This is the healthcare system that I’m most familiar with – and still the most confused by. The majority of health insurance is through private companies (through an employer), but there are a few public options (Medicaid and Medicare, namely). Unfortunately, there is no universal healthcare. Coverage of treatments varies wildly (and doesn’t include dental and vision care) depending on insurance and healthcare is well known for being expensive – for good reason!

Life expectancy has been declining – especially after the start of the COVID-19 pandemic. Maternal mortality rates have also increased - and particularly for BIPOC. Obesity rates have also been increasing; in general, the healthcare system is deeply flawed with many factors contributing to the issue. Some efforts to reform the system have been proposed, notably the Affordable Care Act (ACA, “Obamacare”), but conservatives have largely blocked such reforms. Even the ACA has been targeted by such politicians as they want to repeal it.

Private insurance

Most insurance is provided by an employer (for full time employees only). A regular payment premium is paid to the insurance company; for most plans, the person must meet a deductible (amount paid before the share will be paid by insurance) before the insurance will “kick in”. Different plans have an out-of-pocket amount (amount paid by the person) and once the amount is met, the insurance company will pay the full amount. This is often thousands of dollars.

It’s very confusing.

Public Insurance

The two main types of public insurance are Medicaid and Medicare. These are not provided through an employer, but from the government. Often, people with this type of insurance are over 65 years old, disabled, or low income or a combination of the three. There is no regular payment for some of these, but they are often less expensive, as is the deductible. There are subdivisions of these plans, depending on if you receive social security benefits and other factors.

Costs

As mentioned before, the USA is very well known for expensive healthcare. The number one cause of debt and bankruptcy has been medical expenses for many years! Often, travelers from other countries will return home for medical care, when possible, because it is less expensive.

So how expensive is it? Let’s look at the average costs of some procedures and medications:

• Zovinsky: $89,480

• Hip replacement: $40,364

• Gastric Bypass: $25,000

• Clozaril: $196.24

• Albuterol inhaler: $52.21

• Motegrity: $485.42

• Spinal Fusion: $110,000

• Mavenclad: $63,993

• Knee Replacement: $35,000

• Heart Bypass: $123,000

• EpiPen: $377.57

I’ve personally had a hospital bill of about $1.3M for my ICU stay for my neurological injuries in 2016.

Medical supplies are also expensive! A lot of electric wheelchairs are $30,000+ and accessible vans can be around $50,000! It’s easy to see how medical debts can pile up fast.

The USA ranks low for efficiency of medical spending and life expectancy is declining – what are we paying so much extra for?

Covid-19 Pandemic

The first recorded case of covid-19 in the US was January 21, 2020. The pandemic is currently ongoing and has been marked by a series of failures to prevent its spread. Responses were weak at best, and often any efforts to contain it were strongly opposed. Covid-19 became a political cry and weaponized for political gain. Though most Americans (87%) are currently in high risk areas of transmission, no federal mandates are in place and most choose to live as if the pandemic is over.

Mandates were inconsistent and lifted/eased prematurely and followed a cycle of increasing precautions, slightly less cases, decreased precautions, another wave of cases, and repeat. As a result, the pandemic has gone on longer than the Influenza Pandemic of the 1910s (“Spanish Influenza”) and the US has the highest amount of covid-19 cases in the world. Various supply shortages were linked to the high number of infections.

To combat the spread, vaccines were developed rapidly. The major covid-19 vaccines in the US are Pfizer, Moderna, and Johnson & Johnson; the Pfizer and Moderna vaccines use mRNA. The technology has been studied in labs for years, but was only commercially available in a vaccine upon the release of the Pfizer vaccine December 11, 2020.

Due to a mixture of distrust in science, the novelty of the vaccine, and weaponization of this distrust by politicians, vaccination efforts were slow and met with intense opposition. As of now, only 79.3% have received one dose of the vaccine and 67.6% have received two doses – lower than the ideal 94% vaccinated population needed to disrupt transmission and provide herd immunity.

The largest surge in infections occurred in January 2022, with some days having over 800,000 new cases in one day! I unfortunately am part of this statistic and contracted it in early January.

Thankfully, I am one of the 82,220,986 Americans who recovered from it and not one of the 1,051,912 Americans who died from it. To put it in perspective, the amount of Americans deceased from covid is approximately the population of Rhode Island and those recovered from covid is approximately that of population of California, Texas, and Pennsylvania combined!

Unfortunately, the number of cases continues to increase as more people drop precautions and leaders are dismissive of its continued presence.