The United States has just passed the tough milestone of 800,000 official deaths from Covid-19, more than any other country, and the actual death toll is probably much higher. The country needs to be asked as more than 100 people have died over 100 days and face the potential for more infectious variants that could diminish the effectiveness of the vaccine. How did the wealthiest nations in the world get here? There are several reasons, but the main reason is that there is no free universal health insurance system in the United States. The lack of a national health insurance program affects everything from vaccine hesitation to the ability to be tested and how to manage the virus in the future.
In the United States, we are accustomed to paying the basic medical costs, so if it is offered free of charge, it is a foreign concept. A major barrier to vaccination is that some people believe that they will be charged for vaccination. This may be one of the reasons why uninsured people are among the lowest vaccinated people, and according to the latest survey by Kaiser Health News, 56% are more than Republicans and white evangelicals. A low percentage reports that they received one vaccination. The fear of having to pay for the services offered for free is not unreasonable. Due to a loophole in federal regulations, some people were mistakenly charged for vaccines. This is also true for testing. Many cities offer free PCR tests, but they are not universally free. After being tested in a privately run laboratory, many people have received large invoices. According to a pre-pandemic survey, 22% of Americans are delaying their medical needs due to costs. For the same reason, you may avoid testing and vaccination.
Cost and lack of access undermine trust. In the United States, trust in medical institutions is low, but trust in primary care physicians is high. A CDC study of adults who have not been vaccinated since summer found that primary care providers are the most reliable source of information for those who are uncertain or will not be vaccinated. I reported. However, the proportion of Americans to primary care physicians has declined in recent years, and the United States spends far less on primary care than in other countries. In fact, quite a few Americans receive medical care from the emergency room. According to one study, almost 50% of the medical care required in hospitals was in the emergency room.
All of this is important not only for vaccination, but also for future ways of managing Covid. Much progress has been made in the development of antiviral therapies that reduce the risk of hospitalization after infection. Pfizer and Merck have released promising medicines. However, for these drugs to be effective, treatment should be started immediately after the person is infected. In short, patients need a doctor who can be tested and prescribed early. For immunocompromised patients, the FDA approves regular antibody treatment with AstraZeneca, but cost and access are still important issues. This means that even after Covid becomes endemic, there is likely to be a disparity between illness and death along racial and socio-economic lines.
The lack of insurance was fatal to too many. Nearly one-third of Covid’s deaths are associated with health insurance gaps, according to reports from consumer health advocacy group Families USA. However, instead of addressing these gaps, there was a move to strengthen the barriers. Many employers now charge unvaccinated people an additional fee along with insurance. Even the first attempt by the White House to improve access to the test couldn’t make the test free. Instead, people are required to submit their invoices to their insurance company for repayment. After being pressured, the White House announced plans to make 500 million rapid inspections available free of charge.
The recent call to distribute free masks in addition to this measure and vaccines would be a good start, but free health care cannot be a temporary measure. The pandemic shows that privatized health systems cannot ensure the health of the people. We have barely overcome this pandemic. And without universal health insurance, we cannot survive the next pandemic.
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