A little bit of future good news:
This means that the money allocated in the House bill for covering testing for uninsured patients through NMDS authority should go a long way: https://t.co/N0XbzCxeY6 https://t.co/1S8BrrGoZJ
— Loren Adler (@LorenAdler) March 13, 2020
CMS has released standard Medicare rates for COVID19 screening tests. Depending on the test type and area of the country, Medicare will pay between $35 to just under $52 per test. Assuming the House relief bill is signed quickly, states will be able to pay for testing for uninsured individuals at either the Medicare rate or at a 100% federal match via the Medicaid program. Either pathway means that there will be no cost barriers to testing once the kits become widely available.
There are still many direct medical and indirect or non-medical cost barriers that need to be vaulted over, but the first one that will allow our public health experts to accurately assess the scale of the problem looks to be coming down fairly quickly.
The problem right now is that many states are refusing testing of symptomatic patients unless they have had contact with a coronavirus patient. That means any community acquired infection is ignored. This is unacceptable and dangerous.
@yellowdog: That is because there are so few test kits. No one is willing to actually use the ones they do have.
Would an uninsured person (no private insurance, no Medicare, no Medicaid) who had C-19 symptoms take advantage of a free test? I’m not sure since that person would then be on the hook for treatment costs if the test was positive.
The one positive outcome of this horror show may be a live demonstration that yes, making sure every single person living in this country has access to healthcare without facing financial ruin is important.
@Betty Cracker: It’s a living demonstration, but one a large number of Republicans will flat out ignore.
@Betty Cracker: You nailed it. The test may be free, but if it’s positive, they aint lettin you walk out the door (or without insurance, actually maybe they would….with a push). Assuming they dont, now your “free” test becomes a $5K+ hospital treatment plan out of pocket. Who the hell is going to risk that?
I think that the vast majority of Democratic politicians are already on board. Now we see if this crisis manages to convince healthy people who think they’re invincible that they need health insurance, too, in case something like this shows up that they didn’t expect.
@Mnemosyne: It’s been my observation that the people who “like” their insurance, and don’t want to see any changes, haven’t really used it.
It’s like those backpack parachutes. Makes you feel better having it, but you haven’t put it on and jumped off a roof yet.
It’s annoying but okay to have a common and acute illness, or a chronic, but manageable, one. But the instant your well-being starts bending some cost curve on the spreadsheet, things descend.
The worse off you are, the worse it gets.
This is widespread and somehow dismissible. But not when it happens all at once.
I have no idea how I get a test myself even though I now know I was sharing a floor with at least one (and likely at least several) people who have the virus. The health clinic my PCP gave me had a long hold and eventually hung up. I have zero symptoms, so I assume that life is just going to go on in whatever weird stasis it is in now.
@PsiFighter37: At this point, testing should likely follow symptoms, just as it does for the flu and other diseases. It’s a given that people in the community have been exposed and might test positive. The only additional steps I would take (in addition to hand washing, etc.) would be to monitor my temperature (fever apparently being on of the two most prevalent symptoms — dry cough being the other) and make sure to avoid contact with anyone who is at high risk if you can.
There is no “early treatment” for the virus. If you did get it and your symptoms remain mild, most likely you will require no treatment at all. If you are at high risk yourself, I would maybe monitor fever more than once daily, and I would contact someone who you can call to help you get care if you start to feel bad.
The only other useful tip I have heard is that if you do start having respiratory symptoms, it’s important to get breathing support earlier rather than later.
Hang in there.
@Feathers: No, there are test kits in a lot of places. There are no materials to process the test kits. Also some places are running out of nasal swabs, so no idea what’s going to happen there.
With asymptomatic transmission, it is important to test those without symptoms that have had possible exposure.
Especially after witnessing this omnishambles, I think it’s going to be really, really hard to convince people to give up their current employer-provided insurance based on promises that the government will totally get it right from now on, promise!
The good news is that universal healthcare coverage doesn’t require that. Germany, Japan, Switzerland, and other countries all incorporate private employer-provided insurance into their universal healthcare programs. It’s going to take a huge act of will by Congress to put the strict regulations on our current insurance companies that will be required, but if they can’t do that, how are they going to build a useful government-provided system from scratch?
MedicAID for All is actually a much better idea than MediCARE for All since Medicaid is more comprehensive for all stages of life and covers more stuff, so I hope we go back to that direction (which was the direction of PPACA) rather than trying to reinvent the wheel when there are plenty of existing wheels that we can look at and take useful tips from.
@Inventor: The point is that once it is in the community, everyone has had possible exposure. Until testing becomes more widely available, trying to get tested when you don’t have symptoms means interfacing with an already stretched health care system that is highly likely to turn down your request to get tested. I have a friend in this boat right now. If you have been in close contact with someone you know has tested positive, you should self-isolate if you can, and maybe try to get tested if your job or activities make it impossible to self-isolate and bring you in contact with high risk people.
@Inventor: We’re past that point. You can’t constantly test the whole population. You’re going to get it. If you get symptoms, go home, don’t spread it, assume you have it. If later you get sick again, assume you had something else the first time, go home, don’t spread it, assume you have it.
If you can avoid places where it may spread, do so.
What about the 1,331.00 that Katie Porter talked about as the cost yesterday?
@Mnemosyne: The point being that change MUST come. The current situation has improved, but obviously is not up to, say, the present emergency.
I said to myself, “this is a piece of good news, but the comments will tell me why it isn’t”. I wasn’t exactly wrong.
@Mnemosyne: That would definitely require a retooling of Medicaid. It’s the worst paying of any system out there including Medicare. That would require a much heftier tax increase to keep providers from going Galt, but it would be worth it. Or tie Medicaid to a payroll tax.