Many people have likely seen the social media post where a patient asks his doctor if he could live without either his insulin or his medication for high blood pressure, as he could not afford both at the time. Stories are circulating all over the internet about people who need medical attention but don’t want to see their primary care physician (PCP), a specialist, be treated at the hospital, call an ambulance or buy necessary medications due to the exorbitant costs.
And unfortunately, many of us may have firsthand or secondhand experience with this. Medical care in the U.S. is far too expensive for many people to the point that people risk their lives and health to prevent becoming bankrupt.
This is an even bigger concern during the COVID-19 pandemic. With health insurance often tied to jobs, and the fact that many lost their jobs due to the pandemic, many lost their health insurance coverage. As of July 2020, about 5.4 million people in the U.S. had become uninsured after losing their jobs to COVID-19.
Although there are insurance options, such as Medicaid, for those who qualify, this often does not cover all the costs of healthcare. For example, Medicaid is federally required to cover inpatient and outpatient hospital visits. However, aspects of healthcare such as dental care, optometry, podiatry and respiratory services are considered optional, meaning states decide whether or not these services are covered. Even something as essential as eyeglasses, which many of us take for granted, are deemed optional.
Health insurance is in dire need of change. People should not have to pick and choose what aspects of healthcare they need most solely based on what they can afford at the time. In many cases, it is a life or death situation, and people should not make that decision based on what won’t leave them bankrupt.
Instead, health insurance must be universal. Many nations around the world have some form of universal healthcare, which makes healthcare more financially accessible for everyone. This is not just one set-in-stone framework — most nations with universal healthcare differ on its implementation, but they all share the same goal of making healthcare accessible.
As defined by the World Health Organization, universal healthcare essentially means “all individuals and communities receive the health services they need without suffering financial hardship,” including a “full spectrum of essential, quality healthcare services.”
Switzerland, the Netherlands and Germany have a blended system of universal healthcare that ensures everyone is covered. In Germany, the quality of care people receive from the private and public systems are supposed to be equal. In Denmark, residents, including immigrants and asylum-seeking refugees, are covered by publicly funded healthcare. Additionally, undocumented immigrants have access to healthcare services through privately funded initiatives.
The U.S. needs a similar system — it does not necessarily have to be identical to universal healthcare coverage in these nations, but it should work for the nation and all the people living in it.
It cannot only include hospital care and visits to the doctor — it must also include pre-hospital care, which has a reputation of being unaffordable for many in the U.S.
Over the summer, I volunteered in my hometown as an emergency medical technician. In my small town, the cost of being transported to the hospital with EMTs only — who can provide basic life saving techniques, such as CPR, AED use, bleeding control and administer certain medications — is between $1000 and $1500. With a paramedic — who can provide advanced life saving techniques such as intubation, more medications and intravenous and intraosseous treatment — the cost of an ambulance ride is at least $2000. I remember having at least one patient who had no documented insurance and given their ailment, needed a paramedic in order to be transported. That’s about $2000 charged out of pocket, which does not even begin to include the hospital stay itself.
Because of these costs, people are deterred from calling 911 when they have an illness or injury. They already must deal with hospital costs, so they often do not want to deal with pre-hospital costs as well. In other cases, people avoid the hospital and treatment for their illnesses and injuries altogether. It is horrific that people must choose between their own well-being and their ability to provide for themselves and their families.
The financial aspect of the healthcare system is in dire need of change. This includes pre-hospital care, hospital care, visits to a PCP, specialized care and pharmaceuticals. Healthcare should not be unaffordable for so many people across the U.S. and should be treated as a right, not a luxury.