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  • An exterior view of VacaValley Hospital in Vacaville, California, USA.

    An exterior view of VacaValley Hospital in Vacaville, California, USA. | Photo: EFE

Published 10 March 2020 (4 hours 21 minutes ago)
Opinion

Employers in the United States are not required by federal law to provide their employees with paid sick leave.

The presence of the novel coronavirus in the United States, a country where crowdfunding platform GoFundMe is used as a health-care lifeline and even insured patients can face hefty co-payments when visiting the doctor for minor ailments, poses a major challenge for an inequality-riddled system.

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The viral outbreak has revealed gaping holes in healthcare coverage at a time when people may need it most. Most European countries and Canada have universal healthcare systems, but the U.S. relies on a patchwork of public and private insurance.

Only 43 percent of service workers in the U.S. have access to healthcare benefits. U.S. employers with 50 or more employees are required to offer health insurance but the same protection isn’t provided to part-time workers or independent contractors.

An estimated 27.9 million people lack any type of health coverage in the country (roughly eight percent of the population), while an additional 44 million have cheap, bare-bones plans, known as catastrophic coverage, that have very high deductibles and co-payments, according to estimates from the Commonwealth Fund, a private, healthcare-focused U.S. foundation.

Doctor’s visits for many people, therefore, are the last resort and, according to a 2018 survey by the Agency for Healthcare Research and Quality, an agency within the U.S. Department of Health and Human Services, just eight percent of adults 35 and older take advantage of preventive services.

This situation could result in COVID-19 carriers not being detected on time in the United States, where nearly 700 cases have been confirmed thus far, and the disease spreading beyond authorities’ monitoring systems.

“Under our current, dysfunctional for-profit health care system, people don’t go to the doctor if they cannot afford it. And during an infectious health crisis like this one, that means that potential carriers of the virus may not get checked out if they’re showing symptoms,” Vermont Senator Bernie Sanders, a leading candidate for the Democratic presidential nomination and proponent of a European-style healthcare system, said on Monday in a letter to his supporters.

Waiter Joey Ingham, who works at a barbecue restaurant in Kansas City, Missouri, popular with business travelers, says he doesn’t have insurance. His protection? Washing his hands more often.

“If I wasn’t able to come into work, it would be hard to make ends meet,” said Ingham, who waits on 80 to 120 people a shift. If he felt sick, he’d “probably talk to a manager” about what to do, but noted management hasn’t yet outlined any policies.

Liss-Reardon said most gig workers — independent or temporary contractors — she represents don’t have health insurance.

“We won’t have a fully insured population until we get universal healthcare,” he said. “There are going to be these huge gaps. The burden is falling on the poorest and most vulnerable in our society. This is just another example.”

“The recommendations on what people should be doing to protect themselves really gives a sharp indication of the divide between white-collar and blue-collar workers,” said Shannon Liss-Reardon, a workers rights attorney in Boston, quoted by AP. “Our social safety net is just not equipped at this moment to deal with a crisis like this, and it will disproportionately affect the most vulnerable low wage workers.”

Only 29 percent of U.S. workers have the option to work from home, according to the Bureau of Labor Statistics, while about 27 percent of private-sector workers don’t have access to paid sick leave since there is no federal sick leave policy in the U.S.

This leads many workers to go to work ill out of fear of losing their jobs or not being paid, a situation states like New York are trying to combat with new emergency legislation that would force employers to pay sick leave to coronavirus patients who are isolated or quarantined (normally for a period of two weeks).

The Walmart cashier in Malvern, Arkansas, serves hundreds of people a day and her big worry is what will happen to her income if she catches the virus or comes in contact with someone who’s had it and must self-quarantine for 14 days.

“If I can’t go to work, I could try to take a leave but it will be unpaid,” said Hughes to AP, who earns US$11.60 an hour. “I don’t know what I would be doing about taking care of my family.”

Hughes, a diabetic and mother of four, gets 48 hours of sick leave a year but she fears it wouldn’t be nearly enough time to recover.

Economic inequality in the U.S. makes it difficult to take actions that should be the first line of defense against the epidemic.

For example, Richard Carranza, the chancellor of schools in New York City, where 750,000 children are poor and rely on schools for three meals a day and medical care, said recently that long-term school closings would be a last resort in response to the coronavirus.

The increase in the number of coronavirus infections follows an exponential growth curve in the first few weeks, with roughly 20 percent of those diagnosed with the disease requiring hospitalization and four to five percent needing to be placed in intensive care.

That reality has prompted health experts to urge U.S. authorities to prepare for possible severe hospital shortages in the most affected areas.

A study by Johns Hopkins University’s Center for Health Security is projecting that at least one million people may need to be hospitalized with coronavirus in the country and that around 200,000 will need to be placed in intensive care units in a country that has around 46,000 medical ICU beds and could convert up to 100,000 for that purpose in a crisis.

“U.S. hospitals routinely operate at or near full capacity and have limited ability to rapidly increase services,” scholars at that center said in an article late last month. “There are currently shortages of healthcare workers of all kinds. Emergency departments are overcrowded and often have to divert patients to other hospitals.”

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