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Doctors for America – Health for All Working Group – Statement on COVID-19
by Cedric Dark, MD, MPH, FACEP & James Scott, MD
Health care is not working for patients, it’s not working for clinicians, and it’s not working for the American public. In the past few weeks, these facts have become abundantly clear. Doctors For America recently outlined five principles upon which we should reform our health care system, which adapted to this unprecedented pandemic of COVID-19, can provide lessons for our local, state, and national leaders.
No one in the United States should go without coverage. We know that when people are without coverage, they either delay or are denied care due to cost. This pandemic attacks both rich and poor, both celebrities and ordinary citizens, both heads of states and heads of households alike. Treatment and testing, therefore, must be available to everyone.
In this time of crisis, there should be no financial barriers to appropriate care – no co-pays, no deductibles, no unnecessary barriers to coverage like Medicaid. This is not the time to limit care based on income, insurance status, or zip code. Although we would love to spend less on health care services and more on “health,” in order to combat COVID-19 now is the time to spare no expense. And to ensure that American families do not fall victim to profiteering in the health care space, it is incumbent that the public sector bear the burden of the cost of the current crisis. If there has ever been a time for big government, now is the time.
We must seek equity in the allocation of valuable health resources. While doctors in Silicon Valley tell us that they have had to ration whether or not their patients can be tested; others simply dropped in at Google to receive on demand testing. Our health care system must provide equity such that our health workers can be sure they are safe and our patients can be appropriately diagnosed, before celebrities and the wealthy get tested when our resources are limited. When we do this we will have better health for everyone.
Improving Population Health
Years of neglect of our public health infrastructure have severely hampered our ability to respond to this crisis – we cannot forget these lessons as we go forward with a focus on Healing America. For many practicing physicians, we have never seen such a robust emphasis on public health in our lifetimes. Investing in our communities, especially in times of relative calm and excess, would aid us in critical times such as these.
The current COVID-19 crisis underlines the need for adaptability in health care at the national, state, and local levels. The ability to be nimble and to make sensible adjustments to policies and procedures in response to changing circumstances couldn’t be more evident. Our fragmented, bureaucratic, profit-driven system impedes our ability to cope – in spite of heroic efforts by so many health care workers to adapt with limited supplies and despite a newfound embrace of telecommunications. It is clear that given the right resources, health care workers can respond to evolving health care needs.
The immediate public sector response must include expanding Medicaid in states that have yet to do so and opening the ACA enrollment period to help reduce the number of newly uninsured who have lost jobs and with it their employer-provided insurance.
Government has the responsibility of keeping funds flowing to a health care sector under immense pressure – supplying front line providers with personal protective equipment and diagnostic and treatment capability – so they can faithfully serve a greater public good.
Meanwhile, we are thankful for the innovators in the private sector. Telemedicine has allowed for safer physician-patient interactions, private testing laboratories have expanded capacity when local health departments are overwhelmed, and hopefully industry can soon supply the needed number of ventilators required to save the lives of our sickest patients.
At Doctors for America, we believe that universality, affordability, health equity, population health, and adaptability are the five key principles that will serve our nation well not only during this current pandemic, but can be leaned upon to improve our health care system long after this storm has passed.