Coronavirus is shedding a merciless light on the failings of the U.S. health care delivery system.
The first is its deficient primarycare capability. Many Americans lack access to affordable primary-care providers they know and trust, and who know them. In the case of epidemic illness, primarycare professionals offer a first line of defense in the form of trusted advice and care that keeps people from flooding emergency rooms and hospital outpatient departments.
Another problem is the lack of reserve capacity to handle health care crises of the type that the country may now be experiencing. Nationally, there is legitimate concern that the nation’s supply of 160,000 ventilators may be insufficient to care for the critically ill victims who are unable to breathe for themselves during a major outbreak. Such patients need intensive care unit beds.
For years, epidemiologists have warned of possibly catastrophic epidemics of new flulike illnesses — whether swine flu or bird flu or SARS or MERS — but the U.S. delivery system is still not ready. The U.S. needs a much more robust national reserve of health care resources — think of the U.S. strategic petroleum reserve — that it can draw on when the apparently inevitable crisis arrives. Congress would have to appropriate the necessary funds, but it has been reluctant to provide even minimal relief for past epidemics, much less support advance preparedness at the level required.
Despite the many strengths of the U.S. health care system — especially its care of highly complex, specialized problems — it often falls short on the basics. As COVID-19’S spread continues, it will demonstrate how essential those missing basics truly are.
