The international response to the new coronavirus revealed this: The United States has been less prepared for a pandemic than countries with universal health systems.
There is a real concern that Americans, with their higher uninsured rate and higher out-of-pocket costs compared to the rest of the world, will not seek care because of costs. Even before the crisis began, the United States had fewer doctors and hospital beds per capita than most other developed countries. The launch of the Covid-19 test has been erratic, relying on a combination of government and private labs to expand capacity to run the tens of thousands of tests that will be required.
"Everyone who works in this field agrees that regardless of how you measure it, the United States is far behind," says Jane Keats, director of global health and HIV policy for the Kaiser Family Foundation.
People should go to a doctor and get tested if they have Covid-19 symptoms, however, Americans can avoid medical care, even in severe cases, due to costs. Hospitals will need rooms for people who need close follow-up in a clinical setting, and ICU beds and ventilation units for patients who get worse and need mechanical support to keep their bodies functioning.
But none of these drives is still empty at this time; they already have coronavirus-free patients who need them and will continue to need them during the crisis. New York Governor Andrew Cuomo said Sunday that nearly 80 percent of intensive care units in New York City are already full, even as the Covid-19 outbreak continues.
By any of these pandemic preparedness measures, the United States lags behind most of the rest of the developed world.
"The United States is performing worse than the average among equally rich and large countries in almost all pandemic preparedness measures," Cynthia Cox, director of the Peterson-Kaiser Health System Tracking System, told me. "The coronavirus outbreak is already exposing deficiencies and inequalities in our healthcare system, and is likely to put more pressure on the system in the coming weeks."
The slow start of testing in the United States will exacerbate these problems.
Testing is important not just because it diagnoses people and undergoes proper treatment if they have an infection. It also determines how far the virus actually spreads. Experts know the scale of the problem, they know the speed at which people will be hospitalized or die, and they can track their movements. This leads to a more informed response.
But the United States has failed to implement coronavirus testing, putting us far behind our economic counterparts in tracking the outbreak. A manufacturing issue with test kits initially shipped to the field and delays in approval of commercial tests have caused the nation to stop or slow down Covid-19 again.
"Failing a test puts additional pressure on our already challenging healthcare system," Cox said. "The combination of all these factors will make the United States worse off than similar countries."
Comprehensive health care is not an ideal treatment for emergencies like this. Italy has a universal health care system, which is a federal national health insurance program similar to Canada's, but an inevitable outbreak of the disease has forced the country to lock itself away as cases and deaths continue to pile up.
However, other countries are still generally more prepared for the pandemic than the United States, and we are now seeing the consequences of this gap.
For now, American politicians are proposing to make American health care like these other countries: make care free or cheap at the point of service, either by making the government cover more of the cost or by forcing private insurers to cover services related to the outbreak.
However, it is only a temporary patch for these structural problems.
There is a real concern that Americans, with their higher uninsured rate and higher out-of-pocket costs compared to the rest of the world, will not seek care because of costs. Even before the crisis began, the United States had fewer doctors and hospital beds per capita than most other developed countries. The launch of the Covid-19 test has been erratic, relying on a combination of government and private labs to expand capacity to run the tens of thousands of tests that will be required.
"Everyone who works in this field agrees that regardless of how you measure it, the United States is far behind," says Jane Keats, director of global health and HIV policy for the Kaiser Family Foundation.
People should go to a doctor and get tested if they have Covid-19 symptoms, however, Americans can avoid medical care, even in severe cases, due to costs. Hospitals will need rooms for people who need close follow-up in a clinical setting, and ICU beds and ventilation units for patients who get worse and need mechanical support to keep their bodies functioning.
But none of these drives is still empty at this time; they already have coronavirus-free patients who need them and will continue to need them during the crisis. New York Governor Andrew Cuomo said Sunday that nearly 80 percent of intensive care units in New York City are already full, even as the Covid-19 outbreak continues.
By any of these pandemic preparedness measures, the United States lags behind most of the rest of the developed world.
"The United States is performing worse than the average among equally rich and large countries in almost all pandemic preparedness measures," Cynthia Cox, director of the Peterson-Kaiser Health System Tracking System, told me. "The coronavirus outbreak is already exposing deficiencies and inequalities in our healthcare system, and is likely to put more pressure on the system in the coming weeks."
The slow start of testing in the United States will exacerbate these problems.
Testing is important not just because it diagnoses people and undergoes proper treatment if they have an infection. It also determines how far the virus actually spreads. Experts know the scale of the problem, they know the speed at which people will be hospitalized or die, and they can track their movements. This leads to a more informed response.
But the United States has failed to implement coronavirus testing, putting us far behind our economic counterparts in tracking the outbreak. A manufacturing issue with test kits initially shipped to the field and delays in approval of commercial tests have caused the nation to stop or slow down Covid-19 again.
"Failing a test puts additional pressure on our already challenging healthcare system," Cox said. "The combination of all these factors will make the United States worse off than similar countries."
Comprehensive health care is not an ideal treatment for emergencies like this. Italy has a universal health care system, which is a federal national health insurance program similar to Canada's, but an inevitable outbreak of the disease has forced the country to lock itself away as cases and deaths continue to pile up.
However, other countries are still generally more prepared for the pandemic than the United States, and we are now seeing the consequences of this gap.
For now, American politicians are proposing to make American health care like these other countries: make care free or cheap at the point of service, either by making the government cover more of the cost or by forcing private insurers to cover services related to the outbreak.
However, it is only a temporary patch for these structural problems.
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