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The Coronavirus Isn’t the Only American Health Epidemic

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Lately my work in the hospital consists of two activities. Admit patients with Covid-19, and, if lucky, discharge patients with Covid-19. The work is monotonous. But then the loudspeakers click on and Andra Day’s “Rise Up” plays throughout the hospital, and for a moment I’m transported away from the oxygen tubes and ventilators. Someone with Covid-19 is going home. The melody offers hope, but that quickly disappears.

A couple of months ago—before all my patients had Covid-19—Peter arrived at the emergency room gasping for air. A severe asthma exacerbation had grabbed his lungs and wouldn’t let go. Peter was intubated, stabilized, and sent to the ICU. The first crisis was avoided.

The second crisis began the following day, within minutes after he was extubated. His nurse paged me: “Patient is distressed. He’s leaving ASAP.” I walked into the room and saw Peter breathing quickly, but asthma was no longer the culprit. “Do you have monthly payment plans?” he asked. His eyes held a familiar fear of uncertainty, of normalcy slipping away. Like millions of Americans, Peter was uninsured. He wanted to leave because of his mounting medical bills.

Each day I spend in the hospital now I hear that Andra Day song. With mounting Covid-19-related deaths I need some source of hope. But when I know patients are expelled back into an unreliable health care system, one that is notorious for financial ruin, celebration feels misplaced.

Far before SARS-CoV-2 dominated news cycles and hospitals alike, there were already established epidemics in US health care: namely, medical bills and uncertainty. In 2019, a third of US adults reported that their families couldn’t afford health care and 44 percent endorsed skipping a doctor’s visit because of cost. Medication affordability wasn’t much better: 29 percent of adults reported not taking a medication as prescribed due to cost.

Enter: Covid-19. You could almost hear the virus salivate.

When this coronavirus arrived in the United States, and when Donald Trump downplayed a pandemic while tests were delayed, the confusion over whether health insurance would cover testing and treatment began. The public needed confirmation that testing and treatment was accessible and affordable. Instead, Trump did what Trump does: make empty promises and baseless claims.

In a White House address on March 11, Trump incorrectly claimed the commercial health insurance industry “agreed to waive all copayments for coronavirus treatments.” He then doubled down and falsely said surprise medical bills—charges that come from out-of-network providers—would also be canceled for Covid-19. Surprise bills were not eliminated, and they still are not.

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