Coronavirus Hits America Where It’s Weakest With Big Health Gaps
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Jennie Gordon runs quality checks on medical implants at one of the largest hospital suppliers in the U.S. It’s meticulous work, and a hygienic environment is crucial. But Gordon says that if she gets sick, she’ll still show up to work.
That’s one way diseases spread. But Gordon feels like she has no choice.
Her employer near Washington allows six paid sick days a year, of which she’s already used half. Gordon has a chronic condition, and takes medications that suppress her immune system — making her more vulnerable to the coronavirus. But if she exceeds her sick-day limit, she risks getting fired. And then she would lose her work-sponsored health insurance plan, and her ability to get any medical treatment at all.
“You just hope you don’t get sick,” says Gordon, who’s 29. Tens of millions of Americans are in an even more precarious position — either working in jobs that offer no paid sick leave, or lacking any medical insurance, or both.
The numbers reveal a virus dilemma that’s unique to the U.S. — on top of the ones alarming policy makers everywhere, as the epidemic shuts down swaths of the world economy and sends markets into a tailspin. Policy makers, from President Donald Trump’s advisers to lawmakers in Congress, are starting to recognize the challenge, though they’re far from fully addressing it.
Almost all other developed economies require employers to offer sick pay for workers. And all of them, except the U.S., provide health care to all citizens regardless of their personal finances.
These gaps already loom large in the 2020 presidential election. They become especially acute during an epidemic like the coronavirus.
Public officials, at the Centers for Disease Control and Prevention for example, are advising Americans to stay home from work, or get tested and treated, if they feel the need. The risks to everyone become greater if swaths of the population can’t take that advice, said Elise Gould, a senior economist at Economic Policy Institute.
“The CDC says ‘stay home and see a doctor,’” Gould said. “But the fact there are these recommendations that no one can follow is a problem. It’s not an economy or a health problem — it’s both.”
“If you can get ahead of this, do everything in your power to keep it from spreading,” she said. “Not only will that help those people, but you’re also going to put a lot less pressure on the healthcare system” — and ultimately the economy, too.
About one-third of private U.S. workers don’t get medical benefits via their job, according to government data. Low-wage service industries like restaurants and stores – where employees have direct contact with customers, and where job creation has been concentrated lately — have some of the worst access.
All told, the share of the population without health insurance rose to 8.5% — 27.5 million — in 2018, when the economy had been expanding for almost a decade.
The figures on sick leave are in the same ballpark. More than a quarter of private U.S. workers don’t have any, including more than half of part-time workers and about 40% of service employees.
American fiscal policy makers are scrambling to put together a virus response. While the outbreak is nowhere near the scale it’s reached in China, or countries like Italy and South Korea, new cases are getting reported in different U.S. states every day.
Two Democratic lawmakers proposed legislation Friday that would mandate companies to provide 14 days of sick leave during a public health emergency like coronavirus, and seven days outside of such events. Larry Kudlow, Trump’s chief economic adviser, said the White House would take a targeted approach to help those staying at home and small businesses, but didn’t specify how.
Congress already passed an emergency package worth about $8 billion, which Trump signed Friday. It includes support for tele-health services targeting the elderly, but no provisions that would extend health care to those who don’t have insurance.
‘If You Can’
Trump was at one point exploring a temporary measure under which the government would cover costs for uninsured people who receive coronavirus treatment, according to the Wall Street Journal.
Even people with coverage may face financial shocks. Newspapers have reported surprise bills arriving on the doorsteps of patients who got themselves tested, worrying they might have coronavirus symptoms, or who got quarantined.
And even those with insurance are at risk in the U.S. About 29% of Americans who did have health policies in 2018 could be classified as “underinsured,” up from 23% in 2014, according to the Commonwealth Fund, a private health-care foundation that conducts a biennial survey.
Justasia Zakiyya works full-time in the produce section at a Walmart store in North Carolina. The 30-year-old gets health insurance through the company, but says she still struggles with out-of-pocket costs. Two doctor’s visits, each carrying a $40 charge, amount to a day’s pay.
“Please take your health into consideration — if you can,” said Zakiyya, speaking from home where she’s recovering from the flu. She called in sick, which counts as a point against her. Two more points and she’ll lose her bonus. It amounts to an incentive to come to work even when sick, she said, and so that’s what many colleagues routinely do.
Jami Lamontagne, a Walmart spokeswoman, said that “anytime our associates are not feeling well, we want them to stay home and get healthy.” She said by email that there are paid-time-off and flexible scheduling options to support them.
The wider problem the U.S. faces right now, according to LeaAnne DeRigne, an associate professor at Florida Atlantic University who focuses on health-care policy, is that so many people have no paid sick leave at all.
It’s “definitely a public health crisis,” she said. “It really does exacerbate a pandemic and all but guarantees that the people rolling your burritos and taking your blood at a lab might be doing it while they’re sick.”
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