To seek care or not to seek care: the fear of being uninsured during a pandemic

by Molly McMillen

As a young woman in my 20s, I know many people my age who are no stranger to the lifestyle of the proverbial “starving college student;” however, many of them are not students at all, but full-time employed young people who struggle to pay rent and put food on the table, let alone pay for health care during a pandemic. In a recent conversation with a friend, I asked him what he would do if he became infected with COVID-19; he does not have health insurance. He said that he would quarantine for two weeks and hope that he did not become so ill that he would die. At first that sounded drastic to me, but the unfortunate truth is he is only one of millions of Americans of all ages and backgrounds who would not seek treatment for COVID-19 due to their inability to pay for medical care.

In a recent Gallup-West Health study, one in seven Americans said that they would not seek medical treatment if experiencing symptoms related to COVID-19, including coughing and fever. One in 11 said that they would still not seek treatment even if they were highly suspected to be infected with COVID-19. Why? Because they fear they could not afford to pay for care.

The fear of seeking treatment is especially apparent in specific communities. The number of people who would avoid COVID-19 treatment reaches one in five for non-white Americans; those who have less than a college education; those under 30; and those with lower annual incomes. These populations are also already at higher risk for being uninsured. COVID-19 thus has severe impacts on socioeconomic and racial groups which are already targeted by inequality in many ways.

Many underinsured and uninsured Americans that already cannot afford care also are unable to take time off of work when ill, due to the extreme financial burden that unpaid sick leave presents. Not only does leaving work for much-needed recovery time present a temporary loss of income, it often threatens that individual’s position and even their employment status as a whole.

In a country where high co-pays and devastating deductibles plague those who are insured, the rising number of Americans losing their jobs due to the pandemic may leave millions more uninsured. The debilitating fear of financial ruin as a result of COVID-19 illness is exacerbated by the fear of losing one’s income completely.

Not only does the perceived—and very real— financial inability to seek treatment put the lives of millions of underinsured and uninsured Americans at risk, but it threatens the entire country. If people who are ill are unable to receive the care that they need and—worse still—are unable to leave work to recover, this only presents further opportunities for the virus to spread. The lack of high-quality, affordable health care is a critical component of the COVID-19 pandemic in the United States and will only continue to compound the devastating effects of this illness.

The simultaneous growth of health care costs, unemployment, and uninsured rates begs the question: how can Americans be expected to receive the care that they desperately need when they can hardly afford a basic standard of living? And how can Americans be expected to afford this basic standard of living when they cannot access the care which allows them to be healthy enough to work?

Molly McMillen is a senior undergraduate pre-medical student at Fort Lewis College in Durango, CO with an intense passion for writing, health care, and advocating for better access to quality care. She is currently a certified nursing assistant and hopes to go into anesthesiology after finishing her undergraduate and graduate degrees

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