Compared with most COVID-diagnosed patients, President Trump seemed to bounce back from his bout with COVID quite quickly. Appearing happy and healthy, he encouraged Americans to have no fear of the virus and downplaying the seriousness of the disease.
He did not mention, however, the exceptional treatment he had received: experimental antibody therapy, steroid infusions, and around the clock monitoring by the highest of trained medical staff. These are bountiful advantages not shared with the majority of Americans.
The experimental drugs he received are usually “reserved for the sickest of Covid patients who have been ill for weeks, not days,” only to “aid and hasten his recovery,” according to Michelle Roberts, the Health editor of BBC news.
According to the Guardian, the experimental monoclonal antibody treatment he received would (alone) cost $386,924, if it was even available to patients on the market yet, which it isn’t. The cost of his Remdesivir antiviral medication treatment, $3,120 per 5-day course, pales in comparison. And the two flights in air ambulances he undertook totaled to around $78,000. These costs are only a fraction of the medical attention he received and don’t fully consider the hospital, doctor, and equipment costs that also add to a hospital bill. In addition, he also took “zinc, vitamin D, famotidine, melatonin and aspirin.”
This high profile case serves to underscore the vast differences in health care afforded to those at opposite ends of the socioeconomic spectrum in the United States. The average Covid patient’s bill looks surprisingly similar, minus the experimental drugs and the helicopter rides. Except, the average person cannot easily afford to pay these bills.
For a patient over 60, the “median charge” is around “$61,912,” likely for the most basic of treatment, still nowhere close to Trump’s near 6-figure expenditure on Covid treatment. But a bill can range by hundreds of thousands of dollars, taking into account “surprise” bills, costs of ventilators, staff care, treatment for side-effects or illnesses, and the amount federal aid or insurance will cover. Some states like Texas have even $6,408 for a drive-through Covid test.
The NY Times interviewed recovered Covid patient, Janet Mendez, who received a bill of $400,000 and was quite uncertain if her insurance would help her cover the costs.
But unlike Trump, who has been “repeatedly ignoring public health guidelines,” the average person also takes precautionary measures to avoid infection with COVID. As Laksham Susamy, an ICU physician at Cambridge Health Alliance in Massachusetts, stated, “COVID is all about privilege. The more privilege you have, the more you can ignore some of the rules of COVID.”
This is specifically pertinent to Trump’s case. He held campaign rallies in the White House, held Supreme Court announcements, and refused masks while debating. His blatant dismissiveness to the viability of transmission and infection of Covid, comes from his perspective of privilege, like many other upper-class patients.
While the President encourages the public not to let it Covid “dominate your life,” many minority groups and lower-income patients have a much higher likelihood of having to fight for their lives against this disease. The death rate from COVID is more than twice as high for black patients, and nearly twice as high for Native Americans or Alaskan Natives. About 35% of patients with household income under $15,000 became seriously ill with COVID compared to 16% with an income over $50,000. This is likely the combination of the fact that “wealthier people also have fewer underlying health conditions that exacerbate COVID-19” and that lower-income patients cannot afford the expensive and exclusive COVID treatments.
Fear of overwhelming debt associated with treatment for COVID is one factor keeping many Americans from seeking early treatment that could decrease the severity of the disease. Instead, many wait until symptoms become so severe and the disease progresses so far that they have no other option than to seek hospital care. “They are only hospitalized if signs of severe infection emerge.” Clearly, this makes it harder to battle a disease if you let it worsen to such a bad state.
Chronic medical conditions such as heart disease, obesity, diabetes, and hypertension are all also more prevalent in poorer communities where preventative health care is not available. Coincidentally and unfortunately, these conditions all exacerbate the effects of infection with COVID-19.
The disparity in access to testing and treatment for, and the predisposition to, COVID will likely carry over into preferential access to the vaccine when one becomes available. The wealthy and connected will be the first to receive the vaccine. The most vulnerable poorer populations, for which a vaccine would be most critical and helpful, will be the last to receive access to this vaccine. This will be true for Americans as well as all people around the world, although America does have particularly limited “universal” health care compared with its Western counterparts.
This unfortunate truth about health care disparities will likely ensure that COVID will continue to be a global menace for years to come.