A PERSONAL VIEW OF THE IMPACT OF THE PANDEMIC ON NON–COVID RELATED MEDICAL CARE IN AMERICA

“In medicine, rules maybe absolute, but consequences are variable.”– Celsus

The COVID – 19 pandemic has impacted every aspect of our lives – our health, our work, our pocketbook, our relationships, and it will continue to do so until a safe and effective vaccine is found and manufactured for the entire world population.

The pandemic has shown us just how small our planet really is. It has reinforced just how all of us are connected and interdependent on one another.  And how a virus recognizes no national borders, no race, nor age group.

The pandemic also shows us just how vulnerable and wasteful all of the established healthcare systems are in the world. Let’s look at the USA more closely. 

Since the pandemic started, at the beginning of this year, people in the USA stop going to see their doctor in offices, clinics or hospitals, with the fear of catching the virus, thinking that these are the places where COVID -19 patients go. Hospitals had to cancel all of their elective surgeries, procedures and clinics. Doctors and dentists closed their offices because of no patients and the fear that they could get infected themselves.

Consequences of these decisions have been financially devastating for them. Many doctors who were close to their retirement age closed their offices for good. Hospitals have been forced to cut the salary of their workers, furlough or let go some of their nurses and doctors. Some rural hospitals went bankrupt or were taken over by big hospital chains.

The pandemic also brought to sharp focus many points, excesses, deficiencies and wastes in the American health care system.

First, many of the patients with chronic illnesses stop going to see their doctor for their scheduled appointments seem to have done just fine. A survey among these patients have shown that 86% of them remained stable or the same. Only 1/10 had worsened.

What does this mean?  is a very important question to ask. I don’t know the answer to this question but as I see it, some of the healthcare in America is not needed and is unnecessary and wasteful. The sole purpose of this extra medical care is to make more money. A recent survey among the doctors on this regard revealed that probably 15 – 30% of care in America is unnecessary and in some specialties, probably 20% of surgeries are not needed.

The second point that came to focus is that the biggest moneymaker for hospital are elective surgeries, interventional procedures, imaging studies and emergency department (ER) visits.

The third point is about the fallacy of health insurance companies in America. There are very many of them – private insurances, HMOs, government sponsored insurances like Medicare, Medicate, ACA and employer sponsored health insurances. Yet, there are still about 26 million uninsured people in America because the cost of health insurance is too high for them.

All these insurance companies work as middlemanto share in the biggest pie in the world - the $3.5 trillion yearly health care expenditure in America, without any direct contribution to health carebut hindering the health care to enrich themselves, their shareholders and to pay their CEOs six figure salaries.

The amount of health care expenditures in America is more than Canada, UK, Germany, France, Italy, Spain, Japan, China and Australia put together. Yet, America still loses more peoples to preventable medical conditions than any of these countries.

Why are the yearly health care expenditures so high in America? Why nothing is being done about it?are two main questions to be raised. I believe these questions should be answered by prominent healthcare economists and the government.

But I would like to put my two cents in. I believe it is multifactorial. Among them, the first one is the excessive individualistic American culture, in which the only important and motivating factor is self- interest. Another factor is American exceptionalism and superiority complex, that Americans know everything better, they would not follow anybody’s footsteps and they would do things their own way.

The third factor is employer sponsored health care insurance. Presently 160 million of Americans receive health benefits through their employer sponsored health care insurance. Employers, since their insurance expenses are tax deductible and heavily subsidized by the government, do not want to spend time, money or personnel to check every exuberant bill from hospitals or doctors and simply pays them. But this attitude gives employers an extra incentive to pay less wages to employees. Additionally, if things go bad, as seen in the sudden impact of the pandemic, they can easily lay off all of their workers. Recently as many as 40 million employees have lost their jobs and their health benefits and have applied for unemployment insurance payments.

To me, the American health care is more a patchwork of systems in which health care prices are set at whatever the marketplace could bare. Frequent efforts to check and control the outrageous prices of healthcare by authorities are often bludgeoned by the major interest groups of big corporations, big insurance companies, big pharma, big hospital chains and millionaire doctors. They practically own politicians and law makers and are able to prevent any changes.

Many institutions and systems are using these difficult times created by the pandemic to make changes. I believe this is the time, together with looming election to make changes in the American health care insurance system. Status quo and keep sharing the biggest health care pie in the world, is no longer an option. We don’t have to reinvent the wheel, just look at the success of our neighbor Canada and other advanced European countries, to design a new and universal American health care system.

After all, proper health care is a human right, not a privilege or luxury.