By James G. Fieseher, M.D.
SeacoastOnline.com, April 17, 2020
Much will be written about the lessons learned from the COVID-19 pandemic. Here are a few I have observed at this time in the process.
(1) Employer-based healthcare doesn’t work. First, not all employers provide healthcare. This is especially true for small businesses, but there are some very large businesses that can afford to give their employees healthcare but choose not to do so.
While employer-based healthcare saves most workers the trouble of sorting through all the fine print that is important in picking a healthcare plan, it has the potential of introducing an employer bias in healthcare based upon political, religious, racial or other criteria such as gender bias.
Most importantly, employer-based healthcare is totally useless during a pandemic when thousands of businesses have closed or shut down and tens of millions of Americans have lost their jobs, their insurance and their paychecks.
(2) “Free market” healthcare doesn’t work in a pandemic. Millions of people have lost their jobs and no longer have health insurance. This means that any testing, medication or hospitalization of COVID-19 will have to come out of our own pockets. People who can’t afford testing won’t get tested. They could be potential carriers of the virus and spread a “second wave” of the epidemic once the economy is reopened.
We’ve already seen who our “essential workers” are. Many of them are working without health insurance. If they get the COVID-19 virus, they will not be able to afford treatment.
The countries that have come through this pandemic the easiest so far all have a single-payer healthcare system. China, South Korea, Taiwan and Singapore have been the most efficient at minimizing the health risks to their population and economy with a well-coordinated effort.
(3) Changing our healthcare system isn’t enough. Any politician elected to national office (especially the presidency) can thwart our healthcare system enough to make it dysfunctional. This will put our health, our lives and our economy at risk for years to come.
To illustrate this point, not all countries with a single-payer system have successfully handled the pandemic. Germany took an early aggressive approach to the pandemic and was able to minimize the effects of the pandemic despite being in the middle of a COVID-19 ravaged Europe. Britain took a much less aggressive approach, believing the English Channel somehow protected them from the outbreak. As a result, their single-payer system was much less effective and the infection rate (and death rate) was much higher.
America needs to learn these early lessons if we are to survive as a world power. We have the best-trained doctors and best-equipped hospitals, but our health system is holding us back. On average, 30% of our healthcare dollars are not going towards our health, but into the pockets of the wealthiest people and wealthiest companies as “profit.” Meanwhile, we are experiencing more medical-related bankruptcies on personal and business levels than any other nation.
A national single-payer health system available to all Americans is clearly the most effective and cost efficient way to run a healthcare system, especially during a pandemic. There are lesser solutions that are more costly that also work, which would still be a great improvement over what we have now.
However, no system that we implement will work if we don’t have a consensus. We don’t need 100% of Americans to agree on which healthcare system we should have, but a “supermajority” of 75 to 80% is needed to make it work.
We have already authorized $2 trillion on economic pandemic recovery, which is more than we would have spent to replace our current healthcare system. Most economists estimate it will take 2 to 4 times that amount to bring our economy back on line. It is much cheaper to prevent a problem than it is to fix it.
Having the right system and managing that system correctly will keep all Americans healthy, more productive and living longer. In turn, a healthy America will make our economy more vibrant.
There will likely be many more lessons from our pandemic experience. Let us hope to learn enough to avoid future suffering.
Dr. James Fieseher, of Dover, practices family medicine on the Seacoast.