Mar 4, 2020 - Health

Coronavirus could expose the worst parts of the U.S. health system

Illustration of a giant virus cell crushing a crumbling health plus.

Illustration: Aïda Amer/Axios

The coronavirus may soon become a high-stakes reminder of the flaws in the U.S. health care system.

Why it matters: Our expensive, inaccessible health care system could easily make it harder to control the virus' spread, failing individual patients and putting more people at risk in the process.

"You could see uninsured or underinsured patients, just like they do for other conditions, skipping necessary treatment because they believe they can't afford it," Avalere's Chris Sloan said.

Between the lines: A public health issue like the coronavirus isn't just another health care problem to add to the list of health care problems. Rather, all of those other issues directly complicate the response to the virus.

  • If we end up with a widespread outbreak, these big issues will "not even bubble up — they would really explode out into much more plain view," said Jen Kates of the Kaiser Family Foundation.

The uninsured: Nearly 28 million Americans remain uninsured, despite the insurance gains made under the Affordable Care Act.

  • Uninsured people are more likely to rely on the emergency room. During a pandemic, that can overburden ERs and increase the risk of exposure for uninfected patients waiting to receive care, Kates said.

Costs: Even for patients who have insurance, deductibles and other out-of-pocket costs have been steadily rising.

  • "If you're in the hospital for this or needing treatment, you're likely going to rack up a lot of medical bills, particularly if you're uninsured or simply underinsured with high deductibles," Sloan said.

Surprise bills: A hospital stay often comes with the risk of a big bill no matter what, and emergency rooms are also some of the biggest sources of surprise bills — often for thousands of dollars.

  • This has already happened to at least one family, who got a bill for nearly $4,000 following a mandatory quarantine.

What's next: The Trump administration appears to be taking these concerns seriously. It's considering using a national disaster program to pay providers for the care of uninsured people who have the coronavirus, the WSJ reported yesterday.

  • Although a treatment or vaccine for the coronavirus is still a long ways off, concerns have already been raised about whether they'll be affordable (and thus accessible).
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