It has almost become a cliché to state that the recent pandemic has unveiled the pre-existing weaknesses in the US health care system. It is most certainly true. The observers have found many different weaknesses, and they have drawn various conclusions.
It has tested the US system of its employer-based insurance. Between 2014 and 2019, about 12 to 16 percent of US citizens have reported their lack of health insurance. During the pandemic, unemployment increased a lot more, making people lose the employer coverage they had. People who lacked health insurance were afraid of the financial consequences of visiting a doctor, thus abstained from doing so. Also, the hospital and doctors were not able to handle the high number of patients they received.
The Financial Stress During the Pandemic
Due to the financial stress, hospitals and many other institutions laid off several health care workers, nurses, and doctors. They even shut down the delivery service. This situation damaged the health care sector and the people it tends to serve. Another issue was that COVID-19 patients could not be treated alongside others to prevent contagion. Also, the fee-for-service, which is the core of the health care system, did not have any predefined reimbursable service to treat coronavirus. Therefore, it was important for the White House to Improvise a proper response, but its practical effect was considerably confusing.
The financial crisis that the hospitals underwent when they were filled portrays the unsustainable system, including cross-subsidization among different people for whom various providers bring multiple services, where profitable services cover the costs and other services are delivered at a loss. Besides that, the focus on the care for COVID-19 has crowded out more profitable procedures. In short, the US health care failed at reimbursement design.
What Is Revealed?
The MIT SHASS Communications seemed seven of its scholars that have been involved in the health care research to give their opinions on the US health care system and what is revealed about it during the pandemic. They also asked them about the changes that they believe are needed. All these researchers bring forward great opportunities to make the US health care system more coherent, effective, and equitable, along with preparing it for the next pandemic.
According to him, the pandemic has falsified the concept of rich and poor diseases. The health care policymakers have been under the impression that the developed world does not need to worry about communicable diseases as they have reached the epidemiological transition. Such diseases only exist in places with struggling economics and weak governments.
But COVID-19 proved that national boundaries are no barrier for diseases. It also undermined the assumptions about the health care infrastructures of the global North being paradigmatically more evolved.
The spread of the coronavirus revealed:
- The shortage of hospital beds and their basic equipment.
- The importance and system’s dependency on the underpaid labor of health care workers.
- The challenge of preventing instead of curing.
- The uneven effects of the virus on the marginalized.
- The boundaries of insurance-based models in providing equitable care.
According to her, it is quite clear that the pandemic has revealed a dire need for investment in the public health care infrastructure so that the threats to public health can be monitored and addressed better in the future. In addition, health care access and insurance coverage can be expanded. But the biggest problem that is revealed is the racism rooted in the economic and social policies of the United States.
Public policies created occupational and geographic segregation. In comparison to their White counterparts, it has caused the people of color to,
- Less access to jobs and education,
- Suffer worse housing,
- More exposure to toxins,
- Poorer mental and physical health,
- Greater financial instability,
- Shorter lifespan,
- Higher infant mortality.
It is a colossal waste of human capital which undercuts the economic growth of the nation. These costs are concealed so well that it is hard to understand the counterfactual of what level of growth will be reached if every American prospered.
It is not very beneficial to improve the public and medical health systems when they fail to help the structural drivers of illness and poor health. This opportunity should be used to,
- Implement paid family and sick leaves,
- Enforce regulations on redlining, workplace safety, and environmental hazards,
- Improve schools, nutrition, and housing.
It is not hard for financially stable and healthy people to imagine that the vulnerable are residual. However, it has been revealed by the pandemic that these people are central.
According to him, this pandemic is one of the most important occurrences of the century. Most importantly, it reveals the importance of non-discriminatory, universal health insurance coverage in the US. For Americans, the main source of their health insurance is their jobs. But since the great depression, unemployment has reached its peak, and millions of workers have lost their jobs, and in turn, their health coverage.
Furthermore, COVID-19 will become a pre-existing condition of millions of American citizens when the economy finally recovers. For that reason, it is crucial to work on the previous achievements of the Affordable Care Act to proceed towards a safety net that provides people with insurance options without any discrimination.
- Illustrated the power and strength of remote health care,
- Revealed that telehealth has increased health efficiency and has helped people in the underserved areas,
- Showed the importance of government innovation sponsorship in the health sciences,
- Showed that it is essential for the government to play its role in promoting innovation in health care.
To prepare for the next pandemic, it is important to understand that it is best to be over-prepared than properly prepared. Unless the system is ready to face the next pandemic, which does not happen, it will not possibly be prepared for the next pandemic which does happen.
It is best to work now to develop permanent and mandatorily funded organizations, which will do disease surveillance globally and test any at-risk population whenever a new disease is detected. It is also important to set up a permanent government effort that will finance underdeveloped therapeutics and vaccines.
According to him, the COVID-19 pandemic has uncovered the weaknesses and strengths of the US health care system in extreme ways. For example, although the development of three vaccines within a year of the pandemic is an extraordinary achievement, several missteps and errors have been made in the deployment of contact tracing and rapid tests.
Another aspect that has been made apparent by the pandemic is the inequality and discrimination in the US health care system. In terms of economic and health outcomes, the brunt has been borne by some discriminated communities. Hopefully, the pandemic will spur the system to protect vulnerable society members.
The pandemic made it clear that the population health was not given the attention it needed on a global scale. The initial response by the US to the pandemic was poorly coordinated. It can be determined by the response of East Asian countries that their health systems are coordinated and centralized, which are better equipped to handle population health. The need for an international corporation to monitor new variants and with vaccine supply can already be seen. It is extremely important to invest in developing global infrastructure so that greater corporations can be facilitated in the next pandemic.
What Needs to Change?
The pandemic is considered a crisis due to its immediate threat to the current lifestyle, the economy, and, most importantly, public health. Fortunately, it will end soon, as researchers and scientists are working tirelessly to develop vaccines and treatments. The health officials, frontline workers, nurses, and doctors are doing an outstanding job. However, this pandemic has made the system realize that the health care system cannot serve the very people it is meant for.
In other words, there are some pre-competitive needs of the US health care system that need to be fulfilled. Without concern about the type of system, there will be a decade or two from now. Some of those pre-competitive needs are,
- To align the health care system according to the need to treat and prevent chronic diseases, affecting around 100 million people in the United States.
- Solve the data liquidity dilemma to make information sharing more seamless across systems.
- Train the health care workforce for the problems and challenges of the ongoing twenty-first century instead of the twentieth century.
- Eliminate the obstacles in the way of high-quality and efficient care, such as regulatory burdens and needless paperwork.
- Work to remove racism from the health care institutes and root out systemic inequities which hold the most responsibility for insufficient health outcomes for brown and black communities.
All these needs that have been unveiled due to the pandemic now have existed for a long time. They have now just come to light. All the leaders in technology, business, and health care should now create a collaboration to stop the status quo and create a new pattern for the health system in the country. Otherwise, these problems and needs will persist for a long time. There is a need for a system, which is feasible, efficient, and affordable for everyone.