Saturday, February 29, 2020

Millions of uninsured Americans are a coronavirus timebomb

https://www.theguardian.com/commentisfree/2020/feb/28/coronavirus-millions-of-americans-uninsured

Carl Gibson
Fri 28 Feb 2020 04.10 EST

Like 27.5 million other Americans, I don’t have health insurance. It’s not for a lack of trying – I make too much to qualify for Medicaid, but not enough to buy a private health insurance plan on the Affordable Care Act exchanges. Since I can’t afford to see a doctor, my healthcare strategy as a 32-year-old uninsured American has been simply to sleep eight hours, eat vegetables, and get daily exercise. But now that there are confirmed coronavirus cases in the United States, the deadly virus could spread rapidly, thanks to others like me who have no feasible way to get the care we need if we start exhibiting symptoms.

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Earlier this week, the Department of Health and Human Services secretary, Alex Azar, (a former senior executive at pharmaceutical manufacturer Eli Lilly) refused to commit to implementing price controls on a coronavirus vaccine “because we need the private sector to invest … price controls won’t get us there”. Even the House speaker, Nancy Pelosi, notably didn’t use the word “free” when referring to a coronavirus vaccine, and instead used the word “affordable”. What may be considered affordable for the third-most powerful person in the US government with an estimated net worth of $16m may not be affordable for someone who can’t afford a basic private health insurance plan that still requires a patient to pay thousands of dollars out of pocket.

Given the high cost of healthcare in the US, I haven’t seen a doctor since 2013, when I visited an emergency room after being run off the road while riding my bike. After waiting for four hours, the doctor put my arm in a sling, prescribed pain medication and sent me home. That visit cost more than $4,000, and the unpaid balance eventually went to collections and still haunts my credit to this day, making it needlessly difficult to rent an apartment or buy a car. But even a low-premium bronze plan on the exchange comes with a sky-high deductible in the thousands of dollars, meaning even if I was insured, I’d have still paid for that ER visit entirely out of pocket.

This system is exactly why a 2018 West Health Institute/NORC at the University of Chicago national poll found that 44% of Americans declined to see a doctor due to cost, and why nearly a third of Americans polled said they didn’t get their prescriptions filled due to the high cost of their medicine.

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