COVID-19 exposes gaps in the U.S. healthcare system
Kee Park

Editor's note:  Accurate and rigorous testing is essential to containing the spread of novel coronavirus. After the initial slow rollout of testing kits in the U.S. and the country's attempt to up its low testing capacity, some Americans who wish to be tested for the virus have met another hurdle: the high cost of testing. According to an estimate, it costs at minimum 1,300 U.S. dollars per person. Kee Park, a faculty member at Harvard Medical School and a consultant for the World Health Organization, shared his views with CGTN on the impact of the high costs of testing in the U.S. The article reflects the author's opinions and not necessarily the views of CGTN.

CGTN: How have testing costs affected America's ability to contain the COVID-19?

Kee Park: There's clearly a desire. I think we heard from Vice President Pence, the CDC director, and a lot of the lawmakers to make sure that these tests are not a financial burden. People should not have to pay to get these tests done. South Korea was a perfect example where there these tests are done for free.

The only problem is that the U.S. health care system is so fragmented and with multiple payers, how they would be able to implement such a policy would be very challenging.

That raises the question: How are we going to contain this virus if patients are afraid to seek medical care if they're sick? [That is] number one. And number two: If they don't want to get tested, it will be more difficult to detect these cases. It doesn't work well in an epidemic situation where everybody has to be covered.

CGTN: Why is it so difficult for the U.S. to have free COVID-19 testing?

Kee Park: The U.S. healthcare system has a private insurance portion. And within the private insurance company, you've got hundreds, if not thousands of different plans. So, if you have this one plan from this one health insurance company, you don't know whether or not [it covers] an ER visit, how much you have to pay for your ER visit, how much the test would cost if you have to have the test. It varies for every insurance policy. It's very complex.

When the White House COVID-19 team states its policy saying, "We will make sure that no one would have to pay for these tests," or that co-pays or out of pocket expenses should be minimized, if not free, how they'll be implemented is a big question, because the system is so complex, you have so many different payers. Its payments required. Patients have a lot of out-of-pocket components to it. It doesn't help the overall public health intervention.

CGTN: What kind of gaps has the COVID-19 pandemic exposed in the U.S. healthcare system?

Kee Park: The current rate of increases in healthcare spending in the U.S., which now is over three trillion U.S. dollars a year. This is healthcare in the U.S. – three trillion U.S. dollars a year. It's about 10,000 U.S. dollars per person. Are we getting good value for that? Are we getting that much value in return?

And the coronavirus situation is a perfect example where we're not; we're paying three times, four times more than other countries. We have people that are trying to figure out if their insurance will actually cover a COVID-19 test.

So I think the day of reckoning is coming to the U.S. where the people who have allowed this healthcare system, which is fragmented, which is for profit. It's industry-driven in many ways. It's poorly regulated. The day of reckoning is coming where the people who set the system up or who allow this to happen are held accountable for the looming catastrophe that we're going to see.

Hopefully that doesn't happen. Hopefully the interventions should come in. People won't have to die, not nearly as many as predicted. But if anything this coronavirus situation has highlighted is the healthcare system in the U.S. is dysfunctional and it needs to be reformed for equity. It has to actually provide health security. And it doesn't.

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