When Frank Wucinski received a medical bill for his coronavirus-related quarantine after being evacuated from Wuhan last month, he did what many Americans do when they face a surprise medical bill: He started a GoFundMe. His costs were high: the emergency evacuation flight from China, emergency transportation to the hospital in the United States, X-rays and isolation, all amounting to thousands of dollars. After inquiries from reporters, hospital officials said they made a mistake in sending the physicians’ bill, but the other costs still had to be paid.
Wucinski did not have health insurance in the United States.
We Canadians have been watching the United States closely to see how the country, the only developed nation without universal health care, manages the crisis. Canadians are used to public health care. For us, it’s normal in an emergency to not have to consider costs before you decide to go to a hospital. The emerging coronavirus crisis is a good reminder of why we have the system we have.
Thanks to Canada’s health-care system, Canadians can be seen and tested for free: There is no cost barrier that would stop someone from entering an emergency room if they were worried they might be sick with the coronavirus, or covid-19.
There are also no costs if the patient has covid-19 and needs to access medical tests, X-rays or ventilators, or receive medication in the hospital. There are no costs if they must see multiple doctors or are hospitalized for several days. The upfront barriers that stop millions of Americans from seeking medical aid are simply not part of the equation.
Key to slowing the spread of the coronavirus is early detection, so that if someone has coronavirus, they can be placed into quarantine to reduce the chance of transmission. But early detection relies on access to tests — both access to the necessary lab kits that can identify coronavirus and access to a hospital emergency room that can order the tests.
With approximately 27.9 million Americans who have no health insurance, detecting covid-19 becomes an economic problem. Millions of people are simply unable to afford getting to the doctor proactively, let alone being hospitalized with the illness.
Poverty and a weak social-service net can make a pandemic far worse. Because the coronavirus is more dangerous to older people and people with underlying medical issues, the lack of a public option threatens people who are already vulnerable.
American health care for elderly people is already worse than in other developed countries, making the coronavirus potentially even more dangerous. One study placed the United States at the bottom or near the bottom on almost every indicator of quality of health care for elderly people: access, affordability, timeliness of care and the coordination of care. The study compared the United States with Australia, Canada, France, Germany, the Netherlands, New Zealand, Norway, Sweden, Switzerland and Britain, and concluded that out-of-pocket expenses and a weak social-safety net has placed elderly Americans in more precarious positions than elderly people from the other nations.
A system funded by private insurance creates other problems, too. When Australia introduced a semi-private insurance model, wait times for those who didn’t have private insurance increased. Health-care professionals moved into higher-paid positions to service the private-pay system, leaving the public system to struggle to keep up with demand.
Of course, Canada’s public system must be improved. Like in the United States, Canada’s gaps have been laid bare by the coronavirus outbreak. For example, Canadians need universal health care to extend to include pharmacare, which would give low-income Canadians better access to expensive medicines.
Canadians also need paid workplace leave provisions. While the Canadian Labour Code guarantees up to 17 weeks of sick leave, that leave is unpaid. If workers are encouraged to self-quarantine, they need the financial support to make this possible. But the bedrock of the system is ensuring there is universal access to health care when someone needs it.
In December 2019, approximately 2.1 million U.S. residents made the trip to Canada, and 3.8 million trips were made by Canadians to the United States. As stories of travelers who have come into contact with covid-19 emerge, they remind us of how globally interconnected we all are. We must see our response to coronavirus as a collective endeavor. The most efficient way Canada has done this is through its public health-care system. Americans would benefit from a move in this direction.
Nora Loreto is a Canadian freelance writer and author of “From Demonized to Organized: Building the New Union Movement.”