The way our broken healthcare and insurance system deters testing for infectious diseases shows how vulnerable we will be to COVID-19 and other pandemics:

After returning to Miami last month from a work trip in China, Osmel Martinez Azcue found himself in a frightening position: he was developing flu-like symptoms, just as coronavirus was ravaging the country he had visited…. Then hospital staff members told him he’d need a CT scan to screen for coronavirus, but Azcue said he asked for a flu test first…. “This will be out of my pocket,” Azcue, who has a very limited insurance plan, recalled saying. “Let’s start with the blood test, and if I test positive, just discharge me.”…. But two weeks later, Azcue got unwelcome news in the form of a notice from his insurance company about a claim for $3,270….. Hospital officials at Jackson told the Miami Herald that, based on his insurance, Azcue would only be responsible for $1,400 of that bill, but Azcue said he heard from his insurer that he would also have to provide additional documentation: three years of medical records to prove that the flu he got didn’t relate to a preexisting condition.

So even though he had COVID-19 symptoms and had just come back from China, this man chose to not even get tested for COVID-19, since that testing would be even more expensive; instead, he got the cheaper flu test and assumed he didn’t have COVID-19 because he had the flu. But what if he has both COVID-19 and the flu? We’ll never know, because he just couldn’t afford the COVID-19 test. He could be spreading COVID-19 to hundreds of people right now as a result.

And how ridiculous is it that he will have to pay even more unless he can prove that he didn’t have a “pre-existing condition” that made him more vulnerable to flu?

Millions of Americans will be faced with this kind of dilemma once the pandemic reaches us:

Azcue’s plan wouldn’t have existed if Donald Trump’s administration hadn’t rolled back provisions of the Affordable Care Act (ACA) that prevented insurers from denying coverage over pre-existing conditions or refusing to things like hospitalization in 2018. The White House added links to the federal ACA exchange to outside sites that sold such “short-term plans,” according to the Washington Post, despite these not meeting the original requirements; that’s in addition to the Trump administration’s other efforts to weaken key provisions of the law or throw it out entirely. Azcue makes $55,000 a year and took one of those short-term plans to lower his premiums from $400 a month to $180, according to the Herald

The possibility of being struck with one of these bills is a major driver in Americans avoiding seeking medical attention for a health issue. Gallup polling in 2019 found that 68 million Americans, or roughly one out of four, had skipped treatment due to costs in the prior twelve months. Set this system on a collision course with a dangerous disease spreading across the world and the outlook isn’t great. The federal government has said it will pay for costs like mandatory quarantines (which can be extremely expensive) for uninsured individuals returning from China. But in prior situations like the 2014-2016 Ebola outbreak, individuals were still on the hook for bills, and whether more financial assistance would be forthcoming is the prerogative of a federal government already hard pressed to pay for overhead costs of emergency response. Azcue didn’t even have the disease or technically even receive a test for it, making it less likely his costs will be defrayed. Fear of high medical bills is also a factor in overcrowding in emergency departments across the country, as many people won’t seek treatment until they are obviously ill. If the coronavirus gains a foothold in the U.S., that could contribute to spread in medical settings where SARS-CoV-2 already has a proven ability to spread.

This is yet another reason we need to elect as many Democrats as possible in 2020. Our lives will depend on it.