Experts are warning that within two to four weeks the United States will find itself facing a full-blown pandemic caused by the COVID-19 coronavirus.
We often hear mindless propaganda from conservative and liberal politicians alike declaring the the U.S. has “the best health care system in the world.”
It may be true that the rich can get the best care in the world. But the truth is that ours is a terrible health “system” because it is virtually unavailable to the 30 million Americans without health insurance and to the 50 million more Americans who only have basically useless insurance that has outrageously high deductibles (the money you have to spend out of pocket for doctors, treatment and even hospitalization before your policy starts to cover you). These deductibles can range from $2000 per year on up past $6000 per year.
For families and even individuals living paycheck-to-paycheck who have at best a few hundred bucks in the bank, it’s simply not possible to come up with the $75 or more it can cost to see a doctor or, if no doctor is available in a crisis, the $200 it can cost to go to an urgent care center.
The result of this situation is that many Americans just don’t get seen if they get sick. Only when they are so ill that they have to go to a hospital emergency room do they get to see a doctor, and if they can get admitted at that point (some hospitals turn people away without insurance or ready cash) their care is hugely expensive because they’re receiving it so late.
That’s bad enough if a person has pneumonia, a heart problem or something like a serious ulcer, but when they’ve contracted a potentially fatal and highly contagious pandemic disease for which there is no easy cure, it is a social and national catastrophe, not “just” a personal one.
Confronted with a looming epidemic, what we should want is for everyone in a society to have ready access to free testing to see if their symptoms indicate that they have the disease, and that if they do, for them to have access to prompt treatment and medication to minimize the risk that they will spread that disease to others or get a serious complication themselves.
As things stand, at least 80 million Americans — about one in four of us — don’t have that.
But it gets worse. More than a hundred million of the poorest Americans these days, when they have employment, typically work in the service sector, where they perform jobs that put them in close contact, either directly or indirectly, with many people. Think of maids, janitors, hotel workers, theater ushers, hospital orderlies and nurse’s aides, warehouse and delivery drivers, supermarket cashiers and counter workers, restaurant staff, including waiters, busing staff and kitchen staff, etc. Most such people work at minimum wage or close to it (below minimum for many waiters and others who receive tips as part of their compensation). Their jobs are generally non-union, and a majority do not even get sick days. Even most of those who do get a few measly sick days a year don’t get paid for those days they stay home because of illness. Many who responsibly skip work because of a cold, risk getting the sack from the boss. But even those who are allowed to miss work, but who don’t get paid for a sick day, have to think twice about staying home. If they are barely making enough each month to pay for food and rent on their wages, missing a few days’ pay can mean not having enough for those crucial expenses. Understandably, many will just opt for going to work sick.
Again, most Americans probably don’t care or even think about the fact that the person serving them might have a sore throat or be suffering from an ulcer or a painful impacted tooth, but if those service workers are coming to work with early symptoms of coronavirus, that’s a serious problem not just for the individual in question but for those they come in contact with.
How do we solve this? It’s not like we can suddenly revamp the U.S. healthcare system and establish free taxpayer-funded Medicare for All like Bernie Sanders is calling for in his campaign. Certainly not in the few weeks we have left before Coronavirus starts to really spread in this country.
But there are things we could do quickly.
The first issue is to establish nationwide free testing for the COVID-19 virus.
Test kits are being developed and produced for distribution quickly, but these can reportedly cost patients hundreds of dollars per test. If people can’t afford to be tested, they won’t get the tests. So Congress should pass legislation making tests freely available, like publicly offered flu shots. The test kits could be provided to pharmacies, hospitals, doctors offices and clinics with the stipulation that there be no charge to anyone for the tests. Congress just passed and the president signed a bill making $8.5 billion in emergency funding available for dealing with this pandemic — more than enough to handle that initiative.
But what about getting care?
Since this is a national crisis, we need to make sure everyone who contracts this disease can get timely treatment.
The first need will be for primary care. Most people who contract coronavirus infections can be given antiviral drugs and antibiotics to prevent secondary infections but can get well from the infection at home isolated from others who might be infected. It would make sense to provide funding for visiting nurses to check on such people if they don’t have access to a doctor, though.
But many communities don’t even have hospitals or visiting nurse organizations nearby. Many rural folks need to travel or to find transportation to bring them as much as 50 miles away to access such facilities.
Here’s an idea though: The Veterans Administration has huge hospitals and also out-patient clinics all over the country. This being a national emergency, the federal government should temporarily make these first-class federally run facilities available to those without adequate medical insurance. Where there are no such VA facilities nearby, we finally have something useful the military can do to “keep Americans safe.” They can set up tent hospitals staffed by trained medics to administer care. If we could do that for the ebola crisis in Africa, or in Haiti after the earthquake, we can do it here at home! (Although the failure of the U.S. to provide prompt medical assistance to Puerto Rico, an American territory populated by U.S. citizens, after Hurricane Maria and the recent earthquake struck there, means perhaps we can’t…or won’t.)
While all this gets organized, we should all start contemplating how unnecessary this would all be if we had a Medicare for All system of health care in place in this country, and why we should move quickly in that direction before the next health crisis strikes.
Meanwhile we need to come together as a nation and work cooperatively in this current crisis.
It’s not happening, now. I went out to the store today to buy a container of disinfectant wipes. It’s an issue particularly serious for those above 65, and those with vulnerable lungs or hearts — the people most likely to die from the disease if they contract it (I’m 70 myself). But I discovered that grocery stores, pharmacies and other outlets have all been denuded of such wipes, as well as spray bottles of disinfectant, sanitary lotions and even bottles of rubbing alcohol and hydrogen peroxide. Why stripped, you might ask? Because, I’m told, people have been rushing to stores and filling shopping carts with everything on the shelves for themselves, leaving nothing for anyone else.
This is incredibly antisocial behavior! It is also self-defeating: If I buy up ten packages of wipes, and leave none, I’ll have plenty of disinfectant products for myself but others, who won’t be able to find any, will be out and about spreading disease on surfaces and on their own hands, which means they will spread the germs to where I could catch them. It is in everyone’s interest to insure that everyone in the country has the ability to protect themselves and others from this disease.
Americans, we’re told, don’t like socialism. I’m not sure that’s true, but for those who like to think of themselves only, and not about their fellow citizens, there’s nothing like a pandemic to offer a wake-up call that we need to be our brothers’ and sisters’ keepers. It’s not just a good Biblical injunction; it’s common sense in an interconnected world.
Even conservatives and libertarians understand the need to make polio shots and flu shots free to all. But we also need to make medical care for infectious diseases free for the same reason. Doing so protects us all. Not doing so puts even the wealthiest of us at risk.