The U.S. healthcare system isn’t built to handle a pandemic because it’s not built to help everyone
A 17-year-old boy from Lancaster, California died in March due to COVID-19 complications. After having serious respiratory problems the boy went to an urgent care facility. The facility denied care due to lack of insurance. While en route to the closest public hospital, the boy went into cardiac arrest and died hours later.
“But by the time he got there [the local public hospital], it was too late,” Lancaster Mayor R. Rex Parris said.
After the boy passed, doctors confirmed he had COVID-19.
The tragic death of this 17-year-old boy shows the obvious divide and unfair treatment within the U.S. healthcare system. If the boy had been insured or affluent enough to pay upfront for whatever treatment he needed, he would have received care and possibly still be alive.
There are 6,146 hospitals in the United States. Some are community owned, some are owned by the state or government, and some are privately owned.
According to 2018 data from the American Hospital Association, 58% of community-owned hospitals in the U.S. are non-profit. Out of all U.S. hospitals, 21% are for-profit.
There is a distinct separation in our healthcare system, but it’s not just about where hospital funding comes from and goes. Hospitals also differ when it comes to if patients actually receive healthcare.
In 1986 Congress passed the Emergency Medical and Treatment Labor Act, which restricts all hospitals from denying care to patients based on a lack of insurance or ability to pay. But this hasn’t stopped privately owned hospitals from denying care to uninsured patients. In a pandemic, this can have deadly consequences.
Universal healthcare works to prevent these situations. The Netherlands has universal healthcare and is taking a completely different approach to dealing with COVID-19.
March 16, Netherlands Prime Minister Mark Rutte made an address to the nation.
“The reality is that in the near future a large part of the Dutch population will be infected with the virus,” he said.
He went on to introduce a concept called group immunity.
“Those who have had the virus are usually immune afterwards,” he said. “Just like in the old days with measles. The larger the group that is immune, the less chance that the virus will jump to vulnerable elderly people and people with poor health. With group immunity you build, as it were, a protective wall around them.”
This is similar to what United Kingdom Chief Science Adviser Sir Patrick Vallance calls herd immunity. Herd immunity is the idea of letting the population be exposed and eventually become immune.
Although the Netherlands has closed some facilities like schools and restaurants, that might not be the case for long. Rutte believes a lockdown will not stop COVID-19. He also has much more confidence in the Netherlands’ hospitals and healthcare system than the U.S. has in its own systems.
“We build immunity and ensure that the healthcare system can handle it,” Rutte said. “With the aim that nursing homes, in-home care, hospitals and especially intensive care units are not overloaded. So that there is always sufficient capacity to help the people who are most vulnerable.”
“We cannot and will not close our eyes to the economic consequences of this crisis,” Rutte said near the end of his speech.
Rutte is obviously concerned with the economy of his nation, but he also seems relatively confident that the Netherlands healthcare system could support their entire population if infected by the virus. It’s important to note, the Netherlands pays for their universal healthcare services through taxes as well as a monthly premium payed by individuals.
This is very different from the current situation in the U.S. By all accounts, our healthcare system couldn’t handle the whole population getting infected by the coronavirus. Hence the need to flatten the curve.
Even with social distancing rules in place, cities like New York are struggling to find personal protective equipment or have enough intensive care unit beds for infected patients. Whether or not herd immunity is an effective or morally acceptable approach, the U.S. healthcare system isn’t built to handle it because it’s not built to help everyone.