Everything's under control

Cost of delay

Every man for himself

Medicine is not for everyone

Americans have always been at the forefront of the fight against global epidemics. The outbreaks of SARS, Zika and Ebola, if affecting the United States, did not threaten national security.America, in the words of former NATO Secretary-General Anders Fogh Rasmussen, is surrounded by “friendly neighbors and fish” — partners Canada and Mexico and the two oceans. The United States has not been a battleground for both real enemies and viruses for decades, and now that the threat comes from within, the country simply does not know what to do.The opinion of President Donald Trump has changed rapidly — just as the epidemic has spread. From January 22, when the first patient was registered, and until mid-March, while there were fewer than a hundred dead, Trump assured: everything is under control, the risk of infection is low, the virus will recede as soon as it becomes warmer.And two weeks ago, he said: “This is a pandemic. I knew that it was a pandemic, long before that, you just had to look at other countries. ”Today, the United States came out on top in the number of infected in the world: 163.5 thousand. The victims — more than three thousand. New York turned into the main focus of the epidemic, and the authorities lost control over the situation in a matter of days.According to some American experts, Washington lost six weeks. It was possible to prepare tests, masks, protective suits for doctors, stock up on mechanical ventilation devices. This is not done.Even now, authorities do not recognize the criticality of the shortage of medical equipment. When the governor of the hot spot — the state of New York — Andrew Cuomo said that the region needed at least 30 thousand ventilation machines, Trump did not believe it. “I have a feeling that many of the figures that are called are very high. I doubt that you will need 40 or 30 thousand mechanical ventilation, ” he reasoned last week when the state already had five percent of all patients with COVID-19 in the world.Although the president was slowly responding to the growing threat, he was not the only culprit. “This is also the omission of the administrations of Barack Obama and George W. Bush. Experts warned that something would happen, but neither team nor the other prepared for such an epidemic, ”explained in a conversation a US resident Jacob Blass, who worked in four non-profit healthcare organizations for twenty years, and he headed three.Nevertheless, the current president, in his opinion, exacerbated the situation. In 2018, the “pandemic team” created by Obama was abolished — the Department of Global Security in Health and Biosecurity at the White House. Trump believed that hiring people would not be a problem again if necessary.The chance to minimize the epidemic was missed, according to another agency interlocutor — MD and practicing pathologist from North Carolina Margaret Johnson. “Prevention of a pandemic is not the responsibility of the healthcare system, but government structures such as the Centers for Disease Control and Prevention,” she says. — However, the authorities acted too slowly. “Trump did not listen to experts, closed programs that could track the development of the epidemic in China and prevent it in the States.”Another negative factor is the split in American society, not only political but also in the healthcare sector. “The main cause of the crisis is the lack of a unified medical system: all hospitals are on their own,” says Jacob Blass.The vast majority of hospitals in the United States are private and in no way dependent on the state or on each other. There are large networks, there are small local hospitals. However, under conditions of a general shortage of beds, equipment, and protective equipment, medical facilities are switching to the “every man for himself” regime and are trying to make up the missing supplies on their own. Roughly speaking, all hospitals call the same plant with a request to put the missing ventilation, masks, robes, and tests.However, some hospitals are so small that they have no way to go to the provider. Due to lack of funds, they are closing, explained Margaret Johnson. “There is simply not enough money to work when all the patients are old and poor,” she said.Trump was expected to enact the Defense Industry Act. This would allow increasing the production and supply of necessary equipment to hospitals in the “wartime” mode.In late March, more than a hundred former employees of the National Security Council called on the head of state to take this step. The answer came a few days later: the president ordered General Motors to produce more ventilators. However, sources told reporters that the company had not officially received any order to enact the law.Another health vulnerability that constantly raises political debate is the insurance system.“For many in the country, access to medicine is a problem, and the pandemic simply brought it to the fore,” says Johnson. Americans can be divided into three categories. The first is wealthy citizens who simply buy insurance. The price depends on a lot: staff, its laws, place of work, income. Such an American pays an average of $440 per month for personal insurance and about $1,168 for family insurance.In this case, the client usually pays for medical services himself, and then receives a refund. However, with a sudden serious illness, not everyone is able to lay out a round sum from their own pocket. And the company reimburses only part of the costs, usually 80 percent.The second category is poor. People living below the poverty line are entitled to state insurance Medicaid. It provides free or low-cost care to millions of Americans. The program has its own criteria: take into account earnings, family size, place of residence. Some states have announced in the wake of the pandemic that Medicaid will continue to operate normally.The most vulnerable in the current situation are 27.5 million Americans who have no insurance at all. In other words, 8.5 percent of the population does not have a chance to use medical services. Of course, they can come to the emergency room and get in line, but this does not guarantee anything.“Hospitals work for money, you just can't go to the hospital and say that you have health problems,” explains Jacob Blass. “And in the emergency departments, there are no quarantine rooms, no means of protection, nothing.” And it’s not clear who will pay for it. ”It was for this group that the so-called Obamacare — health care reform was intended. Up to 95 percent of the country's citizens should have received health insurance. Congress approved the reform in 2010, but its constitutionality has been debated for a long time. Confused too much budget spending. As a result, after taking office in 2017, Donald Trump ushered in the abolition of Obamacare. In December 2018, the Fort Worth Texas-based Federal Court of Justice declared the reform unconstitutional.There are still solvent citizens over 65 in the United States. They are entitled to state health insurance. Its cost is about $250 per month, this amount is deducted from the pension. However, it does not cover all medical expenses, but only partially reimburses bills from the hospital. Older Americans can also buy an additional package from the insurance company (just over a hundred dollars), which allows you to receive any kind of medical care for free. “Personally, I have excellent insurance, I am not complaining,” Margaret Johnson admitted.“I pay an extra 120 dollars a month. So, in recent years I have performed two operations on my arm, two on my eyes and one on my heart. Only the latter would cost me more than 50 thousand dollars, but I did not give a cent. “I stayed in the hospital for three days for free, although otherwise it would have cost me three to five thousand dollars,” says Jacob Blass. “In addition, I have another additional insurance package for $30 per month that covers drug costs.”Both interlocutors agree: they were much luckier than many compatriots: for 350 dollars a month, you don’t have to worry about the cost of treatment. However, what about the millions of Americans who are not able to afford even basic insurance, they, like the government of the country, do not know.