By now, we’re aware of the sobering predictions for this fall’s spread of H1N1 influenza.
But, as the Washington Post’s Ezra Klein points out, our health system is ill-suited to deal with the situation:
It’s simply too fractured to do anything different. Almost 50 million Americans have no insurance. Many more are underinsured. Many don’t have a particular doctor or even medical center where they feel comfortable receiving care. Many are uncertain about what is and isn’t covered in their health plan. Many have recently been uninsured, and so have no regular contact with the medical system and haven’t established an obvious way to begin having some.
The emergency room will be overwhelmed by patients concerned about flu-like symptoms, and when you consider the fact that a good proportion of health care professionals aren’t likely to get vaccinated themselves, it’s a recipe for disaster.
But will simply insuring everyone stem the spread of future pandemics? Well, that’s debatable as well, since the primary care system is also ill-equipped to deal with a surge of patients as well. Calling a physician’s office, only to receive an appointment weeks away also will drive patients to the ER.
Again, it starts with having enough primary care access to meet the demand of ill-visits brought on by H1N1. And that will stay true whether we have universal health coverage or not.
Related posts:
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- Who’s most likely to spread infection in the hospital?
- Why giving free care to the uninsured is good business
- H1N1 rap and a swine flu freestyle
- Should specialists spread the wealth to primary care?
{ 3 comments }
The premise that having health coverage or no coverage will have any effect on the spread of H1NI implies that those with coverage will take the vaccination. With vaccines that have not completed clinical trials, media reports of health care workers indicating that they will not take the vaccine and many people’s predisposed beliefs that vaccines are bad, the spread of H1NI is unfortunately far more tied to personal decisions and personal hygiene than much else than any health authority can control directly
One should also factor in the retail walk-in clinics. Even if they are unable to treat H1N1 patients, they can refer to the MD affiliated with them.
More importantly, by off-loading a lot of routine problems (sinus infections, some bladder problems, colds, earaches, fevers less than 103, etc) from primary care physicians, that frees up space at the primary care MDs’ offices.
Walk-ins will be one way the market will deal with the lack of primary care MDs. And, for the unsured, the fees are relatively reasonable. Typically about $45 but one just opened in my city (staffed with PAs, NPs, AND an MD on duty) for only $22.
Seems the free market will solve these problems if we just get out of its way.
This is a bigger picture issue IMHO.
Uninsured are not getting flu shots anyway. They’re also not going to the doctor for other health problems that may compromise their immune system making the potentially more likely to become ill.
In addition to that it’s a good guess that a lot of them are the “working poor” so they can’t AFFORD to miss work if they’re having mild (or even severe) flu-like symptoms. Or better yet, they do work but have Big-Co Pay-HMO and can’t afford to use their insurance much anyway.
So, they go to work and spread H1N1 around to all their coworkers and anyone else they come in contact with at work (retail) or on their way to and from work (think bus-ride).
These same people are likely to bring a host of family members with them when they finally do go to the emergency room nicely spreading things around even more.
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