October 16, 2021

The Queens County Citizen

Complete Canadian News World

Coronavirus treatment is the same. Very different price tags.

Italy healthcare system coronavirus nurse photo vpx_00000000

“People don’t avoid health care because of costs in Europe,” said Reggie D. Williams II, an international health policy expert at the US-based Commonwealth Fund. “Unfortunately, Americans face two burdens of concern about access to care … and then affordability.”

The health system everywhere is being stretched out by the pandemic. Hundreds of thousands of people around the world suddenly need the same care. The problem is similar in all areas: inadequate testing capacity, high demand for hospital beds, lack of ventilators, personal protective equipment (PPE) and medical staff.

Health experts say it is too early to issue a final decision on which countries are working well and those that are failing because the pandemic is far from over. But there are lessons to be learned.

Rifat Atun, a professor of Global Health Systems at Harvard University in the US, said evidence so far showed that a more centralized, publicly funded system with universal coverage and a solid chain of command and control had better overcome the crisis. They are able to increase testing faster, coordinate responses, gather resources, and reduce mortality rates.

“The chain is as strong as the weakest chain,” he said. “In the US, there is not one health system per se, but several systems in each state, and within each state there are different subsystems, so it is very difficult to have an intelligent and coordinated response – and that has implications because, you know , the virus does not recognize borders from one country to another. “

However, one place where the US is separate from other countries is how much this pandemic costs people infected by the virus.

Calculating costs

Paolone, who is 56 years old and lives in Monte Silvano in middle east Italy, called an ambulance last month after suffering persistent chest pain. He was sent to the emergency room and was later diagnosed with Covid-19 – something he did not expect. He found himself in an isolation unit with a nurse wrapped his head to the end with protective gear that reminded him of the space clothes that examined him through the glass window.

“I have an oxygen mask, but I can’t breathe … there’s a bell next to my bed and I ring the bell,” he said. He woke up six days later, in a different hospital. “Doctors and nurses applauded when I woke up and they said I was taken [in] by helicopter. ”

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Blomberg’s Covid-19 trip sounded very similar. Days of fatigue and pain, the decision to call an ambulance, medically induced coma and ventilator.

Both Paolone and Blomberg have a long recovery ahead of them. But unlike Blomberg, Paolone doesn’t need to worry about the cost of care that saved his life. “I paid nothing. Not a cent,” he said. He does not have private health insurance and is currently unemployed, but that does not affect his access to health care. The Italian system is funded through taxes; free primary care and hospitalization at the point of use for all citizens and permanent residents.

Blomberg, 35, lives in Muskego, Wisconsin. She lost her job during the pandemic, but had health insurance through her husband’s employer – unlike 28 million Americans, according to the US Census Bureau, was not insured in 2018. But even with insurance, the bills he faced with his Covid-19 treatment were very tempting.

“The ambulance trip itself, two thousand,” he said.

Blomberg has so far received a bill that only covers a few treatments and recipes. “They were only for a doctor’s visit during my first few days in the hospital and each doctor’s visit cost between $ 300 [and] $ 400. “

United Healthcare, Blomberg’s insurance company, told CNN that they are eliminating the cost sharing for Covid-19 care for its members in Medicare, Medicaid, individual markets and certain health insurance plans sponsored by employers. But others who have a United Healthcare policy through their work may have to pay for their care.

Blomberg has not received indications that his accusations will be acquitted.

He was too ill to care about the cost of treatment when calling for an ambulance. “My concern is that I’m still alive, it’s not a bill,” he said. “I can take the rest of my life paying it back.”

But study after study shows that money is a major consideration for many Americans.

According to the Commonwealth Fund, even before the Covid-19 crisis, one in three adults in the US missed medical treatment because of the cost, compared to one in 10 in Britain, Germany, the Netherlands and Sweden. When the foundation surveyed people in the US about the corona virus, two-thirds said cost would be a very important factor in their decision to get treatment if they had symptoms.

Even those with health insurance may not seek treatment that quickly, in large part because they may face a large deductible and unaffordable costs for doctor visits, emergency room trips and care. About 153 million Americans who have coverage through their work have to get out about $ 1,655 per year, on average, before their coverage comes in, according The Kaiser Family Foundation.

“I believe costs have become a deterrent for many people accessing services … and in fact, if we look at the US, most of those who are dying are those from underprivileged groups,” Atun said. “This shows me that these people usually do not access services, may delay their decision and arrive late.”

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This is a dangerous approach, especially when dealing with a highly contagious virus. “That makes it very difficult to reduce and control a pandemic … if people don’t go and do tests, we don’t know whether they are infected and that has policy implications,” said Liina-Kaisa Tynkkynen, an assistant professor of Health Sciences at the University of Tampere in Finland.

Since the outbreak began, many major health insurance companies in the US have said they will waive pocket expenses for many of their policyholders for corona virus treatment in hospitals. And it The Trump administration says it will reimburse hospital costs to treat uninsured coronavirus patients and require hospitals that receive federal assistance not to charge patients at a higher rate if the hospital or doctor is not in their insurance company network. Blomberg said that the decision to make people like him wonder if they would be better without insurance.
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The US also has a lack of other health care that can make it more difficult to fight viruses. It has fewer practicing doctors per 1,000 people than many developed countries, and it lags behind other rich countries in hospitals per million people and hospital beds per capita, according to the Kaiser Family Foundation.
In addition, health insurance is often associated with American employment status – which means that some of the 26.5 million people who have applied for unemployment because of this pandemic are also at risk lose their coverage.

“The crisis underscores the value of having a universal public health system as well as a wider social security system,” Tynkkynen said. “When a crisis like this happens, it not only affects people’s health but also their social welfare, their work, their economic situation,” he added.

The system does not starve because of money. US spent almost 17% of GDP is for health care, roughly twice the average among other developed countries. But despite all that money, the US lags behind other countries in performance. The Commonwealth Fund has compared health care systems in high-income countries for two decades, looking at quality of care, access, administrative efficiency, equity and health outcomes and a healthy life. According to Roosa Tikkanen, the fund The US has come as a whole last in every one of those funds comparison report.
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For many experts, this pandemic explains all the reasons for major health reform in the US.

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“There are many resources in the health care system in the United States that can be channeled to achieve universal coverage goals,” Williams said. “Yes, there are political obstacles. Yes, there are obstacles around government taxation and trust, but I think this pandemic has shown that the lack of universal coverage really allows many people to fall between the gaps.”

Blomberg said he preferred the universal coverage system to his personal health insurance. “I think it will be far, far better for everyone,” he said, quickly adding that he was pretty sure the system would not change anytime soon. “I don’t see universal health care being the actual choice now,” he said.

“Part of the problem is, you know, the people who make this decision, they don’t need to worry about it. Because they are fully covered in government work. They make ridiculous amounts of money. And if people don’t” I’m not affected by something “That will not change their opinion about various things,” he said.