COVID-19 in the United StatesUS healthcare system on the brink of collapse
Day after day, the television news is overwhelming with skyrocketing numbers of cases and gloomy records, with dramatic images and moving stories. The USA has become the global epicenter of the corona crisis.
Politicians should have been warned, says Bill Custer, health economist at Georgia State University in Atlanta, in an interview via Skype. The CDC health authority tested in a simulation game two years ago how the United States is prepared for a pandemic. The simulation showed that medical supplies, masks and ventilators would be in short supply, he says. The problem was identified, but nothing happened.
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The health infrastructure is fragmented
Now the simulation game is bitter reality, the COVID-19 epidemic is sweeping the country and brutally exposing the structural weaknesses of the American health system. The response to the crisis was a perfect storm of human and institutional failure, says Bill Custer.
Initially, the Trump administration downplayed the threat of the virus and lost precious time. In addition, the infrastructure of the American health system is fragmented and fragmented. The attempt to bundle the various units in the crisis has failed. One example of this is the tests for COVID-19. Keren Landman is an infection medicine specialist and epidemiologist based in Atlanta. In addition to the delay, she sees another, more profound problem with testing: the largely private laboratories work in a non-transparent and uncoordinated manner, says Keren Landman. The reason for this is that in normal times they maintain their market position primarily with tests protected by patent. The competitive nature of these laboratories means that they are unable to coordinate their work in times of crisis. The result: inconsistent and error-prone tests, long waiting times for execution and evaluation.
No uniform management
Much like the world of test laboratories, the structure of the various hospital systems as well as the municipal, regional, state and federal health agencies impede rapid epidemic management, says health economist Custer. It is difficult to distribute the necessary medical equipment and equipment efficiently when every hospital, every authority is only focused on its own acute problems and does not have the bigger picture in mind, according to Bill Custer.
These structural weaknesses paralyze the responsiveness of the American health system - the ability to provide fast and good care to large numbers of patients in the event of a crisis. It's not just about the technical infrastructure: intensive care beds, ventilators, protective equipment, but also about specialist personnel such as ventilation specialists.
The most expensive healthcare system in the world
The US has the most expensive healthcare system in the world. Doctor and hospital bills are the leading cause of personal bankruptcy. This has dangerous, potentially fatal consequences in the corona crisis, says infection medicine specialist Landman. Many people were reluctant to get tested for the virus or treatment. And thereby increased the risk to their family and community.
It could have been worse. In the midst of the swelling corona crisis, the health reform of former President Barack Obama celebrated its tenth birthday. The Affordable Care Act, known by friends and foes as Obamacare, was designed to provide Americans with comprehensive and affordable health insurance coverage.
That was only partially successful. After all, 20 million more Americans have health insurance today than there were ten years ago. But the Trump administration has already overruled parts of Obamacare and weakened others. The law is like a wounded boxer who keeps getting up, says Bill Custer. Even in the corona crisis, Obamacare offers protection, especially for poorer Americans, and help for smaller, regional hospitals.
Health reform will be the hot topic
One thing is clear: the reform of the health care system should have the highest priority after the crisis, even in the currently frozen presidential election campaign. Epidemiologist Keren Landman hopes the coronavirus pandemic will open the way for general and public health insurance. Universal health care is not just a system, she says, but a culture. A culture that understands that our own health is closely related to the health of those around us.
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