health care system is unable at this time to effectively test all the Americans who need to be tested for the coronavirus. There has been no assurance from the federal or any other government agency that if and when they are physically ready, coronavirus tests will be available to all at no cost. Thus, millions will choose to go un-tested even where the tests are available.
According to Columbia University health economist Sherry Glied, some 44 million Americans have no health insurance and another 38 million have policies that are “inadequate.” Thus, tens of millions here are unsure how to pay for coronavirus testing. We — the coauthors of this piece — have already encountered at least one American — a 50-year-old in Charlotte, North Carolina — who does have insurance and who was charged $500 in co-pays for being tested.
Millions of Americans suffering preliminary symptoms may be unwilling to seek preventative treatment prior to testing because they can’t afford that either. And millions suffering preliminary symptoms may not want to be tested because they know that if they test positive, they could be quarantined and financially destroyed by hospitalization for which they are uninsured or underinsured. In such cases, millions will predictably opt to choose “chicken soup or death” rather than suffer the destitution that comes with modern catastrophic medical care.
Meanwhile, emergency rooms are also being flooded with worried citizens who are willing to be tested but who are being turned away by private doctors who are unwilling to treat those who are uninsured or underinsured. Despite laws to the contrary, even many of those for-profit emergency rooms are also turning away patients who are uninsured and underinsured, as evidenced by a major study by Sara Rosenbaum, a professor of health law and policy at George Washington University. “If we do not start aggressively enforcing the law, millions of uninsured Americans will continue to get no care at all or incomplete care,” according to Rosenbaum.
Through no fault of their own, these uninsured and underinsured citizens are in turn spreading the risk of disease to the community at large.
Because tens of millions may be avoiding testing and hospitalization for financial reasons, even those who can afford prevention, testing and treatment are vulnerable to diseases spread by the lack of unified, affordable public health management.
H.R.676 — a bill introduced back in 2017 by Rep. John Conyers and known as the “Expanded and Improved Medicare For All Act” — would have prepared the U.S. much better for this moment by creating a close, coordinated integration of medical professionals on the local, state and federal levels. If it had passed, there would now be much more up-to-date data on where the federal government could most effectively target public resources from a fully-funded Medicare for All national trust fund. But unfortunately, due to the power of entrenched interests in the health care industry, Congress did not adopt it.
According to Physicians for a National Health Program, a unified national health insurance system could save $150 billion a year just on avoided paperwork. One of every four of the trillions spent on health care, they say, “goes to marketing, billing, utilization review, and other forms of waste.” That money instead should go to medicines, treatment and the actual work of fighting problems like the coronavirus, including things like protective masks, universal free testing, vitally needed medicines and more.
Meanwhile, due to a 2012 Supreme Court decision, 14 states have opted out of Medicaid programs that would have enhanced their ability to cope with this epidemic, including Wyoming, South Dakota, Kansas, Texas, Louisiana, Arkansas, Mississippi, Alabama, Florida, Georgia, South Carolina, North Carolina, Tennessee and Wisconsin.
Along with exposing us all to deadly disease and financial ruin, the coronavirus is exposing the real costs of a corporate profit-driven medical system.
Our current system is about making money, not protecting the public health. As a result, it is ill-equipped to cope with communicable epidemics, mass sickness, avoidable death, medical bankruptcies and macroeconomic devastation.
The coronavirus ravaging our nation is exposing the dangers of a frayed patchwork of for-profit medical corporations competing to enrich stockholders. With health insurance companies collecting as much money as our giant tech industry, our current health system denies us the coordinated network of cooperative caregivers we so desperately need.
Those advocating an “incremental” rather than immediate transition to a unified universal health care system must face the realities of what the coronavirus is doing to our physical and economic well-being, and the inability of our current system to deal with it.