COVID-19 Exposing Structural Flaws in the U.S. Healthcare System

by MAX KANUK


What You Can Do:

  • Remember preventative treatment; don’t neglect everyday reasons to go to the doctor, but always remember be safe, wear a mask, wash your hands, and maintain social distances as best you can. Life still goes on, people still get injured and get sick, so make sure that if you need it, go to the doctors, and look after yourself. 
  • Stay home and protect yourself and others. The more people play their part in reducing the overall impact of this virus and stopping the spread, the sooner the nation will open up and people can get back to work. 
  • Do some research about your own health insurance plans/policy. What do they charge on premiums, and how do their premiums change after you have filed claims (often insurance premiums can increase if you have filed claims in the past). What types of care/treatment does your health insurance provide? Does it include dental or other additional benefits? If you do need to file a claim in the future, what is the process for making a claim for your particular health insurance policy? Know what you are dealing with. 
  • Often people have the choice to keep their previous employer-provided health insurance for a small period of time after termination (typically ~6 months). See if you or people you know qualify for this. 
  • Do some research and compare the U.S. healthcare systems with nations like France, New Zealand, Israel, Australia, and Japan. It may also be helpful to look into your state’s healthcare policies, and compare it to Hawaii (supposedly the best state for healthcare).

As the current COVID-19 pandemic continues to sweep the globe, economic consequences are prevalent with businesses closing down, mass unemployment, and economic activity ceasing almost to a halt. In the midst of these economic impacts, the influence that this pandemic will have – particularly in the long-run – on the healthcare system in the United States is largely under-discussed. Specifically, COVID is making the flaws of the United States healthcare system more visible than ever. While the United States spends $2.6 trillion annually on health care – the highest figure per capita in the industrial world – the nation unfortunately has some of the lowest affordability rates [1]. In other words, even though the U.S. spends remarkably high amounts of money on healthcare, there is a disproportionate fraction of our population who cannot afford healthcare costs. In fact, medical bills are the leading cause of bankruptcy in the United States [2]. Long-term impacts are going to be felt in the wake of this crisis; notably, our over reliance of employer-provided health insurance, the shortcoming and fragility of our government-backed public health insurance, and skyrocketing private health insurance premiums and deductibles.

49% of Americans are covered primarily by employer-provided health insurance [1], although in the last few months, over 30 million people filed for unemployment in the United States with greater figures likely to ensue [3][4][5][6]. This poses a major problem: millions of Americans are going to be suddenly under- or uninsured in the midst of a global pandemic, without a known end in sight. 

There are two main types of healthcare treatment: preventative and reactive. Preventative measures are taken to identify and treat medical conditions early before they manifest into bigger issues, while reactive treatments are taken in response to already-present issues [7]. The facts show that on a general basis, preventative measures are much less expensive than reactive treatments [8] [9]. To give two straightforward examples, vaccines – a preventative measure – are much less expensive and more cost-effective than waiting until after an individual has caught an illness and needs to be hospitalized – reactive treatment. Similarly, seeing a primary care physician for an infection to receive antibiotics is much less expensive than waiting for the infection to grow and present a much more serious threat requiring hospitalization and potential surgery. Trends show that people who are under- or uninsured often neglect preventative healthcare measures out of fear that they cannot afford medical bills, and instead only seek reactive medical treatment when more serious situations arise [10] [11] [12]. 

Since millions of Americans are suddenly under- or uninsured due to the pandemic from mass unemployment, the financial security safety net for their medical bills has disappeared. Therefore, people are more likely to begin neglecting preventative measures, and start resorting to reactive measures. This shift will be further compounded due to the fact that hospitals and primary care physicians are now hot spots of the coronavirus spread, and thus people are going to be even less inclined to seek treatment except in the most dire of conditions. The higher cost of reactive treatments will cause bankruptcy among the uninsured and will result in high increases of future health insurance premiums for those with private health insurance. Ultimately, the loss of employer-provided healthcare leads to a decline of preventative measures, resulting in much higher-cost medical bills for reactive treatment, increasing bankruptcy numbers and skyrocketing private health insurance premiums. 

An influence that these increasing health insurance premiums will likely bring is the exit out of private health insurance due to the inability to pay for such premiums, and the resort to Medicaid [13] [16]. 

Medicaid is designed to provide financial medical aid for the poor and disabled, but with record rates of unemployment and under-insured people in the country currently, huge numbers of people are flocking to Medicaid. Unfortunately, Medicaid may not be capable of providing care for such volume [16]. Experts say it is possible that this crisis could remain for at least another six months [17], and with so many people out of work and under- or uninsured during a potential six-month economic stand-still, the capabilities of Medicaid, and the responsibilities and roles of the government are really being brought into question. 

On March 25th, the US Senate passed a $2 trillion bill providing emergency aid packages in response to the COVID-19 crisis [18]. In Connecticut, state Medicaid funding in the last three months has increased 10% to account for growing COVID patients and the rapidly growing unemployed [19]. The swiftly growing reliance on Medicaid as a primary healthcare provider is exposing a major flaw in the US public healthcare system; Medicaid is not designed to account for such a volume of beneficiaries. 

The importance for a government-funded public health insurance and the benefits such a system would provide is becoming more obvious in the wake of this crisis. As the long-term impacts of this crisis – including skyrocketing private health insurance premiums, the over reliance of employer-provided health insurance, and the shortcomings of the current government-funded public health insurance (Medicaid) – materialize, the flaws of the nation’s healthcare system are becoming more visible, and increasing numbers of Americans must reap these consequences.


Works Cited:

  1. https://open.lib.umn.edu/socialproblems/chapter/13-4-problems-of-health-care-in-the-united-states/#barkansoc_1.0-ch13_s04_s01_t01
  2. https://www.apexedi.com/medical-bills-the-leading-cause-of-bankruptcy-in-the-united-states/
  3. https://www.rollcall.com/2020/04/02/medicaid-enrollment-will-likely-increase-because-of-covid-19-experts-say/
  4. https://www.vanguardngr.com/2020/04/us-virus-job-losses-hit-22-million-as-trump-eyes-restart/
  5. https://www.bloomberg.com/news/articles/2020-04-30/another-3-8-million-in-u-s-filed-for-jobless-benefits-last-week
  6. https://www.bloomberg.com/opinion/articles/2020-04-02/coronavirus-job-losses-get-even-more-staggering
  7. https://www.utmedicalcenter.org/preventive-medicine-prevention-vs-treatment/
  8. https://theincidentaleconomist.com/wordpress/cost-savings-vs-cost-effectiveness-and-preventative-care/
  9. https://www.nejm.org/doi/full/10.1056/NEJMp0708558
  10. https://www.businessinsider.in/science/news/14-statistics-you-probably-didnt-know-about-preventative-health-care-in-the-united-states/articleshow/74663504.cms
  11. https://www.countyhealthrankings.org/explore-health-rankings/measures-data-sources/county-health-rankings-model/health-factors/clinical-care/access-to-care/uninsured
  12. https://khn.org/news/111113-michelle-andrews-preventive-care-uninsured/
  13. https://www.rollcall.com/2020/04/02/medicaid-enrollment-will-likely-increase-because-of-covid-19-experts-say/
  14. https://healthpayerintelligence.com/news/covid-19-recession-to-increase-uninsurance-rates-test-medicaid
  15. https://www.bloomberg.com/news/articles/2020-04-09/how-a-cascade-of-job-losses-left-america-s-safety-net-in-shreds
  16. https://healthpayerintelligence.com/news/covid-19-recession-to-increase-uninsurance-rates-test-medicaid
  17. https://metro.co.uk/2020/04/01/coronavirus-uk-long-will-lockdown-last-will-easter-12491203
  18. https://edition.cnn.com/2020/03/25/politics/stimulus-package-details-coronavirus/index.html
  19. https://www.wtnh.com/news/connecticut/gov-lamont-announces-medicaid-rate-increase-for-nursing-homes-during-coronavirus-pandemic/