The Ebola scare could be the biggest that both the U.S. health insurance system and the “reform” effort known as Obamacare has yet faced.
We’ve actually gotten very lucky on Ebola so far because the only two people infected on American soil are nurses. Nurses are middle class professionals with good health insurance plans; they don’t have to worry about paying for a doctor or a hospital stay.
Nurses also have a good working knowledge of disease and the health care system and how it works. They can recognize the signs of a deadly disease and know where to go to get treatment and who to ask.
Ebola and the Uninsured
What we need to fear is not a nurse with Ebola but an uninsured or underinsured American catching the deadly virus. There are roughly 41 million Americans with no health insurance whatsoever and tens of millions more with inadequate or substandard health insurance.
A nurse with Ebola can quickly get in to see a doctor and get into a good hospital; all she might have to worry about is a $50 copay that she can easily put on her credit card. There’s a good chance that an uninsured person has no doctor at all and no extra money to pay the $100 to $200 one might charge. For many poor families, getting that kind of cash involves taking out a payday loan, going to the pawn shop, or borrowing cash from friends or relatives.
Such a person has every incentive to avoid the healthcare system and its high costs. His or her most likely course of action after contracting Ebola would be to think it is the flu. He or she might go home and infect his or her family or, worse, keep working and expose others because many of the uninsured live paycheck to paycheck.
Worse, the Ebola victim might turn to the only place where he or she knows he or she can get access to healthcare—the emergency room. Many poor families use the emergency room as “the family doctor.” One Ebola victim could infect hundreds of people, many of them already sick or injured, and dozens of healthcare workers at an emergency room.
The hysteria generated by an Ebola case at an emergency room might be worse than the disease itself. Imagine a situation in which vast numbers of sick and injured refuse to get medical care out of fear of the disease.
Another likely scenario is that the Ebola victim will simply go home and die, exposing family, friends, lovers, and neighbors. Perhaps he or his family will call 911—another source of guaranteed medical care for the poor. This could expose first responders such as paramedics, firefighters, and police officers to Ebola. Think of the damage that could do to a city’s infrastructure.
The danger from Ebola is magnified because of who the uninsured are, the working poor: the janitors, food service workers, waitresses, cooks, food servers, cleaners, cleaning ladies, nurse’s aides, bedpan cleaners, butchers, and workers in food processing plants. They are the people who are most likely to be exposed to Ebola, which spreads through infected feces and human body fluids. The two nurses in Dallas became infected by contact with Eric Thomas Duncan, who was nauseous and dying of Ebola.
They are also the people most likely to spread it to others. We know that Ebola can spread through contaminated meat; the prevailing theory is that humans first caught it by eating infected bush meat—wild game—in Africa. Imagine what would happen if somebody with Ebola were working at McDonalds or the meat counter of a major supermarket?
Another danger is that many of these people are poorly educated and not plugged into the media. They are those that are mostly likely not to know what Ebola is or understand its threat.
Denying the poor access to basic healthcare could have catastrophic consequences for our society. Yet that is exactly what we have done and continue to do.
Why Obamacare Will Not Stop Ebola
Those that think that Obamacare will solve the problem—such as liberal journalists—are going to be rudely surprised. Despite what they think, Obamacare does not provide access to healthcare; it provides health insurance.
Many of those “insured” by Obamacare were simply placed on the Medicaid rolls. In many communities, there are few doctors or medical facilities that take Medicaid. A person on Medicaid might face a two hour bus ride or a long drive in a junky old car to find a facility that takes it.
To make matters worse, many of those that have purchased insurance through Obamacare have bought so-called catastrophic policies with a high deductible, such as $10,000. Such policies don’t cover basic expenses such as doctors’ visits. Those people would have to pay for a doctor out of pocket.
Like the uninsured, they won’t seek medical care until they are desperately ill. If they had Ebola, that means they wouldn’t be taken for care until they became infectious and started infecting others.
We need to rethink both Obamacare and our present health insurance system in the face of threats like Ebola. The system needs to be restructured so that all Americans have access to basic healthcare at no cost or a very low cost. That probably means some sort of national health insurance, something like Medicare, that all Americans can access.
Yes, that would be expensive, but it would be far cheaper than an American Ebola epidemic, which could cause thousands of deaths and potentially destroy our healthcare infrastructure. Without such a system the only available response to something like Ebola would be draconian—send in the Army, and have it round up any possible victim and march them down for treatment or quarantine.
It looks like our health insurance system and Obamacare could become casualties of Ebola. America is about to pay a high price for its refusal to create a modern health insurance system.