The covid19 pandemic is both a healthcare crisis and and an economic crisis. The American healthcare system of for profit medicine is not equipped to handle either yet alone both.
Before the crisis started thirty million Americans were already without health coverage. That’s thirty million people who are afraid to go to the doctor because it could mean financial ruin. And sometimes even when they do go, they are turned away. That’s what happened to a 17 year old boy in California when he showed up at an urgent care facility, was denied care due to lacking insurance, then died after going into cardiac arrest on the way to a public hospital. Some are now pointing out that he may have died from causes unrelated to corona. But who the fuck cares? A 17 year old boy was denied treatment in one of the most progressive states in the richest country on Earth and he died. That’s a tragedy that sadly happens all the time even without a pandemic!
A Pittsburgh woman faced the same fate when she refused to go to the hospital over concerns regarding cost. This is a gamble the uninsured take all the time. And many, even in the best of times, pay for that gamble with their lives.
There are probably other cases like theirs, and behind each one, a person killed by our collective failure to protect them. About 45 percent of American adults were either uninsured or underinsured in 2018, the Commonwealth Fund estimates. Those people are uniquely vulnerable to the effects of any pandemic. They’re more likely to wait to seek care for fear of the expense, or to go entirely without it, and their ranks will increase over the next weeks and months. Because we tie health insurance to employment, a COVID-connected recession could potentially strand thousands, if not millions, without secure access to health care in the middle of a pandemic.
Our health-care system is not the best in the world, as the New York Times credulously claimed a few days ago. It is failing. Heavily privatized, dependent on the whims of industry and the vagaries of insurance companies, it is collapsing under the weight of a crisis.
The best estimates are that millions more have already been stranded without secure access to health care at the very moment when we can least afford it. Our health insurance system is not built for a pandemic OR an economic crisis and it is facing both:
To put it another way: Despite Congress’ best attempt at an intervention, Americans could still end up in mountains of debt because they were victims of a plague.
Making matters worse, millions of Americans are likely losing the job-based insurance they relied on now that the economy is going into a deep freeze and layoffs are mounting. We don’t know the exact number of people who have been kicked off their coverage, but the Economic Policy Institute estimates that 3.5 million faced a high risk of forfeiting it over the last two weeks. That number is only going to grow.
Getting new coverage, unfortunately, could require jumping through a number of hoops, especially if your income is too high to qualify for Medicaid (in some states, unemployment benefits alone could put you over the limit) and you aren’t rich enough to afford the premiums on COBRA (really, who is?).
That’s 3.5 million more being added to the ranks of the uninsured in just the past two weeks! Many of these people can’t pay rent and may not even be able to afford food. Would you risk going to the doctor in that situation? You probably look at the numbers and say “Well, seems like only about 20 percent or so need hospitalization so I should just stay home. Otherwise I have to tell my kids there will be nothing to eat.”
That’s the kind of cold calculation millions MORE are now having to make. Let us not forget that millions of Americans already faced that choice every month for years on end. Let us also not forget that while the government has promised free TESTING for covid19, there has been no such promise to cover the treatment. And the cost for that treatment can be enormous, even for those WITH insurance:
While costs will vary, recent news reports suggest that getting tested and treated for coronavirus can much as high as $35,000 for uninsured patients, painting a devastating picture for those U.S. residents without health coverage — nearly a tenth of the U.S. population.
Even those who are insured could face high costs associated with coronavirus treatment.
A recent study by the Kaiser Family Foundation estimates that the average cost of coronavirus treatment for someone with employer insurance can range from $9,000 to $20,000 depending on the severity of the case and whether complications arise.
You just lost your job. You just lost your insurance. You got sick. Now here’s a bill for $35,000. With so many Americans already in debt to student loans, credit cards, mortgage payments and the like, how many of us would ever be able to climb out from under that kind of financial hit? Is it any wonder that some people decide to risk death, possibly feeling like if I have to pay that much you might as well kill me anyway? Nearly forty percent of Americans would struggle to come up with the money for a sudden emergency expense of $400. I’m pretty sure the number must be closer to the 99 percent who would struggle to cover $35k.
And this effects EVERYBODY, not just the uninsured. When people can’t afford treatment they get sicker. Desperate for money they go to work when sick and spread the disease. Unable to pay for treatment if they do get it they now can’t make rent, loan payments and the like. This effects the health and wealth of the whole society.
It is past time to stop tying health insurance to jobs. Health care should be a human right. There could still be a market for elective care like lasik vision or cosmetic surgery. But basic care should never be for profit because the cost of those profits is far too often human life.