Money for Testing and Treatment – CV-19

While most medical insurers are waiving the cost of being tested for CV-19, still hard to find, the same cannot be held true of those actually requiring treatment. That assumes that you are even offered treatment. There are some pretty nasty ethical issues that are being reviewed right now.

This appeared in the March 24^th Coronavirus Special Supplement from the Los Angeles Times (emphasis in red added): “Here’s what’s happening with the coronavirus outbreak in California and beyond… A steep rise in the number of people being hospitalized with COVID-19 in Los Angeles County is probably a sign that a wave of extremely sick patients could overwhelm hospitals in the coming weeks. Medical providers say they’re rushing to draft policies to handle the tough decisions they anticipate they’ll have to make.”

Let me translate that for you if you need real treatment: if there are way too few supplies and facilities available, someone is going to make an evaluation of both your likelihood of survival and exactly how valuable you are to society. If you are a senior, already being asked by highly placed Republicans to take one to boost the economy, you are unlikely to get that treatment when someone significantly younger needs that same ventilator/respirator/ICU bed. Where there are the worst shortages, seniors are probably best left at home to try and make it from there… if they can. Good luck with that one. 65% of the deaths in the United States from CV-19 are seniors (80% worldwide), who also occupy 45% of the hospital beds and over half of the ICU stations.

Except for a little personal feud with General Motors, where the President is forcing the carmaker to manufacture ventilators under the Defense Production Act, Trump is otherwise relying corporations voluntarily to make ventilators and is letting the market determine pricing… and not otherwise using that law to get enough ventilators made. Guess what, old folks?!

So for all those attending parties flaunting CV-19, spring breakers partying like crazy, those attending birthday celebrations (for a 40^th in Westchester, NY; for a 70^th at the Trump golf club in Rancho Palos Verdes, CA), the now-infamous Kentucky sneering coronavirus party, each of which turned into CV-19 super-spreader events, ask yourself how many folks you think you just might have help kill or seriously damage for life? Or bankrupt? You don’t really see the damage unless you live in or near a city. And if you do, no matter where you are in the United States, brace, brace, brace! Mardi Gras in New Orleans? Guess which major city is next?

Assuming you are one of those that gets CV-19 and unlike a few who have more moderate symptoms, assuming you actually do qualify for hospital treatment, what can you expect the cost of that treatment to be? “A report from the Kaiser Family Foundation estimated that the total cost of coronavirus treatment in a hospital could top $20,000 when factoring in out-of-pocket costs and insurance coverage. 

“The research factored in the average total cost of treatment for an inpatient admission for pneumonia (pneumonia is among the most serious coronavirus complications) among large employer plans in 2018. For those who suffered major complications, the cost was $20,292. For less than major complications, it cost $13,767 and for those with no complications, the cost was $9,763.

“Danni Askini, an uninsured woman treated for coronavirus in a Boston-area hospital, was slammed with a $34,927.43 hospital bill between testing and treatment… ‘I was pretty sticker-shocked,’ she told TIME [magazine]. ‘I personally don’t know anybody who has that kind of money.’” Yahoo Money, March 25^th. It always costs more when you are uninsured, because you do not have the volume bargaining power of a major healthcare provider to negotiate rates and caps… and hospitals do not extend those rates to the uninsured. Serious complications and that bill could rise into six figures. If you are in a state where Medicaid coverage was extended – generally blue states with a few red ones thrown in out of desperation – you might get coverage that way.

But let’s say you do have healthcare coverage, it’s a pandemic; aren’t we supposed to be fully covered? “‘That’s the great thing about private health insurance — you always have to say it depends on the plan,’ Karen Pollitz, a senior fellow at the Kaiser Family Foundation, told Yahoo Money. ‘So you have to hit the deductible and then you can get at least some coverage for it. But there still may be a copay or there still may be 20% insurance. The plan will pay 80% and you pay 20% up to some out-of-pocket limit.’” Yahoo Money. All that talk from Bernie Sanders and Joe Biden in their last debate notwithstanding, the government isn’t covering treatment for everyone. A few, maybe. Highly placed government officials who make the policy and happen to be seniors? Of course!

And you have to read the fine print in your insurance policy. If you are transported to a hospital that is not inside the plan, assuming you could have made that choice, you just might face some subsequent surprises… but even if you are “in network”: “An additional thing to keep in mind for those with health insurance during the pandemic is to watch out for surprise medical bills.

“‘Essentially, it’s two situations,’ Matthew Rae, associate director of the Healthcare Marketplace Project at the Kaiser Family Foundation, told Yahoo Money. ‘One is to go to in-network hospitals. You did your research, you found a hospital which is in your provider network, and then you end up seeing a provider who’s not part of your network.’

“If the hospital you go to is in your provider network, there could still be providers within the hospital [even within a plan approved hospital!!!!] who are not, such as a radiologist or pathologist. They can charge you what’s known as balance billing — this is when a provider bills you for the difference between their charge and the allowed amount.

“‘When you get a balance bill, it’s typically a much higher cost,’ Rae said. ‘And these bills can be very expensive for people and importantly, these are financial protections that are baked into your insurance plan. So out-of-pocket maximums don’t apply to spending.’” Yahoo Money. And when there are shortages of specialist inside the plan? One thing folks in France, Spain and Italy – areas of intense CV-19 infection – do not have to worry about is medical bills.

There’s another side to medical issues during this crisis. Red states are seeing a path to ban abortions. Already, Texas and Ohio governors have deemed abortions as elective and/or non-essential medical procedures, which must legally be postponed. A March 23^rd statement to the Texas Tribune from Texas Attorney General Ken Paxton’s office said, "no one is exempt from the governor's executive order on medically unnecessary surgeries and procedures, including abortion providers.” That statement noted any providers in violation of the order - which expires April 21^st - could be fined $1,000 or jailed for up to 180 days. Republicans using a crisis to reverse Roe vs Wade and impose other GOP platform policies on their constituents? You might recall that Texas has a whole lot of folks without health insurance! They have fought the Affordable Care Act, tooth (oh, Medicare and the ACA don’t cover dental!) and nail.

But you know what the GOP will say if and when there is a universal healthcare bill before the Congress? The one that Trump promised in his 2016 presidential campaign but never materialized? “We just cannot afford that right now; the deficit is out of control.” From corporate socialism – the big tax cut and all that bailout money in the stimulus package. Screw people!

            I’m Peter Dekom, and the one thing that will abound aplenty when this pandemic settles down will be American medical bankruptcies and more than a few children with parents unable to care for them.