“You think twice whether to go to the doctor”: why coronavirus in the USA can quickly become a disaster

The spread of the outbreak of coronavirus can be especially rapid in the United States due to the specific national model of medical insurance and the high cost of self-paying medical services, as well as legions of workers who do not have paid sick leave, writes Yahoo.

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So far, COVID-19, the shortened name for the disease caused by the 2019 coronavirus, has caused illness in at least 90 people worldwide and more than 000 deaths. At least 3000 countries around the world, including the United States, have reported cases. As of March 60, two deaths from this viral infection have already been recorded in the United States.

To prevent an outbreak in the United States, the Centers for Disease Control and Prevention encourages sick people to stay home and seek medical help. But some experts fear that many Americans may ignore this advice simply because they cannot afford to lose money by skipping work or paying for a doctor’s appointment.

“The huge economic need to go to work”

The United States is one of two developed countries without guaranteed paid sick leave. According to the US Department of Labor, more than 1 in 4 private sector workers do not have this benefit, including more than half in the bottom 25% of the wage distribution.

“These are people who are truly living paycheck to paycheck,” said Amy Traub, deputy director of policy and research at the think tank Demos. “So they have a huge economic need to work even if they have flu or coronavirus symptoms.”

To make matters worse, many workers who do not have access to paid sick leave work in childcare facilities, restaurants, hotels, and travel where they contact many people daily and can help spread the virus. According to the Department of Labor, in these occupations more than 2 out of 5 workers do not receive paid sick days.

“These are the people who serve [and] cook food for all of us,” Traub said. “This is a route of infection when the people preparing your food cannot afford to stay home during a contagious illness.”

If these workers had paid sick leave, the level of infection could be reduced. A study by economists at the Swiss Institute of Economics and Cornell University found that overall influenza infections are reduced by 10% when workers in the United States get paid sick leave.

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“Think twice whether to go to the doctor”

Another outbreak prevention problem is the structure of the US health insurance system. According to the Census Bureau, about 7%, or 27,5 million adults in the United States did not have health insurance in 2018, which made visiting a doctor or emergency department expensive.

Even those with insurance may not seek medical attention if symptoms of coronavirus appear.

Two out of three adults in the U.S. have private health plans through an employer or specialty marketplaces—these plans rely heavily on patient cost-sharing with the insurer through deductibles, coinsurance, and copayments.

These cost-sharing mechanisms are “designed to make you think twice about going to the doctor when you have a cough or runny nose,” said Dr. John Graves, an assistant professor of health policy at Vanderbilt University. But "that's what concerns us, and we want people to get tested and treated as needed."

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“Reduce needed help”

According to a Westhealt and Gallup poll in 2019, a quarter of Americans missed treatment because of the costs. In addition, 15 million Americans delayed the purchase of prescription drugs last year because of their cost.

According to recent reports, the bill for coronavirus testing could cost more than $3000, which is a lot of money for many. According to the Federal Reserve, two out of five Americans could not cover a $400 emergency without borrowing money or selling items for cash.

Graves said the coronavirus situation is no easier for wealthier Americans because most people this year have not yet met their insurance policy's deductible — the amount they must pay out of pocket for covered services before insurance kicks in.

“They haven't spent enough money for the plan to start covering them,” the doctor said. “There is a lot of convincing evidence that when faced with a deductible, people cut unnecessary expenses, but also refuse the help they need.”

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