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Comment by nl | Hacker News Reader

The big problem when Covid19 hits the US won't be the number of deaths (although of course there will tragically be many).

It will be the number of medical bankruptcies.

Also it'll be interesting to see how much more contagious it will be in a country where people avoid hospitals because of the cost.

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This is my big concern too. The bills are going to be massive, people are going to avoid the doctor because they don't have the financial means to pay. Everyone will be at increased risk because we've failed to have the decency to put together even basic universal health care in this country.

That's exactly why people will ignore the symptoms till they fall dead. This virus will be an interesting lesson for both China and America: China will learn the cost of being too authoritarian, since people there are afraid to seek help, and America will learn the cost of greed, since people here are afraid to well.. seek help, but for financial reasons.

It will be very very bad.

There is little to none surge capacity at US hospitals.

Why would you expect medical bankruptcies for something without any existing treatment? There is nothing to pay for.

The bigger problem is people who keep going to work when they're sick instead of staying home.

What are you talking about? ICU, ventilators, ECMO. None of that is free.

None of that is commonly required either. For the large majority of cases you stay home and wait until you're better. The primary danger here isn't that it's more severe than the flu, it's that it's more infectious to other people.

Contrary to popular rhetoric, only a small percentage of people in the US don't have health insurance. If so many people get infected that the intersection of people with such severe cases that they need ECMO and people without health insurance is any significant number of people, they're not going to have enough hospital rooms and equipment anyway. Which is hopefully not going to happen regardless.

How do you treat ARDS at home? I'm curious.

Even the test is thousands of dollars.

https://www.google.com/amp/s/amp.miamiherald.com/news/health...

And treatment for at least some cases involves hospital stays similar to pneumonia.

Everything is thousands of dollars in a hospital emergency room. They charge hundreds of dollars for a band aid. It's not the place to go for a routine diagnostic test if you care at all about the price.

I don't think coronavirus is a routine diagnosis. CDC missed the one this story bid about for example.

The test that cost thousands of dollars in your article was the routine diagnostic test for the flu. It didn't cost thousands of dollars because it was for the coronavirus, it cost thousands of dollars because it was done in an emergency room.

Sure, but the CDC is referring travellers with flu-like symptoms to hospital. It's not an outrageous thing to have done.

As of February 23, 11 travelers were referred to a hospital and tested for infection; one tested positive and was isolated and managed medically.

https://www.cdc.gov/mmwr/volumes/69/wr/mm6908e1.htm

thousands of dollars through the US health system, $4 on alibaba https://diagnos.en.alibaba.com/product/62484012192-213331414...

I daresay the quality may not be the same. Really the US govt should do free testing.

He literally made your second point - people _not_ going to the doctor because of associated costs

This is 100% true, not sure why you're being downvoted. I imagine this will be the leading cause for the spread in the US. We like to on the image that we're first world, but that's only in regards to our professions and their education and training. Once you get into the details of the rest of the system we are anything but that. The healthcare system is merely another profit generating tool in this capitalism-above-all nation.

And would you rather be in a Chinese hospital or an American one? And, before you answer, you might want to have visited a regular Chinese hospital first. In China, you would be safer far away from a hospital.

This is unfounded, xenophobic fearmongering.

You don't have to be racist to prefer a hospital in a wealthy first-world country over a hospital in an authoritarian third-world country.

Anyone who has experienced both can speak to the disparity.

China is not a third-world country.

True, especially since the definitions have shifted since the end of the cold war. China is a developing country.

Google "Medical Tourism India".

> It will be the number of medical bankruptcies.

There will be exactly zero medical bankruptcies because of this.

If you are poor you get free healthcare, or at least subsidized. If you have more money you buy insurance, or your employer offers it.

At most you'll have to pay a several thousand dollar deductible, which isn't going to bankrupt anyone (remember that poor people get the free version).

Most Americans cannot afford several thousand dollars and that much time away from work.

You’re wrong, on both points. 44% of Americans say they’ve skipped going to the doctor because of costs: https://www.forbes.com/sites/brucejapsen/2018/03/26/poll-44-...

40% of Americans would have difficulty paying an unexpected 400$ expense: https://www.federalreserve.gov/publications/2019-economic-we...

28 million uninsured: https://www.census.gov/library/stories/2018/09/who-are-the-u...

Tens of millions more are under-insured.

40% of Americans can't afford $400 for an emergency expense: https://www.federalreserve.gov/publications/files/2017-repor...

You have no idea what you're talking about.

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