Casual Cruelty: Pandemic profiteering in a failing healthcare system

Illustrated by Shelly Xu

When President Donald Trump contracted Covid-19, he was taken to Walter Reed Medical Center and received the best medical treatment the United States had to offer. He was given an intense cocktail of drugs that showed promise against Covid-19. Specialists flocked to his bedside in droves, and unlike most Americans, he did not have to worry about the bill afterwards. Shortly after leaving the hospital and returning to the White House, he urged his supporters not to let the coronavirus “dominate your life,” because “we have the best medicines in the world,” and yet, a third of U.S. adults do not fill a prescription, see a doctor when sick or get recommended care because of the cost of healthcare.[3] In a survey by the Commonwealth Fund, 51 percent of Americans struggle to even find care in the evenings and on weekends without going to an emergency room.[3] The pandemic and ensuing economic downturn has only heightened the pressure on an already strained healthcare system, and people are falling through the cracks in a way that is becoming increasingly normalized. 

The ongoing pandemic is continually exposing old weaknesses in the American healthcare system. At the same time that the Trump administration attempts to tear down the Affordable Care Act, 8.5 percent of Americans are uninsured, an increase from when Trump took office.[3] Ironically, his own administration’s efforts would have led Trump to be discriminated against for having a pre-existing condition if he had been an average citizen who had contracted Covid-19. This debate about health insurance coverage during the pandemic also carries over to co-payments. In the first few months of the pandemic, both the Medicare program and private health insurance companies wanted to encourage telemedicine alternatives to in-person care by waiving the co-payments that would normally be charged for those appointments. However, starting October 1 two of the largest health insurers, Anthem and UnitedHealthcare, are no longer waiving copayments and deductibles for some customers.[2] In the midst of a historic economic downturn, even a $35 co-payment could end up discouraging Americans from seeing their doctors. 

Meanwhile, health insurance companies have actually made massive profits during this pandemic while hospitals and private practices struggle. Although some hospitals have been overwhelmed by the rising tide of Covid-19 patients, many smaller practices and rural hospitals are struggling to stay open because of the decrease of non-Covid-19 patients. Hospitals have been forced to cut staff in many cases as they struggle to stay afloat without their usual patient base. The patients too suffer from this, as many are no longer receiving essential medical care. For example, elective surgery means any non-emergency surgery, so in many cases, elective surgery is not optional for survival or basic quality of life. It includes time-sensitive conditions such as breast cancer or kidney transplants. Other forms of medical care such as access to prescription drugs or dialysis for impaired kidney function also became harder to access during the pandemic. However, during this crisis insurers have paid billions less in medical claims during the pandemic because elective surgeries have been postponed in many places, and fewer patients are going to emergency rooms and doctor’s offices. Some of the largest companies, including both Anthem and UnitedHealthcare, reported second-quarter earnings that are double what they were a year ago.[1] This pandemic profiteering is taking place during a time when state governments are facing massive budget shortfalls as businesses collapse, unemployment rises and tax revenues plummet.
While the focus of public attention has justifiably been on Covid-19 patients, the development of a vaccine and increasing testing, there are other aspects of the healthcare system that teeter on the edge of complete breakdown. Rural hospitals that are the only source of care for entire towns are fighting to make ends meet. Doctors risking their own health in order to treat patients are being told they are being let go because the hospital cannot afford to keep them on staff during a public health crisis. Patients are dying of completely preventable causes because they cannot access healthcare or simply cannot afford it. The casual cruelty of the American healthcare system is not news to anyone. Indeed, it is hard to find anyone working in healthcare who does not have a story about a patient who could not afford a treatment that would save their life or who would take less than the prescribed dose to make their prescriptions stretch longer. There needs to be serious reform of the healthcare system, expanded protections for patients receiving federal health insurance and regulations on private insurance companies. If the previous normal was not providing adequate care to Americans, then without further action this new normal will be a death sentence for many. 

Edited by: Jessica Wu
Illustrated by: Shelly Xu

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