I haven’t gone to the doctor since 2013. When you multiply my situation by 27.5 million, that’s a scary prospectLike 27.5 million other Americans, I don’t have health insurance. It’s not for a lack of trying – I make too much to qualify for Medicaid, but not enough to buy a private health insurance plan on the Affordable Care Act exchanges. Since I can’t afford to see a doctor, my healthcare strategy as a 32-year-old uninsured American has been simply to sleep eight hours, eat vegetables, and get daily exercise. But now that there are confirmed coronavirus cases in the United States, the deadly virus could spread rapidly, thanks to others like me who have no feasible way to get the care we need if we start exhibiting symptoms.According to the Centers for Disease Control and Prevention, there are confirmed coronavirus cases in at least 50 countries on six continents, and more than 2,800 patients have died from the virus. This certainly qualifies as a pandemic under the World Health Organization’s (WHO) definition of the term, which, under a typical presidency, should necessitate a swift response from US health officials. However, the Trump administration appears to still be prioritizing the profit margin of the healthcare industry over preventing the spread of a deadly pandemic.Earlier this week, the Department of Health and Human Services secretary, Alex Azar, (a former senior executive at pharmaceutical manufacturer Eli Lilly) refused to commit to implementing price controls on a coronavirus vaccine “because we need the private sector to invest … price controls won’t get us there”. Even the House speaker, Nancy Pelosi, notably didn’t use the word “free” when referring to a coronavirus vaccine, and instead used the word “affordable”. What may be considered affordable for the third-most powerful person in the US government with an estimated net worth of $16m may not be affordable for someone who can’t afford a basic private health insurance plan that still requires a patient to pay thousands of dollars out of pocket.Given the high cost of healthcare in the US, I haven’t seen a doctor since 2013, when I visited an emergency room after being run off the road while riding my bike. After waiting for four hours, the doctor put my arm in a sling, prescribed pain medication and sent me home. That visit cost more than $4,000, and the unpaid balance eventually went to collections and still haunts my credit to this day, making it needlessly difficult to rent an apartment or buy a car. But even a low-premium bronze plan on the exchange comes with a sky-high deductible in the thousands of dollars, meaning even if I was insured, I’d have still paid for that ER visit entirely out of pocket.> When you multiply my situation by 27.5 million, you end up with a country full of people who won’t see a doctor unless they’re extremely sickThis system is exactly why a 2018 West Health Institute/NORC at the University of Chicago national poll found that 44% of Americans declined to see a doctor due to cost, and why nearly a third of Americans polled said they didn’t get their prescriptions filled due to the high cost of their medicine. This is the same system that killed 38-year-old Texas public school teacher Heather Holland, who couldn’t afford the $116 co-pay for her flu medication and later died from flu complications. It’s the same system that Guardian contributor Luke O’Neil refers to as “Go viral or die trying”, in which Americans who can’t afford life-saving healthcare procedures are forced to become their own advocate and PR agency by launching a viral GoFundMe campaign to ask strangers on the internet to save their lives.When you multiply my situation by 27.5 million, you end up with a country full of people who won’t see a doctor unless they’re extremely sick. And when you combine a for-profit healthcare system – in which only those wealthy enough to get care actually receive it – with a global pandemic, the only outcome will be unmitigated disaster. This could be somewhat remedied if the US had a single-payer, universal healthcare system, like every other industrialized nation. And as a team of Yale epidemiologists discovered in a study recently published in the Lancet, a single-payer healthcare system in the US could simultaneously save 68,000 lives and $450bn in taxpayer dollars each year.Yes, countries with single-payer systems still have coronavirus cases, Italy and Japan. But the spread of the virus in those countries would likely pale in comparison to the potential spread of coronavirus in the US, in which a significant portion of the population simply won’t go to the doctor if they’re sick. Coronavirus is a worldwide public health emergency, and massive profits for health insurers and pharmaceutical manufacturers shouldn’t come before the basic health and safety of human beings. * Carl Gibson is an independent journalist whose work has been published in CNN, the Guardian, the Washington Post, the Houston Chronicle and NPR, among others
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