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Old 03-23-2020, 08:01 AM
Francis Vaughan is offline
Join Date: Sep 2009
Location: Adelaide, Australia
Posts: 5,320
Originally Posted by jtur88 View Post
Probably not. Even the US will have to go single-payer for Covid-related care. You can't afford to let a single case to fall through the cracks. Now is when you discover that, no matter how many you could blow off when there was no emergency and you had an expendable sub-class.

Imagine what it would already be like if all Covid-positive case were treated according to their ability to self-pay, and a quarter of them were walking around untreated.
The danger is that the divide comes about a bit differently. The walking infected don't need treatment. They need to be isolated, but they will get better. They are not much of a burden on the health system. It is the critically ill who are the serious problem. They need expensive (in all senses) care, and they compete for that care with one another and with people who are seriously ill for other reasons. Currently it seems there is little chance the US has enough capability to cope with the expected onslaught. Even best case scenarios are showing significant deficits in capability, and bad scenarios have the country with a 3:1 shortfall of capability running for many months. There is only one source of money to even try to cover this, and it isn't private health funds. Any notion that private cover and private hospitals will be in some way able to run on a different pair of rails to the public system is not going to work. The private sector will be overwhelmed, and it won't matter what level of private insurance you have, you will only get what the system can spare, no more. In the face a major blowout expect the private hospitals to be simply commandeered to the effort. Sorting out the money will have to come later. It will probably be years before it is sorted.

Here in Oz, it is pretty clear, despite having a dual public/private health system, the public sector will be carrying the brunt. Currently testing and care is almost all public sector. Access to GPs is pretty much assured to the entire populace, so first line care is on the public purse.
Private hospitals will be getting ready for the worst. For them that means they won't be filling beds with lucrative short stay surgical patients. Indeed, bar emergencies, theatres are probably going to silent as equipment is pressed into service keeping the critically ill alive. Private hospitals hate long stay patients. They hold down a bed that could be used for a surgical patient. They make their money on the theatres, not on the beds. The private health insurance business isn't in great shape over here. It is hard to make money. How this crisis affects the insurers will be interesting to see. If things go really bad I would expect some serious conversations with the government about how to avoid the insurers all exiting the market.