The paper examines chronic respiratory diseases as pre-existing conditions and universal healthcare as the most appropriate way to manage them. CRDs, which include such diseases as bronchial asthma, chronic obstructive pulmonary disease, and others, are serious factors that contribute to the complication of other acute diseases and increase death risk. This became especially evident during the coronavirus pandemic, which revealed the high risks of people diagnosed with CRDs (To et al., 2020). The main problem is that the American health insurance system creates apparent inequalities in health care among different population groups. At the same time, the influence of pre-existing conditions and insufficient expert medical supervision implicitly affects the country’s economy. Thus, universal healthcare is seen as the most appropriate approach to managing such diseases, both from the point of view of a fair approach to the provision of medical care to all segments of the population and from the point of view of supporting the country’s economic development.
Today it has become evident that chronic respiratory diseases are a global problem that imposes a large public health burden in the U.S. and internationally. As stated by Dwyer-Lindgren et al. (2017), “A total of 4 616 711 deaths due to chronic respiratory diseases were recorded in the United States from January 1, 1980, through December 31, 2014” (1136). Despite the improvement of preventive and therapeutic methods and the emergence of new highly effective drugs in the arsenal of doctors, respiratory diseases continue to remain a challenging problem of modern medicine, which is associated with a high incidence of both children and adults, frequent complications and colossal economic damage caused by them.
The main drawback of the health care system in the United States is the following: the cost of treating one resident is the highest globally, but at the same time, there is a relatively high mortality rate, especially among members of racial minorities. Large socioeconomic groups do not have access to regular health care. Experts offer various explanations for the low effectiveness and high cost of medical care in the United States. First, many Americans do not have access to insurances. Second, the focus is on disease diagnosis rather than on occupational health and safety and disease prevention.
Twenty million Americans have similar insurance. On average, the monthly payment is $ 440 per person, per family – $ 1168. There are also two government insurance programs. The federal Medicare program for seniors over 65 and disabled is funded by a 2.9% payroll tax split equally between employee and employer (and 0.9% on income over $ 200,000 per year). And for low-income citizens, there is a Medicaid program controlled by the state authorities (64 million insured) (Gee & Spiro, 2019). The remaining 28 million Americans (or 8% of the population at the beginning of the epidemic) did not have any health insurance (To et al., 2020). When the latter seek help, they are forced to pay the full cost of services out of their own pockets, and very often, it is not affordable. For 2019, these administrative costs alone were estimated at $ 496 billion, or 13.8% of total expenses (Gee & Spiro, 2019). As noted by Dwyer Lindgren et al. (2017), “Costs due to chronic respiratory diseases increased by 3.7% per year between 1996 and 2013, resulting in an estimated $ 132 billion in personal health expenditures in 2013” (1136). This leads to undertreatment, inappropriate approaches in self-care, and many other deficiencies.
At the same time, the introduction of temporary measures to support citizens does not solve the problem. According to Galvani et al. (2020), “Although they are permitted to purchase insurance on the federal exchange, switching networks disrupts continuity of care, which is particularly detrimental for those living with chronic health conditions. Furthermore, the majority of families are unable to afford health insurance upon becoming unemployed, given that more than half of American families live paycheck to paycheck”(para. 3). To et al. (2020) focus on the social and economic impact of COVID-19 on people diagnosed with chronic respiratory diseases. The critical message here is that “the US CDC reported CRDs (mainly asthma) as the second most prevalent comorbid condition in hospitalized COVID-19 patients aged 18–29 years” (para. 3). This is the particular case of the U.S. since, in other countries, CRDs have not become a major comorbid condition. The reason for that is that in the U.S., people mostly do not have access to an appropriate treatment of these diseases or do not know about their existence at all, i.e., have never been diagnosed.
Galvani et al. (2020) argue that universal health care must be addressed to combat the development of COVID-19 pandemic in the United States. The researchers place particular emphasis on the loss of health insurance due to their inability to work. At the same time, people with pre-existing conditions, being in the most severe risk group from the consequences of coronavirus infection, often cannot afford not to work. This is especially true for vulnerable groups of the population, where racial and economic conditions become primary and interrelated. Thus, universal healthcare becomes an obviously better choice for combating CDRs as pre-existing diseases, especially in the times of the COVID-19 pandemics.
References
Dwyer-Lindgren, L., Bertozzi-Villa, A., Stubbs, R. W., Morozoff, C., Shirude, S., Naghavi, M.,… & Murray, C. J. (2017). Trends and patterns of differences in chronic respiratory disease mortality among U.S. counties, 1980-2014. Jama, 318(12), 1136-1149.
Galvani, A. P., Parpia, A. S., Pandey, A., Zimmer, C., Kahn, J. G., & Fitzpatrick, M. C. (2020). The imperative for universal healthcare to curtail the COVID-19 outbreak in the USA. EClinicalMedicine. Web.
Gee, E., & Spiro, T. (2019). Excess Administrative Costs Burden the U.S. Health Care System. Center for American Progress. Web.
To, T., Viegi, G., Cruz, A., Taborda-Barata, L., Asher, I., Behera, D.,… & Conceiçao, C. (2020). A global respiratory perspective on the COVID-19 pandemic: commentary and action proposals. European Respiratory Journal. Web.