Healthcare providers have never been as widely appreciated or recognized as they have been in COVID 19 times – take the daily 7PM clapping in New York or Israel for example. Moreover, the impression that individuals would get from reading the news is that healthcare workers are all “maxed out,” working days and nights, with full workloads and jammed hospitals. Images from New York, Louisiana, Italy and Spain reveal a stressed medical infrastructure. Personal stories from the front lines convey despair and desperation as healthcare workers struggle against an overwhelming enemy, a coronavirus powerful and mighty. While these images are true – they indicate one thing: all acute care providers and medical institutions are overwhelmed. What it does not describe is what is transpiring with the other 80% of healthcare – what is truly occurring in outpatient clinics, specialty hospital wards, elective procedural suites and other non-emergent facilities.
The truth is this: Healthcare has been among the hardest hit segments of the economy, with an estimated 75-85% loss of revenue over the last two months. MOST individuals in healthcare are NOT providing acute care, and they have almost all been sidelined over this time period. Anyone not intimately involved in caring for COVID 19 patients has been enduring the same work restrictions as the general society. Moreover, even those actively caring for COVID 19 patients are often not generating profits, as hospitals lose tens if not hundreds of thousands of dollars for COVID 19 patients who consume massive resources, have prolonged hospital stays and for whom hospitals receive less than adequate compensation. Generally, hospitals can offset these losses with other non emergent/elective procedures, encounters and services that are profitable. Those, however, have all been cancelled to ensure that all resources can be available, to make available adequate medical infrastructure dedicated to caring for COVID 19 patients.
The irony of physicians suffering financially during the COVID 19 time is challenging on both an emotional and moral level. However, there is an additional concern – that of the economic fallout for regions where healthcare is among the primary generators of income. Many large cities boast robust economies centered around large, profitable healthcare systems who have massive employment and infrastructure needs. To see them suffer during this time of all is disheartening. The GDP of the US depends, in a large part, on healthcare as well. Hence the economic downturn of the healthcare system is among the largest contributors to the poor economic predictions and reports.
A healthcare system that is not economically feasible will be unable to care for its patients, and will cause large – potentially catastrophic – long term negative health affects and outcomes.
We are therefore faced with a dilemma whereby physicians, healthcare systems and patients are all at risk.
In short – it is the perfect storm and I worry that American healthcare will suffer greatly.