Why Can’t Everyone in This Country Get Free COVID-19 Treatment?

Yves here.  Americans find it very hard abandon hustling, as our multi-faceted Covid-19 fiasco illustrates. And the Trump Administration is predictably missing in action in terms of even trying to jawbone health care providers and insurers to foot Covid-19 costs.

By Diane Archer, a senior adviser to Social Security Works and founder and president of Just Care USA, an independent digital hub covering health and financial issues facing boomers and their families and promoting policy solutions. She is the past board chair of Consumer Reports and serves on the Brown University School of Public Health Advisory Board. Ms. Archer began her career in health advocacy in 1989 as founder and president of the Medicare Rights Center, a national organization dedicated to ensuring that older and disabled Americans get the health care they need. She served as director, Health Care for All Project, Institute for America’s Future, between 2005 and 2010. Produced by Economy for All, a project of the Independent Media Institute

Access to COVID-19 treatment is key to helping Americans combat the disease, as well as containing its spread. To their credit, on March 29, Humana and CIGNA—the fourth- and fifth-largest health insurers—under massive public pressure, waived “all COVID-19 costs” for all of their members. But, tens of millions of other Americans continue to face powerful financial barriers to care. Our corporate health care system is not designed to ensure everyone gets needed care, much less to protect the public health.

Over the last month, as the novel coronavirus laid siege on the US, the largest health insurers did nothing to reduce barriers to COVID-19 care. Instead, their web sites advised their members to practice good hygiene and suggested they visit the CDC online for more information. News reports revealed that Americans were loath to seek care for fear of the cost. And, that remains the case for most of the 87 million uninsured and underinsuredin this country.

Today, United Healthcare, the largest health insurer in the country, waived all cost-sharing for its members. But, Anthem, the second-largest health insurer, does not appear to have waived costs for treatment. Aetna, the third-largest health insurer, has only waived some costs for some of its members.

Kaiser Permanente, a non-profit, considered to offer the best health plans in the US, is still not covering the full cost of treatment. Deep down on its coronavirus web page, it simply says: “If you’re diagnosed with COVID-19, additional services, including hospital admission (if applicable), will be covered according to your plan details.”

To ensure people receive COVID-19 treatment and to help stem the spread of the virus all COVID-19 care needs to be free. In a recent eHealth survey, more than six in ten people (64 percent) under 65 said that they would not be able to afford their full deductible. Deductibles averaged $1,655 in 2019. Seventy percent of Americans don’t have $1,000 in cash for emergencies.

Paying health care costs is generally a heavier lift for older adults and people with disabilities, who need more care and live on small fixed incomes. Yet, most health insurers offering Medicare Advantage plans—corporate health plans that provide Medicare benefits to 24 million older and disabled Americans—are not providing their members who are most at risk of becoming gravely ill or dying from COVID-19, easy access to COVID-19 treatment. Curiously, Aetna waived cost sharing for its members under 65 and kept cost-sharing in place for their Medicare Advantage members.

The Centers for Medicare and Medicaid Services (CMS), which administers the Medicare program, has failed to mandate that Medicare Advantage plans waive all costs for COVID-19 care. It has simply given them permission to do so. What’s worse is that CMS’ authority over these corporate health plans appears limited at best.

For example, CMS has required that they cover all COVID-19 care at out-of-network facilities at the same cost as at in-network facilities, without a referral. But, the biggest health insurers’ web sites don’t even inform their Medicare Advantage members of this emergency benefit. As a result, they deter older people from seeking treatment in order to avoid liability for thousands of dollars in copays. Inexplicably, CMS has failed to inform people of this emergency benefit on its coronavirus web page.

Furthermore, CMS did not take a lead among health insurers and provide emergency coverage for the full cost of COVID-19 treatment for people in traditional Medicare. Fortunately, the vast majority of people in traditional Medicare have supplemental coverage which picks up all or virtually all of their out-of-pocket costs. But, the six million people in traditional Medicare without supplemental coverage must pay deductibles and coinsurance costs, with no out-of-pocket cap. This unlimited cost-sharing presents a daunting obstacle to care for them.

In short, Humana, Cigna and UnitedHealthcare members are better off thanks to their insurers’ decision to cover all COVID-19 costs. But, they alone cannot protect us from the ongoing threat the novel coronavirus presents to the public health. For that, everyone else in this country also needs full COVID-19 coverage. Neither other corporate health insurers nor the federal government has stepped up on that front.

It should go without saying that our nation’s failure to provide health care for all has cost us far more than it ever would have cost to provide everyone coverage. “Skin in the game,” the ill-conceived concept that people with health insurance should pay a piece of their health care costs, is a health insurance design feature that is killing our citizenry and belongs in the graveyard. If our lawmakers want to ensure the health and financial well-being of our nation, they will need to guarantee health care for everyone in America.

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48 comments

  1. zagonostra

    If our lawmakers want to ensure the health and financial well-being of our nation, they will need to guarantee health care for everyone in America.

    The problem is they do not.

    Their motives are aligned not with the “well-being of our nation,” for who’s nation is it really? Rather their cues come from their “leadership” and those who finance their continued stay in power.

    It’s not the “well-being of our nation” – a malleable concept akin to “national Interest” – but rather a narrowly carved out “well-being” of specific constituents and contributors that is their prime directive

    Reply
  2. Bsoder

    You said what needed to be said. We know and it feels awful. I’m angry and sad. Crazy people run this country they do not care, they never have cared. I do not think it’s good to leave hopeless people hopeless, you never know what lies they’ll tell or worse what truths. Or worse, what they’ll do.

    Reply
  3. Tom Stone

    Last year I had three emergency cardioversions and a partially successful cardiac ablation.
    This year it’s been chemo, which twice landed me in the ER after being released.
    Once it was in and out in 8 hours, the second required 3 days in hospital, two in ICU.
    Medicare doesn’t cover every thing and Medi Cal has been very difficult to acquire because my income is solely commission based and due to my health issues it was impossible to estimate what my income would be in 2019.
    My unpaid and unpayable medical bills are now somewhat in excess of $300K.
    The good news is that I don’t have enough easily ascertainable assets to make suing me worthwhile, which has so far allowed me to avoid Bankruptcy.
    I’m one of Millions in the same boat, cold comfort but better than none.

    Reply
    1. TMoney

      Sorry to hear that Tom. I hope your on the mend (or as much as you can be) we need your comments on NC for a long time to come. Sigh. Too many crappy stories like this and too few politicians that understand (or is it care) about the real costs of our current system – and i’m not talking money.

      Reply
    2. bmeisen

      What’s happened to Tom Stone is impossible in Germany and in other advanced democracies that provide “public” universal health insurance. The 2 most widely used financing models are 1) effectively a health insurance tax (NHS in the UK) and 2) individual purchase of needs-blind coverage at income-based pricing from highly regulated non-profit insurers serving a highly regulated non-profit care-provider network.

      It is also impossible to opt out of these systems. Everyone is in by law and everyone must be in, in order to achieve the efficiencies that allow the system to survive. Accordingly young people with typically minimal health care risks have to pay in. Freelancers have to pay in even though they would have more resources to invest in their productivity if they stayed out. The wealthy have to pay in even though they can afford to go outside the regulated non-profit network of care-providers.

      The fact that leadership in the US has allowed an opt-out choice to establish itself is at the center of the failure of health care in the US, a failure exemplified by Mr Stone’s experience.

      Reply
      1. upstater

        I think you are missing a significant factor in the US system — cost, profiteering and lack of substantive regulation.

        As everyone knows, the US healthcare spends roughly double what any other “advanced” country spends on a per capita basis. Just the money the US and state governments spend on an aggregate basis for Medicare, Medicaid (indigent), employee and military health care would be EQUAL to what Canada spends for universal coverage,

        Allowing “opt-out”??? Well, I was self employed for 30 years and only last year qualified for Medicare at age 65. The last full year of employment for me and my wife we had an Obamacare Bronze plan that cost $1000 per month and had a $10,000 deductible. $22,000 would have to go out the door in order before ANY benefits would be paid. And even then it wasn’t going to be 100% coverage. How can a person or family making under $100,000 afford such insurance? And to emphasize, even with the Obamacare subsidies, you are still on the hook for massive costs than can and do bankrupt people.

        Even when Obamacare had the mandate (if you were to opt-out, there was a tax penalty), costs would go up around 15% per year, with supposedly 100% of the citizenry in the “system”.

        Private systems in Europe (e.g., Switzerland), the insurers are very tightly regulated and MUST cover virtually everything. IIRC, the profit margins and administration costs are low single digit percentages. That is not the case in the US. Regulation of insurance companies is largely left to individual states and these can vary widely, even with the Obamacare requirements.

        “…US has allowed an opt-out choice to establish itself is at the center of the failure of health care in the US…”

        That is a ridiculous statement. Opt-out definitely is NOT the problem with US. Greed and profiteering, facilitated by the US leadership is the problem.

        Reply
        1. bmeisen

          The opt-out option opened the door for greed and profiteering. Require everyone to participate, and motivate us to go along with the scheme by providing broad quality care at a fair price. That’s what is missing in the US. To guarantee the fair price the authorities must forbid for-profit insurers as well as regulate the pricing of care. In a nutshell everyone has to be in and all health insurance providers have to be non-profit.

          You seem to hold greed and profitteering are uncontrollable natural forces like gravity. That they dominate health care in America is the consequence of political choices. Ultimately it’s the fallacy of the American Dream that explains the situation: the Dream teaches that we are all free to do whatever we want because when the individual pursues her own optimization then the community maximizes benefits. This is wrong and the failure of the US system of health care provision is convincing proof.

          Reply
          1. upstater

            Opting-out was present in the US health insurance system long before Obama was even born. Why it wasn’t a problem was because insurance was provided by employers. The industry had a failing business model as so many of us were forced to work as independent contractors or had small business employers that simply dropped coverage. Without Obamacare and expanded Medicaid (many states use private insurers to manage care), the industry would have collapsed.

            The mandate was implemented in 2014 and was in place for 5 years. Instead of stabilizing rates, policies purchased on the Obamacare Exchanges had double-digit increases for those 5 years. It is a fallacy to suggest that the mandate would control greed and profiteering; it simply gave the insurance industry a blank check. Was the $22,000 out-of-pocket expense I was paying until 2019 a “fair price”?

            Let it suffice to say that greed and profiteering is an attribute of the US political system. Money is considered free speech. There is no way that is going to change under the current system. So, yes, greed and profiteering is like the law of gravity.

            One need only look at how the political and media forces aligned against Bernie Sanders to insure that the next president is going to be Herbert Hoover 1 or Herbert Hoover 2.

            Reply
            1. bmeisen

              Obamacare was/is flawed because it forced Americans to buy insurance from for-profit insurers. Obamacare is not an argument against mandating coverage. It’s an argument against mandating coverage from for-profit insurers. We were supposed to be reassured by the fact that Washington pitched in a subsidy for the financially challenged.

              The scheme was doomed from the start because for-profit insurers were the true benefactors, not Americans in need of health insurance. Thank goodness some people got some insurance, but not enough of us and corrupt insurers continued to sell over-priced policies. No wonder people continued to want to opt-out, no wonder that they found ways to do so: people who lived in states that did not adopt the plan were allowed to opt-out, as well as those who would have faced excessive costs even with federal subsidies, which might be about the majority of Americans. And since 2017 there isn’t even a penalty for opting-out.

              Covid might be so disasterous that a consensus will emerge to change the system fundamentally. A new system should be based on a converage mandate for all Americans and the removal of for-profit insurers from the scheme. It is morally abhorrent that the shares of American health insurers are traded on stock exchanges and that dividends on them are paid. The government does not have to take over all coverage. It just has to regulate the non-profits who do, as well as the pricing of health care providers.

              Reply
              1. oaf

                …Oaf was penalized for both 2017 and 2018. That was more easily borne than high premiums for low coverage and convoluted financial schemes making rich f—s richer.
                Conscientious objector; believe it is unconstitutional to mandate support for one (unnecessary) sector of the economy; at expense to the rest.
                Paid out of pocket for subscription based care.

                Reply
                1. bmeisen

                  Guess we’re seeing how unnecessary the sector in question is. Will check my info about penalization. Thank you.

                  Reply
  4. bwilli123

    America, sadly is shredding the last remnants of its moral authority. What an amazing decline from the 1960’s. The Moon landing. JFK. To now, and what was once a justifiably proud citizenry, reduced to scrabbling around in the search for the last few scattered crumbs.

    Reply
    1. Samuel Conner

      > shredding the last remnants of its moral authority

      In recent weeks, as it has become apparent that US may fare appreciably worse than nearly every other developed country on the planet, the thought has occurred that the trope of “American leadership” may be well and truly expired. We have “led” a race to the bottom.

      Why will anyone in their right mind pay attention to us in future? Simply because we still have “the bigger battalions”? How much longer will it be possible to sustain even that aspect of our “leadership”?

      We can’t govern well within our own borders. And we claim that we want to bring the benefits of our ways to the rest of the world? The masks are slipping and it’s hard to imagine that they can be fixed back into place.

      Reply
      1. templar555510

        As a Brit I say this is the moment Americans have to get over themselves once and for all . America is not , and never has been a shining light on a hill , or an exceptional nation or any of the other mythological narrative needed by a rapacious capitalism to pretend that goodness oozes out of a society hell bent on burning the house down, one way or another . We love your energy, in so many ways , but now is the time to call a complete halt on all the regime change wars , the desperate poverty and inequality inside America and to render the ‘ military industrial complex ‘ dead .

        Reply
        1. bmeisen

          Thank you templar. I as an American acknowledge the noble sacrifices that Americans made during WWII and the enlightenment of the Marshall Plan. Since then there ain’t been much to write home to mom and dad about.

          Reply
        2. Paul Handover

          Thank you, Templar.

          We are Brits, and naturalised Americans, living in Oregon. This is an amazing part of the world and we wouldn’t go anywhere else. I’m also 75, my wife a little younger, and we love it here. We stay as fit as we can but I can never quieten my mind as to what we do when we get too old. We live in a very rural part of Oregon!

          The American healthcare system is not really a system in the true sense of the word. I tend to be ‘left of centre’ in my politics but I don’t see a real drive across the nation, across all parties, for a different and better system. The poverty and the inequality is critically terrible for a nation that is so wealthy.

          Reply
    2. Ford Prefect

      Please bear in mind that Lyndon Johnson knew when he signed the civil rights acts that he was writing off the South for the Democrats for at least one generation. Richard Nixon promptly used that to win two terms.Nixon’s strategy has been repeated several times since then.

      The US is still struggling to define what moral authority is.

      The simple answer to the headline question “Why Can’t Everyone in This Country Get Free COVID-19 Treatment?” is unfortunately because it would be un-American.

      Reply
    3. John k

      And Vietnam. And assassinations. Not that much moral authority.
      I doubt we would have done so well if this virus hit then.

      Reply
    4. Jeff

      The last significant moral act our government has taken was during the S&L scandal of the 80’s when high level criminals were held accountable and did a perp walk.

      Since then, we’ve been the equivalent a moral Gobi Desert. We talk a good game and voters are fooled election after election into thinking their ‘team’ is the good team and the other guys are either nazis, pansies, socialists, communists, idiots, etc.

      We elect immoral people because the country is full close minded derelicts who are much more knowledgeable about the Kardashians, the NFL or NBA or video games than they are about their own communities.

      We did this to ourselves.

      Reply
      1. rob

        There was nothing moral about what happened before, during, or after the s&l crisis of the 80’s.
        A great book on the matter was written by the journalist who originally brought attention to the scheming. Pete Brewton.
        He wrote a book called ” the Mafia, the CIA, and george bush.”
        They were all very involved, None or the real movers were ever taken to account. Only individuals with no political connections (and some whose connections weren’t strong enough),were held to account for anything. It ended with a 500 billion dollar bailout of the banking elite,by the banking elite(federal reserve system) on the “taxpayer tab”.
        Neither of the two bush brothers’ niel or jeb… who were only like the hundreds of other insiders who knew how to game the system; were ever stained by their association. When george HW bush and his cia/ mafia friends and all the scheming they were funding back then through banks like BCCI and others.. all the iran contra stuff, and what was to become the world of today, .(interesting point of who was in that book from 1992(george W bush, his friend jim bath, and the guy jim bath was the american representative for, Salem bin laden… osama’s older brother) The savings and loan scandal is just a point on the american timeline . All of it corrupt.
        So why can’t we have a real healthcare system…Why can’t we get a “free test for covid;. because organically we “the people” are just useful idiots for wall street mechanisms of profit justification.
        And we have been born into a world where propaganda has reigned supreme for over a hundred years… we were weaned on lies…. and for the most part…. people can’t stomach people telling the truth.

        Reply
  5. catsick

    Its very interesting to also look at the data on countries with efficient BCG vaccination, Japan and Korea are starting to put down the lack of spread to the strain of BCG vaccination used on all babies since ww2 , there is a very good correlation of the spread with the strain used and of course there are only tow major rich countries that have never had widespread bcg for all babies and those countries are Italy and USA, I think this whole thing is going to shine a spotlight on the poor public heath of some supposedly wealthy countries as well as the excellent public health of some very poor countries

    for more info https://www.jsatonotes.com/2020/03/if-i-were-north-americaneuropeanaustral.html

    Reply
    1. Monty

      We all got it in UK during my teens. It’s the one that usually erupts into a giant weeping boil and then leaves a big scar for the rest of your life, isn’t it? Do they give that to babies in other countries? Imagine the size of the scars they must have in adulthood.

      Reply
      1. Susan the other

        Yes I saw that one too. It (BCG) is now used as a treatment for bladder cancer. We are familiar with its efficacy – my husband has had at least 5 doses over the last decade and it has so far cured him. Interesting that BCG (mfg. in Canada to my knowledge) which immunizes against the tuberculosis bacillus – which attacks the lungs – is protective against Corona/Covid-19, which also kills as pneumonia . It makes more sense since it is lung related than the protection given by hydroxychloroquine which is a malaria drug – except for one thing and that is that they now say that up to 50% of Covid patients complained of their first symptom being very painful diarrhea.

        Reply
  6. floyd

    Because people truly love their private health insurance apparently (e.g. Dems going all in on Biden). Especially those getting the employer subsidized, gold plated no/low deductible, large network, access to the best hospitals crowd. The rest can eat poisoned cake. Not suggesting this person has them but there are a lot of crocodile tears out there now from those who just weeks ago were saying the practical thing to do is keep the current health insurance status quo. And anything else was just too expensive and “pie in the sky”.

    Reply
  7. Noel Nospamington

    Statistically speaking seniors tend to vote Republican, who let them keep their Medicare, but do everything possible to deny publically funded healthcare to younger Americans.

    Basically it is an “I got mine and screw everyone else” mentality.

    However current pandamic has really shown that the lack of universal health care, will create a critical large reservoir of infected and untreated younger people who pose a life threatening risk to those seniors. Especially when you consider that younger people are less likely to self quarantine when they are moderately ill, if they cannot afford getting treated and treatment. Which will further increase community spread.

    If there is one good thing that comes from this pandemic in the USA, it should be that the general public hopefully realises that universal healthcare is in the self-interest of everyone.

    Reply
  8. sd

    So…what happens when the COVID-19 patients don’t pay the medical bills? Isn’t that where this is really heading, into a full blown strike of medical bills?

    No one is working, no one has income, most unemployment doesn’t even cover rent.
    10,000,000 people have filed for unemplyment over the last two weeks. The last thing anyone should worry about, let alone pay, is a medical bill.

    Two cents: the companies that waive costs are getting ahead of the inevitable and will actually save money in the long run not wasting their time with billing and chasing people to pay bills.

    Reply
    1. Arizona Slim

      A full-blown medical bill payment strike? IMHO, that’s a good idea.

      Ditto for health insurance premiums. It’s time to withhold them as well.

      Reply
    2. chuck roast

      I like your Two cents, but we know how the insurance companies will respond in the long run. They are not going to eat the COVID costs. They are going to raise rates to cover their loses.

      Interesting that my smug fellow geezers with their Medicare Advantage Plans may be in for a shock to their pocket books when they catch the plague. They will be falling off their golf-carts in their gated communities. Those that survive that is.

      Reply
      1. antidlc

        “I like your Two cents, but we know how the insurance companies will respond in the long run. ”

        icymi

        https://truthout.org/articles/insurance-companies-could-hike-premiums-by-40-percent-amid-pandemic/

        A new analysis warning that U.S. health insurance companies could hike already exorbitant premiums by 40 percent or more next year amid the coronavirus pandemic was received by Medicare for All advocates as further confirmation that America’s healthcare system — driven first and foremost by the profit motive — is ill-equipped to provide necessary care for all, particularly in a time of nationwide crisis.

        The research conducted by Covered California, the state insurance marketplace created under the Affordable Care Act, found (pdf) that “if carriers must recoup 2020 costs, price for the same level of costs next year, and protect their solvency, 2021 premium increases to individuals and employers from COVID-19 alone could range from 4 percent to more than 40 percent.”

        Reply
    3. Trick Shroadé

      They’re not going to give up that easily. There will be enough people who do have enough assets to make it worth going after them. And eventually when people start going back to work they can dock your pay to recoup their costs. Not until the health care industrial complex elites and their enablers are literally in fear for their lives will that change. You can read between the lines on the meaning of that last statement.

      Reply
  9. shinola

    Simple answer to the question posed in the title of this article:

    Because Markets!

    (and as we all know, in the Good Ol’ USA “The Market” is the holiest of holies)

    Reply
  10. marym

    The Sanders emergency plan says to give CMS the funding to pay all the bills and work with federal agencies and private sector to get it done.

    Today (note, his Senator account, not campaign account):

    Bernie Sanders @SenSanders
    Last week, 6.6 million applied for unemployment. Millions more will lose their jobs in the coming weeks. In the midst of this horrific crisis, Congress must pass a new, unprecedented emergency bill that guarantees income and health care for all Americans. Working on details now.
    10:32 AM · Apr 2, 2020

    (Presumes Congress can be bothered doing any work)

    https://berniesanders.com/issues/emergency-response-coronavirus-pandemic/
    https://twitter.com/SenSanders/status/1245735940968124417

    Reply
  11. Bob Hertz

    Thus far about 45% of Covid hospitalizations have been for persons on Medicare. We do not need to worry too much about them.

    Persons who lose their jobs will be able to get Medicaid in about 36 states. Their hospital bills will get paid that way.

    We need a huge federal reinsurance program for the rest of carriers, or their premiums will go up 40% next year. This is not hard to do but it will cost well over $100 billion.

    We must also get rid of the out-of-network price gouging practices. Patients will be sent to any hospital that has room for them.

    Reply
  12. Tom Bradford

    I submitted a post to another article yesterday pointing out to those who argued the current crisis would focus American minds on the advantages of M4A, that the healthcare systems of nations with publicly funded health systems were no more able to cope with this than the US system, as both were for different financial reasons predicated on normal demands.

    However this was on the apparent misunderstanding that all CV health costs were to be picked up by the public purse at state or federal level. Hence I was wrong.

    That leaves me puzzled though. Who or what is going to issue the bills and cover the costs of medical care at the new emergency hospitals that have sprung in Central Park and elsewhere, and on the hospital ship in New York harbour? Is this going to be ‘free’ in some way while those ending up in for-profit – or even at-cost – hospitals still face huge bills?

    Reply
    1. sd

      I would guess they will treat these as public hospitals – in the case of NYC – an extension of Bellevue or in Los Angeles, an extension of County/USC. It’s possible the communities could contract with other providers to manage or operate the facitilites.

      Definitely worth looking into to see what mechanism the emergency medical facilities are operating under.

      Reply
      1. Bob Hertz

        The best way to handle this would be a temporary outlawing of balance billing.

        Whatever insurance a patient has, their bill at any hospital will be based on the rate in their home network.

        If the patient has no insurance, their billing rate would be 125% of Medicare or something similar.

        Reply
  13. mrtmbrnmn

    One good outcome of COVID-19 would be the demise of Globalization. Another would be the kiss of death for the Big Pharma/”Health(?)” Insurance Mafia. Pay-or-die/Pay-and-then-die is not health care, it is extortion. And any politician who takes a bribe (contribution) from these villains and every lobbyist (liar) who promotes & pimps them is an accessory to the crimes. Now is the time to bring back the guillotine and set one up at both ends of Pennsylvania Ave in anticipation/preparation for that moment of truth.

    Reply

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