- Medical debt, one of the disgraces of the world’s most expensive health care in the planet’s wealthiest nations, has spiked during the Covid-19 pandemic. A consumer finance firm recently found that its 22 million members carry $45 billion in bills owed to providers and in collections. With the coronavirus also staggering the economy, bankrupting medical debt is only likely to skyrocket as the nation’s 30 million jobless exhaust their finances and lose health insurance from their work.
- Health insurance offers one of the few widely available means for ordinary folks to try to protect themselves and their loved ones from seeing their finances destroyed by illness or injury. But new U.S. Census data, describing a time before the pandemic, shows that “the first three years of President Trump’s tenure were a period of contracting health insurance coverage,” the Washington Post reported. “The decreases reversed gains that began near the end of the Great Recession and accelerated during early years of expanded access to health plans and Medicaid through the Affordable Care Act — the sprawling law that was a signature domestic achievement of President Barack Obama and has been derided by Republicans, including Trump, ever since.” Just under 30 million Americans were uninsured — 1 in 10 of us, with the numbers rising by several million over the last several years of the Trump term.
Health care persists as one of the top concerns for voters as they consider candidates this fall — not just for the presidency but up and down the ballot.
But beyond the crafted speeches over four nights for each party and looming past the repeated talking points of the candidates and their hand-picked supporters, voters will confront issues of huge gravity — some well known and others maybe less so.
The Covid-19 pandemic continues to slam the practice of medicine, with patients’ infection fears and treatment delays putting at serious financial risk the providers of crucial medical services like primary care doctors and pediatricians.
At the same time, as is too often the case in U.S. medicine, the rich may be getting richer, as resuming care gives patients eye-opening information on the big money in orthopedic and plastic surgery and other cosmetic procedures.
The coronavirus’s economic shocks may most accelerate changes — not all of them happy for patients — for primary care physicians, who account for half the annual doctor visits annually in this country, the independent, nonpartisan Kaiser Health News service reported.
In response to the shattering harms of the Covid-19 pandemic, Congress sought to shore up the U.S. health care system with billions of dollars in emergency aid. But the federal agency that helps to oversee the institutional care for the elderly, sick, and injured performed poorly as a steward of taxpayers’ hard-earned money.
The Health and Human Services department, instead, shoveled hundreds of millions of dollars, “no strings attached,” to dubious owners or operators of facilities nationwide. These “for-profit nursing home providers … have faced accusations of Medicare fraud and kickbacks, labor violations or widespread failures in patient care,” the Washington Post reported.
The newspaper said its analysis of HHS allocations of big sums in the Coronavirus Aid, Relief, and Economic Security Act, or Cares Act, also showed that:
Voters keep sending Republicans — in statehouses, Congress, and the White House — a clear message: Americans want affordable, accessible health insurance, most notably as offered under the GOP-loathed Affordable Care Act, and especially for the poor and working poor via Obamacare’s expansion of Medicaid.
This issue, if anything, may be rising in importance to the U.S. electorate as the Covid-19 pandemic rages without check and millions of Americans wrestle with pervasive joblessness that wiped out many people’s health insurance coverage.
Just weeks after voters in red Oklahoma backed a state constitutional amendment to expand Medicaid and narrowly defied the opposition of powerful GOP politicians who have dominated their state, residents of the “Show Me” state of Missouri showed up in force to approve Missouri’s expansion of the program coverage, by a 53% to 47% margin.
Tens of millions of Americans who have not kicked the harmful smoking habit or who have only recently done so may want to keep a watch on the work of a blue-chip advisory group as its medical scientists consider how much lung-cancer screening best benefits tobacco users.
The panel is seeking expert comment on its proposal for a greater number of older smokers and recent quitters to undergo low-dose computed tomography. That is a diagnostic procedure that combines X-rays and computers to give doctors a better look at patients’ lungs with multiple views and cross-sectional images.
The U.S. Protective Screening Task Force — which advises the federal government on preventive care and issues recommendations that can affect patient costs and insurer coverage for procedures — says more patients should have tomography than the panel recommended in 2014 when it last considered evidence on it.
How has Big Pharma responded to the dire and uncertain circumstances facing American’s health and pocketbooks? By jacking up prescription drug prices and likely jabbing patients not just in the arm but also the wallet for a prospective coronavirus vaccine.
As the online news and politics site Politico reported:
“Drug makers raised the price of hundreds of medicines during the coronavirus pandemic, even in the face of Trump administration vows to crack down on surging drug costs and efforts to tack price controls on Covid-19 relief packages. Pharmaceutical companies logged more than 800 price increases this year and adjusted the cost of 42 medicines upward by an average of 3.3% so far in July, according to GoodRx, which tracks the prices consumers pay at pharmacies.
It is hard to believe, still, the shabby way they are treating the aged, sick, and injured. Just consider this sampling of recent news reports:
“Care” facilities — including centers dealing with veterans — have been too willing to subject residents to risky medical experimentation to fight the novel coronavirus, including what appear to be inappropriate treatments with a much-promoted anti-malarial drug. This echoes a situation involving nursing home residents in Galveston, Texas, and their facility’s dosing them with hydroxychlorquine without their loved ones’ knowledge and iffy circumstances about their individual capacity to consent to receiving the drug. As the Washington Post reported of a Philadelphia area veterans’ facility (shown in federal photo above):
Owners and operators of nursing homes and other long-term care facilities have mounted a “nimfy” (Not My Fault) defense for the tens of thousands of deaths and infections of their residents during the Covid-19 pandemic. They claim they did the best they could under tough circumstances. And now they want not only special legal protections from those who suffered harms but also taxpayer bailouts.
But the industry’s disingenuous bleating has a big problem: It gets undercut by the second by infuriating actions — including by profit-mongering facilities “dumping” thousands of aged, sick, and injured residents on the streets or into flophouses, and by homes that still fail — despite warnings and penalties — to take basic steps to safeguard the vulnerable.
The New York Times — conducting the kind of sleuthing that real federal watchdogs could be taking on — reached out to “more than 80 state-funded nursing-home ombudsmen in 46 states” to detail “involuntary discharges.” As the newspaper explained of these inappropriate evictions by care giving centers, which may number more than 6,400 nationally:
In the middle of a pandemic with a novel virus that has infected at least 2.5 million Americans and killed roughly 127,000, and with 20 million people jobless, what is a prime Republican response? They are advancing yet again a court case to strip tens of millions of poor, working poor, and middle-class Americans of health insurance.
By the way, when doing so — by seeking a total repeal of the Affordable Care Act — the Trump Administration and a collection of states led by Republican attorneys general also would put at huge risk key health insurance safeguards that Americans embrace, including:
- They no longer would be guaranteed the protection of insurers denying them coverage based on pre-existing conditions.