Setting Aside Important Medical Care for Urgent Care

Medical care is in a mess right now. All care, it seems, is urgent care. Primary care offices are empty. Many providers face the possibility of this pandemic tipping them from financial strain to bankruptcy. But can we really afford to set aside important medical care for urgent care?

Unprepared for a Pandemic

Different health systems and different countries have had very different experiences with the COVID-19 pandemic. Taiwan pops up as an example of a country that responded quickly and very effectively. At least part of its success might be down to a miserable experience with the SARS outbreak in 2003. People sometimes retain lessons learned the hard way – if they survive.

In contrast, the U.S. was relatively unprepared for this pandemic. Crystal Watkins, from the Johns Hopkins Bloomberg School of Public Health, describes the situation:

We have this cycle of panic and neglect in public health. We have an emergency, we have an emerging infectious disease. So we throw money at it. We do the work to respond. But then people quickly forget what that response took.

On top of that, it’s becoming clear that the worst outcomes in this pandemic are at least in part due to years of neglect in communities with poor access to healthcare. People with obesity, as well as racial and ethnic minorities, live with a heavier burden of chronic diseases that increases the likelihood of severe symptoms with COVID-19. That burden is the inevitable result of poor access to care.

Now, the bill has come due for years of health neglect.

Primary Care on the Brink

Writing in the Washington Post, Daniel Horn says that the coronavirus pandemic could put your primary care provider out of business:

America began this pandemic with a national primary-care shortage, and without help, they now face existential peril.

So much of health care has rapidly changed during this pandemic, but the payment model has not. As a result, while many doctors are performing heroic acts of service, the health-care system nationally is facing a 55 to 70 percent decrease in revenue, thanks to the sudden absence of in-person visits. Nearly half of medical practices say they’ve had to furlough staff, and 22 percent have made permanent layoffs. Those numbers will grow.

Breaking the System

So in the midst of one health crisis, our health system is headed toward another that may be even larger. The American Academy of Family Physicians estimates that nearly 800,000 primary care jobs will disappear by the end of June, costing $65 billion in lost wages and salaries.

The economic impact will be great. However the health impact will be even greater. Closure of all these primary care practices will mean that a critical shortage in the availability of primary care will grow even greater. Preventive care for chronic diseases, including obesity and its complications, will grow still harder to access. Losses of health insurance connected to employment will make it even worse.

In recent years, access to medical care in the U.S. has grown worse. Because of the coronavirus, it may well come to a breaking point that forces big changes.

Click here, here, here, and here for further perspective.

Urgences, Hénin-Beaumont, Nord-Pas-de-Calais, France; photograph © Patrick BAUDUIN / flickr

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May 3, 2020