Can coronavirus cure our health care system?


By John DiTraglia



We still have so much to learn about how the new SARS-CoV2 does what it’s doing but one thing it is making clear is how and why our health care system is broken.

COVID-19 cases, hospitalizations and deaths are disproportionately higher for African Americans. CDC released a new analysis recently in the MMWR that showed African Americans are a third of the patients hospitalized with COVID-19 – even though they are only 13 percent of the population. That means the likelihood of a black person being hospitalized with COVID-19 is nearly three times higher than the rest of the population.(1,2) Part of this is because the risk factors like obesity and hypertension are higher in this population. But those factors are caused in turn by lack of health insurance and a lack of access to care. Furthermore, the loss of health insurance tied to employment is exacerbated by the worsening job loss of the epidemic. The inability to prevent the spread of this epidemic and the consequent crashing of the economy affects all of us no matter how rich.

One solution that seems obvious and ever more attractive is the Medicare for all idea a la Bernie Sanders and Elizabeth Warren. There are temporary fixes along those lines being proposed in Congress that might even be able to get Republican votes amid this dire situation. This may become ever more politically palatable since Medicare and Medicaid and the Veterans Administration are the most popular health insurance systems among the beneficiaries.

But for those of us who are allergic to government-run healthcare, Obamacare and a healthcare system like the one in Germany leaves multiple private companies to manage the administration of healthcare.

There is another fiasco of the healthcare crisis that predates the coronavirus crisis. This one is taking place among middle aged white folk and spelled out by the bestseller “Deaths of Despair and the Future of Capitalism” by Princeton economists Anne Case and Angus Deaton. These authors give some of the reasons why over the past few decades white Americans in their fifties are having more chronic pain, opioid addiction, alcoholism and suicide. They show that it’s not because of cultural problems – laziness and lack of personal responsibility – as the conservatives and even the victims want to believe. It’s about the economy stupid. (3)

Case and Deaton show that the premiums that employers pay amounts to a perverse tax on the lower-skilled workers. “For a well-paid employee earning a salary of $150,000, the average family policy adds less than 10% to the cost of employing the worker. For a low-wage worker on half the median wage, it is 60%.” The wages of these lower paid employees have gone down while their cost to employers has risen sharply. This is fixable by some simple rule changes. There you go calling on the government again.

Then I was given an insight by a letter to the editor by one Frank Feeley from Concord Mass. commenting on Atul Gawande’s book review of “Deaths of Despair” in the New Yorker. (4) He reminds us that this same kind of social disintegration happened after the collapse of Communism in Russia in 1989 predating our own. We know what happened to Russian politics after that.

And just think, we are getting all this revelation during the Trump administration. Thank you for that free demonstration coronavirus.

1. https://conscienhealth.org/2020/04/bringing-health-disparities-into-plain-view/

2. https://www.cdc.gov/mmwr/volumes/69/wr/mm6915e3.htm

3. Gawande A. The blight. How our economy has created an epidemic of despair. The New Yorker, March 23, 2020.

4. The Mail. The New Yorker, April 13, 2020

John DiTraglia M.D. is a Pediatrician in Portsmouth. He can be reached by e-mail- jditrag@zoomnet.net or phone-354-6605.

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By John DiTraglia

This writer’s opinion is their own and not the opinion of this newspaper.

John DiTraglia M.D. is a Pediatrician in Portsmouth. He can be reached by e-mail- jditrag@zoomnet.net or phone-354-6605.

This writer’s opinion is their own and not the opinion of this newspaper.

John DiTraglia M.D. is a Pediatrician in Portsmouth. He can be reached by e-mail- jditrag@zoomnet.net or phone-354-6605.