Federal health officials continue to urge that it’s not too late to contain coronavirus in the US if people remain informed and vigilant.
So when Osmel Martinez Azcue returned to Miami from China and came down with flu-like symptoms, he thought getting tested for coronavirus was the prudent thing to do for his family, friends and community.
But what might have been prudent for public health certainly wasn’t for Azcue’s wallet. He asked for a flu test, and tested positive for that, more commonplace virus, but the peace of mind came with a more-than-$3,000 price tag.
Azcue told the Miami Herald that he’d had to switch to a health care plan with more limited, complicated coverage and higher out of pocket costs after his premiums for his old plan shot up.
It comes as two major issues in the US heat up: the coronavirus outbreak that’s spread around the world to sicken nearly 80,000 people (including 35 in the US), and the escalating debate over Medicare for All, other single-payer programs or the current US insurance system.
Osmel Martinez Azcue took every precaution when he developed flu-like symptoms after returning to Florida last month from China where the coronavirus outbreak began. He has flu, not coronavirus, but finding out left him with a bill of more than $3,000
Azcue is among about half of Americans whose employers don’t provide them with health care.
But he buys his own insurance separate from his work for a medical device company and takes care of his own health and that of his family.
He had also been alarmed just as the rest of the world was when what began as a few cases of mysterious pneumonia in China turned out to be a never-before-seen virus that soon swept around the globe, killing thousands and sickening tens of thousands.
So when Azcue started to develop flu-like symptoms – difficulty breathing, fever, coughing – he wanted to be sure he hadn’t brought coronavirus back with him after traveling to China last month.
World Health Organization (WHO) and Centers for Disease Control and Prevention (CDC) officials have warned that the new coronavirus – SARS-CoV-2 may be transmissible even in the absence of symptoms.
Azcue would normally have just ridden out the unpleasantness of flu at home with some over-the-counter medications.
But with a worldwide public health emergency ongoing, he wasn’t about to take any chances.
At a Miami-area hospital, Jackson Memorial Hospital, Azcue informed staff of his travel history, symptoms and concerns.
He was whisked into an isolation room and the nurses assisting him zipped themselves into white protective gear.
Azcue told the Herald that some sort of smoke – what he guessed was an aerosol disinfectant – beneath the door before entering.
He told the Herald that the Jackson Memorial wanted to give him a CT scan as part of the process of confirming or clearing him of coronavirus.
But a CT can cost anywhere from $270 to $5,000 according to American Health Imaging.
And with his limited plan, Azcue knew it would be on the high end and out of pocket for him.
Azcue held his ground with the hospital.
Azcue showed his passport which documented his history of travel to China. His efforts to make sure he didn’t contribute to the spread of coronavirus in the US cost him thousands
‘This will be out of my pocket,’ he recounted telling the hospital staff in an interview with the Herald.
‘Let’s start with the blood test, and if I test positive, just discharge me,’ he said, meaning the flu test.
It’s not clear if the CDC considers testing positive for flu a result that ought to rule out coronavirus, but that’s how Jackson Memorial took Azcue’s test outcome.
He was discharged with a flu diagnosis and a sense of relief.
Aczue never guessed that his new insurance would leave him with a $3,270 bill for a flu test.
Others have reported flu tests – the more thorough lab analyzed blood tests – as running as high as $900 before insurance coverage.
In addition to the flu test, Azcue may have been hit with charges for the protective gear, isolation and containment required to handle a patient who may have been exposed to coronavirus.
But something more bizarre was at play in his case as well. The National General Insurance plan he’d switched to last year has a clause that requires a new customer to prove they don’t have any pre-consisting conditions, via offering up three years worth of medical records.
Aczue hadn’t yet done that. So until he coughs up three years worth of medical documentation that there convinces his insurance company that he has no preexisting conditions that would lead him to develop flu, the health care provider won’t cover his bill.
‘When someone has flu-like symptoms, you want them to to seek medical care,’ said Sabrina Corlette, a Georgetown University law professor and co-director of the Center on Health Insurance Reforms.
‘If they have one of these junk plans and they know they might be on the hook for more than they can afford to seek that care, a lot of them just won’t, and that is a public health concern.’
In fact, the CDC has actually instructed hospitals and clinics in five US cities – Los Angeles, San Francisco, New York and Chicago – to start leveraging their flu tracing systems for coronavirus too.
Anyone who has flu-like symptoms and tests negative for flu is supposed to get tested for coronavirus.
And there’s no telling how much that test would have cost Azcue, or how his insurance company would have handled the pre-existing condition question with regard to a screening test for a disease that didn’t exist until a couple months ago.
High costs are cited as a reason that about half of Americans wait longer than they should or don’t see a doctor at all.
But with a highly contagious outbreak teetering on the edge of becoming a pandemic, there’s more even at stake than one’s individual health and well-being.
‘How can they expect normal citizens to contribute to eliminating the potential risk of person-to-person spread if hospitals are waiting to charge us $3.,270 for a simple blood test and a nasal swab?’ said Azcue.