As more Americans contract the coronavirus, medical professionals and experts said that the pandemic has exposed the weaknesses of the country’s healthcare system, reported Daniella Silva of NBC News, a television network. They said the outbreak has shown that Americans need to change the way they think about their healthcare considering that overwhelmed hospitals try to treat an increasing number of COVID-19 patients. Hospitals also lack an adequate supply of PPE (personal protective equipment) to safeguard the health of medical workers.
Surveys About the US Healthcare System
A survey by Public Agenda, USA Today, and Ipsos found that 92% of Americans said changes are needed, according to their Hidden Common Ground report, cited Christine Herman of WBUR, a public radio station. Most Americans wanted “either major changes or a complete overhaul of the system,” noted Chris Jackson, vice president of market research firm Ipsos. In total, 7% would leave the healthcare system as it is, 30% would want to make minor changes to improve it, 40% would make major changes, and 22% would redesign it completely.
50% of Democrats would make major changes to improve the US’s healthcare system, versus 14% of those who would redesign it completely and 31% of Democrats who would make minor changes. Only 4% would leave the country’s healthcare system as it is.
On the other hand, 14% of apolitical Americans said they would the healthcare system as it is (versus 4% of Independents and Democrats and 8% of Republicans). Only 35% would redesign it completely (versus 34% of Independent and 36% of Republicans) and only 27% of apolitical Americans would redesign it completely (versus 31% of Independents and 24% of Republicans).
Overall, 26% of Americans were more likely to support an idea to create a single federal health insurance program that automatically covers all Americans. This would replace employer-provided insurance and would be free for individuals and families; however, it would be paid through taxes. The program could increase taxes for middle and high-income Americans.
Only 25% of Americans were neither more or less likely to support it, while 35% said they were less likely to support it. Only 13% answered they don’t know or they don’t have enough information to say. 55% of Republicans said they were less likely to support it unlike Democrats (17%), Independents (49%), and apolitical (22%).
However, 43% of Democrats were more likely to support it compared to Republicans (8%), Independents (27%), and those who are apolitical (20%). A smaller percentage of Democrats (29%) were neither more or less likely to support it unlike Republicans (24%), Independents (18%), and apolitical (30%). In another survey by American analytics and advisory company Gallup, 14% of US adults would avoid treatment for fever and dry cough due to the cost of care, while 9% would avoid it if they thought they have been infected with coronavirus.
Households earning less than $40,000 would avoid treatment for fever and dry cough (13%) and suspected coronavirus infection (14%) due to cost of care unlike those earning between $40,000-$100,000 (13% and 6%) and more than $100,000 (5% and 3%). Unfortunately, 6% of US adults were denied care due to patient volume. Those with an annual household income of less than $40,000 (11%) were more likely than those earning between $40,000-$100,000 (4%) and over $100,000 (3%) to be denied.
The US Healthcare System Is Broken
Dr. Brendan Carr, chair of emergency medicine for the Mount Sinai Health System in New York noted that there is “a total pause on almost everything that we understand as health care” in New York. This also includes procedures and operations, outpatient visits, and chemotherapy treatments—which are major revenue streams for hospitals. Changes made to how health care businesses operate would be determined by congressional action or by creating payment incentives for hospitals. If congressional bailout for health systems should occur and resume normal business operations, some systems would stockpile more, become mindful about workflows, and increase social distancing.
Dr. Hardeep Singh, a professor of medicine at Baylor College of Medicine in Texas, explained that hospitals have run at near-maximum capacity and are not willing to have excess beds due to financial incentives. "But that has cost us in terms of problems in this day and age, so I think preparedness and having that surge capacity going forward" would play an important role in the future, Dr. Singh said. He added that the US must really focus more on domestic manufacturing of PPEs, which were high in demand (but inadequate) from Chinese manufacturers.
Dr. Singh also emphasized the need to build a public health infrastructure that would enable the country to determine which areas and hot spots will need more supplies. This could be used in future crises as well. “We just don't have a national or regional sort of spine of all the data elements that we need to figure out where do we allocate resources next,” he added.
A Profit-Driven Healthcare
Hospitals and clinics earn more money when they increase the number of costly diagnostic services they offer, said Rebecca Kolins Givan of New York Daily News, an American newspaper. For them, MRI machines and grand concierge floors for high-paying patients are profitable. However, maintaining enough supply of PPEs or bed capacity was seen as “unnecessary costs” until the pandemic. Corporate owners aim to generate more revenue, but sadly, patients and health professionals are suffering from their profit-driven ventures.
Policymakers have a role to play here, but the US’s healthcare system is controlled by private interests ranging from the American Medical Association—which represents about a quarter of practicing physicians— and AHIP, a health insurance provider, to investors driven by profit rather than public health.
New Hope for the US Health System
"I think medical care in so many different ways will be transformed with the really increased use of telemedicine,” said Dr. Paul Biddinger, director of Massachusetts General Hospital's Center for Disaster Medicine. He hoped that telemedicine will be better for patients and providers, especially in cases when patients don’t need to see their doctor in person. The crisis should be treated as a national security health issue, meaning hospitals need to have access to adequate PPE supplies. For Dr. Biddinger, it is akin to having enough military supplies to defend the country.
Patricia Davidson, dean of the Johns Hopkins University School of Nursing, added that the US needs more national and global governance in public health. There were some states that create competition when they individually purchase PPEs’, causing prices to increase. She acknowledged that regional or national coordination of stockpiles of PPEs would be a challenge. Hence, it is important for the US to create a system that would aid in managing inventory and rotating those stockpiles.
Healthcare should not be controlled by profit-driven entities. The health of citizens should be prioritized over profits. There should be adequate supplies of PPE for frontline medical workers. That way, they can treat more patients while reducing their likelihood of contracting the virus.