Here’s why the fear of medical bankruptcy could make the spread of coronavirus even worse in the US
When Dr. Irwin Redlener, co-founder of the Children’s Health Fund (CHF), appeared on MSNBC’s “The Beat” on Thursday afternoon, February 27, to discuss the spread of coronavirus, host Ari Melber asked the well-known pediatrician if the millions of Americans who lack health insurance might be reluctant to seek treatment because they fear being socked with sky-high medical bills. Redlener didn’t mince words, telling Melber, “This is the horrible downside of not having universal health care.” But Melber and Redlener are not the only ones who, in recent days, have been weighing the impact that coronavirus could have on America’s uninsured and underinsured. The threat of coronavirus causing medical bankruptcies has been addressed in major publications ranging from the Washington Post to Axios to the Daily Beast — and the frightening reality is that the United States’ dysfunctional health insurance system could make the spread of coronavirus even worse if, as health officials around the world fear, it becomes a global pandemic.
The appalling experience that Miami resident Osmel Martinez Azcue had after being checked out for coronavirus is a glaring example of why uninsured or underinsured Americans could be reluctant to seek treatment if they suspect that they might have contracted the disease. Azcue, who is underinsured but not uninsured, recently returned to Miami from a business trip to Mainland China — which has been the epicenter of coronavirus. When Azcue developed flu-like symptoms and feared that he might have had coronavirus, he went to Miami’s Jackson Memorial Hospital for treatment and was kept in a closed-off room. It turned out that Azcue had the flu, not coronavirus.
Azcue has a limited insurance plan — the type of junk plan that was illegal under President Barack Obama but allowed after Donald Trump became president. And Azcue told people at Jackson Memorial, “This will be out of my pocket. Let’s start with the blood test, and if I test positive, just discharge me.”
Two weeks after he was discharged, Azcue learned that the cost was $3270 — and he would be responsible for $1400, although he fears that more bills could be on the way. Before he had his current Trump-friendly junk insurance plan, Azcue had a plan through the Affordable Care Act of 2010, a.k.a. Obamacare, that was costing him $278 per month in premiums and covered more if he got sick.
The ACA has plenty of flaws, but by undermining the ACA’s protections, Trump has made the United States’ dysfunctional health care system even worse. And Azcue’s horror story is a glaring example of “Trumpcare” in action.
Azcue told the Miami Herald, “How can they expect normal citizens to contribute to eliminating the potential risk of person-to-person spread if hospitals are waiting to charge us $3270 for a simple blood test and a nasal swab?”
Axios reporter Caitlin Owens said of Azcue’s nightmare, “The episode would be a great parody of the health care system, if it wasn’t real.”
But as a February 21 article that journalist Mike Pearl wrote for the Daily Beast demonstrates, there are millions of Americans who are even worse off than Azcue from a health care standpoint: those who don’t have health insurance at all — and as coronavirus spreads, they are in danger of medical bankruptcy should they contract the deadly disease or fear that they have contracted it.
For example, the Beast interviewed a Washington State-based restaurant manager named Terryl Banta, who lacks health insurance and worries that treatment for coronavirus would devastate her financially. Banta told the Beast, “If I actually had to go to the doctor, it would absolutely drain my savings and change everything. I wouldn’t be able to get married this fall, wouldn’t be able to contribute to a down payment on a house — and I’d probably have to sell my car and cash out my 401(k) from a previous job.”
Pearl, in his article, notes that the number of Americans without health insurance has increased in the Trump era. Citing data from the Kaiser Family Foundation, Pearl reports that “27.9 million people lacked insurance in 2018.”
On December 13, 2019, Kaiser reported, “Since 2016, when the number of uninsured reached historic lows, the number of people who lack health insurance coverage has grown by 1.2 million.”
Obama was still president in 2016. So Trump’s terrible policies, according to Kaiser, have increased the number of uninsured Americans by 1.2 million — which is the last thing the U.S. needs at a time when coronavirus could become a global pandemic. Coronavirus is certainly a threat in Europe, where at least 17 people have died from coronavirus in Italy. But the difference between the U.S. and Europe is that European countries have universal health care. So if a resident of France, Sweden, Belgium or Switzerland suspects that they have coronavirus, they know that seeking treatment won’t lead to medical bankruptcy.
In an excellent February 26 column for the Washington Post, journalist Helaine Olen explains why coronavirus makes a compelling case for Medicare-for-all — and she cites Azcue’s insurance nightmare as an example of why health insurance companies in the United States could make a health crisis even worse.
Olen asserts, “We’re all fixated on the Trump Administration’s day-late-and-billions-of-dollars-short response to the increasing likelihood that coronavirus will cause a public-health crisis in the United States. But the fact remains that even if the government were fully prepared, many Americans will face another barrier to receiving care that will make the crisis worse. That barrier is their wallet.”
When affluent Republicans rail against universal health care, they typically make an “I’ve got mine, screw you” argument — if other Americans are uninsured or underinsured, that’s their problem. To hell with them. But the “I’ve got mine, screw you” approach to health care is ignorant because when it comes to communicable diseases, the uninsured and underinsured are everyone’s problem. Communicable diseases are exactly that: communicable. And as Olen brilliantly lays out in her column, the argument for universal health care is not only a humanitarian argument — it is also a common sense argument. All Americans are well served when someone who has coronavirus or thinks they might have it seeks treatment ASAP rather than worrying about whether or not medical bankruptcy awaits them.
“Medicare-for-all is usually presented as a moral argument: the United States is the richest country ever known — it is not right that we don’t guarantee access to easily affordable and accessible health care like every other First World country,” Olen writes. “But this situation is not simply immoral — it also leaves the United States at a major disadvantage when it comes to combating global pandemics. We don’t want people to be wondering whether they can afford to visit the doctor if they think they’ve got this contagious and possibly deadly disease.”
The disease that Olen is referring to is, of course, coronavirus, which according to CNN, has killed at least 2800 people so far.
The Affordable Care Act of 2010, as envisioned by President Barack Obama, was certainly an improvement over what the U.S. had before it — and millions of Americans became insured because of Obamacare, flaws and all. But as Olen explains, “The average individual deductible for a plan purchased on an Affordable Care Act exchange is more than $4000, and only about half of purchasers receive any help with that sum via cost-sharing subsidies. The Trump Administration has compounded this financial quagmire by approving the sale of so-called junk insurance plans that place hard limits on how much the plan will pay out in hospital and pharmaceutical costs in return for a lower monthly premium — frequently leading to high bills that the plans may or may not cover.”
Olen adds, “There is also the growing problem of surprise medical bills. These occur when someone seeks treatment in an emergency — and I think we can all agree that suspected coronavirus is the definition of an emergency — from a hospital or other medical facility in their network, only to subsequently receive a bill from a doctor or lab affiliated with that institution who wasn’t in network after all.”
Olen fears that there will be a lot more horror stories like Azcue’s as coronavirus spreads in the U.S.
“Viruses and infectious diseases don’t check your deductibles, co-pays and network access before they strike,” Olen warns. “Doubters may claim that our nation can’t afford Medicare-for-all, but it’s increasingly likely that we are about to discover just how costly our current system really is.”
The Democratic presidential candidates have been vigorously debating the ways in which the U.S. can achieve universal health care. Sen. Bernie Sanders and Sen. Elizabeth Warren are proponents of a Medicare-for-all system, while centrists like former Vice President Joe Biden, Sen. Amy Klobuchar and former Sound Bend, Indiana Mayor Pete Buttigieg have proposed an aggressive expansion of Obamacare combined with a public health option (which Buttigieg calls “Medicare for all who want it”).
In Europe, there are arguments for both approaches. Some European countries have achieved excellent results with government-operated health care, while others favor private-sector health care with very strict, tough rules and regulations. But as Europe confronts the threat of coronavirus, the bottom line is that universal health care — in its many different forms — is the law of the land throughout the EU, where health care is viewed as a right rather than a privilege.
It remains to be seen who will win the 2020 Democratic presidential nomination. But whoever it is, that nominee needs to play hardball and slam President Donald Trump and other Republicans as aggressively as possible on health care — making it clear to voters that by trying to rip health insurance away from millions of Americans, the GOP makes a crisis like coronavirus even more perilous. Whether the candidate is Sanders, Biden, Warren, Buttigieg or former New York City Mayor Mike Bloomberg, Democrats — if they’re smart — will make the Republican Party the face of medical bankruptcies during the threat of coronavirus.
As the Washington Post’s Helaine Olen says, “Viruses and infectious diseases don’t check your deductibles.”