One of my concerns, among several, about the possibility of a COVID-19 outbreak in the U.S., as well as our ability to mitigate the damage from an outbreak, is our crappy healthcare system. There are too many assholes who view healthcare as a completely private problem: you might die from a lack of insulin, but I won’t. The problem is that completely breaks down with an infectious disease, as this case from Miami, FL, illustrates (boldface mine):
After returning to Miami last month from a work trip in China, Osmel Martinez Azcue found himself in a frightening position: he was developing flu-like symptoms, just as coronavirus was ravaging the country he had visited.
Under normal circumstances, Azcue said he would have gone to CVS for over-the-counter medicine and fought the flu on his own, but this time was different. As health officials stressed preparedness and vigilance for the respiratory illness, Azcue felt it was his responsibility to his family and his community to get tested for novel coronavirus, known as COVID-19.
He went to Jackson Memorial Hospital, where he said he was placed in a closed-off room. Nurses in protective white suits sprayed some kind of disinfectant smoke under the door before entering, Azcue said. Then hospital staff members told him he’d need a CT scan to screen for coronavirus, but Azcue said he asked for a flu test first.
“This will be out of my pocket,” Azcue, who has a very limited insurance plan, recalled saying. “Let’s start with the blood test, and if I test positive, just discharge me.”
Fortunately, that’s exactly what happened. He had the flu, not the deadly virus that has infected tens of thousands of people, mostly in China, and killed at least 2,239 as of Friday’s update by the World Health Organization.
But two weeks later, Azcue got unwelcome news in the form of a notice from his insurance company about a claim for $3,270.
In 2018, President Donald Trump’s administration rolled back Affordable Care Act regulations and allowed so-called “junk plans” in the market. Consumers mistakenly assume that the plans with lower monthly costs will be better than no insurance at all in case of a medical catastrophe, but often the plans aren’t very different from going without insurance altogether.
Hospital officials at Jackson told the Miami Herald that, based on his insurance, Azcue would only be responsible for $1,400 of that bill, but Azcue said he heard from his insurer that he would also have to provide additional documentation: three years of medical records to prove that the flu he got didn’t relate to a preexisting condition.
People already avoid medical care they need because they can’t afford. For non-communicable diseases, that’s horrible, but it doesn’t directly affect others. Now, people will avoid seeking medical attention because they can’t afford to pay for it. To say that neo-liberal market incentives fail in this situation would be an understatement. Between Trump’s narcissism–and narcissists will desperately latch onto any scintilla of good news (e.g., ‘some coronaviruses become less infectious in warmer weather’), until they fail and them blame everyone but themselves–and general incompetence rivaling that of ‘Heckuva job, Browine’, this will likely be our status if we get hit hard by COVID-19:
If the WHO’s worst predictions come true, the United States of America may be faced with controlling a pandemic while the national leader, an expert in no discernible field outside of reactionary trolling and surrounded by loyalists and sycophants who know truthful dissent means defenestration, devotes at least as much energy to further dismantling an already broken healthcare system as he does to public health and the general welfare.
If COVID-19 hits us hard, we can only hope von Bismarck’s adage ‘God has a special providence for fools, drunkards, and the United States of America’ holds. Hopefully, Trump will stay out of the way and not politicize this, but I’m not optimistic about that, to say the least, especially given his behavior to date.