RANI MARX, PhD, MPH, r_marx at pacbell.net
JAMES G. KAHN, MD, MPH, JGKahn at ucsf.edu,
Marx is an epidemiologist and health services researcher who currently directs the Initiative for Slow Medicine.
Kahn is emeritus professor of health policy, University of California, San Francisco.
They just wrote the piece “COVID-19 and the Myth of ‘Choice’ in American Healthcare,”
They write: “The empty White House promises of paying for COVID-19 services gloss over the messy and painful reality. While $100 billion designated for doctors and hospitals to provide care for patients with COVID-19 includes treating the uninsured, it is unclear how to disentangle who and what is covered and which conditions can be attributed to the virus. It’s crazy: you may get help for medical costs, but only if you can prove that COVID-19 caused your illness. No other wealthy country does this; they have universal standard medical coverage.
“To make matters worse, many of the 6.6 million newly jobless who filed unemployment claims near the end of March will now join the ranks of the uninsured and under-insured whose COVID-19 treatment will not be covered. All of these problems are exacerbated in states that opted out of Medicaid expansion under Obamacare. To add insult to injury, an outsized chunk of the $100 billion will go to hospital administration instead of critically needed care and resources. Insurers stand to realize a big profit from the pandemic due to indefinite cancellation of non-urgent procedures, a high prevalence of deaths among patients with costly co-morbidities, and a projected increase in premiums next year.
“How did we get here? As Wendell Potter (a former public relations executive in the health insurance industry) explained in a New York Times op-ed in January, American choice in healthcare is a ‘P.R. concoction’ that obscures the lack of real choice — of doctors and hospitals. This choice is an unpleasant, ill-informed selection among highly restrictive plans. Not to mention having few options, and loss of coverage due to changes made by employers or job loss. Industry lobbying and advertising have so successfully promulgated the myth that Americans have choice, it was advanced even by many Democratic presidential candidates.”
