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Cover Story: An Honest Appraisal – March 20, 2020

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respect to quarantining patients, as well have been around one who is sympto- those insured will not be able to pay the two aspects of care may be at odds with
as those patients with more severe symp- matic, they must self-quarantine and deductible and copay and coinsurance each other. Rationing of ventilators and
toms requiring being quarantined in spe- refrain from coming to work. Others, amounts they are theoretically responsi- quarantined intensive care unit beds
cial intensive care units, there are family due to issues associated with childcare ble for, especially given that many of (and it would appear that this may
members who will be questioning may need to stay at home. And others them may have lost their jobs. And for indeed occur) may require making very
(potentially aggressively) why they can- will stay away and use sick time or per- those with no insurance at all, the levels difficult decisions as to needs of the
not be with their loved ones. This dis- sonal days, given the risk to themselves of uncompensated and charity care pro- patient, reflecting upon the level of need,
ease affects families physically and emo- and their family members and some of vided by the health care system will be and in turn the chance of survivability
tionally, not only the individual inflicted these individuals may be potentially sup- huge. Now add to this the delay and can- given the lack of life saving resources
with the illness. ported by a union. Now, as a result, one cellation of all elective surgery and the available.
Our frontline care providers, they are is faced with a significant shortage of already precarious financial situation of This is only a small segment of the
at much greater risk then the population needed personnel. This now adds further health care institutions in this country, complexity of the issues we are facing. I
at large, with limited access to protective to the crisis. this will be overwhelming. only wish that this was still a class exer-
gear given the extent of the situation. Regarding the financial stability of our And then there is the ethics … the cise and not the real thing.
Further, they themselves may be spread- heath care institutions, the realization is potential shortage of beds and ventila- Please stay safe all.
ing the disease unknowingly. The one that 35 million people in the United tors delves into the area of who will
significant difference between viruses States are currently uninsured and tens receive potentially lifesaving ventilators
such as SARS, H1N1, Ebola compared to of millions more are underinsured given and Intensive Care Units beds and who
Corona is that with other viruses, conta- high and very high deductible plans (e.g. will not. This cannot be arbitrary. Dr. Steven G. Ullmann, Professor and
gion begins with symptoms. But with $2,500 to $6,500 deductibles). Given Medical ethics is a very complex area but Chair, Department of Health Management
Corona, people are contagious for up to that the test is to be free, and with each there is a potential methodology that and Policy, Director, Center for Health
five days before they show symptoms (if test essentially costing $3,500, free is to might help … the concept of medical Management and Policy, and Special
they show symptoms at all). So, health- the patient but not to the insurance com- utility. This does not take away from the Assistant to the Provost at Miami Herbert
care workers may be affected or pany nor to the provider for those with difficulty of the choices that might ulti- Business School, University of Miami,
unknowingly exposing people to the no insurance. And if treatment, poten- mately have to be made. Medical utility can be reached at (305) 284-9920 or
virus themselves. tially extremely expensive treatment, is looks at a patient’s level of need but also Sullmann@miami.edu.
And for those who are symptomatic or required, facilities will find that many of the patient’s prospect of success. These

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12 April 2020 southfloridahospitalnews.com South Florida Hospital News