Hamblin: So you’re describing a lot of sacrifice and risk taking and heroism on the part of health-care workers. And we’ve heard a lot about that and hope to keep hearing more. And something I’ve been thinking about as well, and heard I guess not quite as much about, is the cost to patients financially. How bad is this hitting people who may be underinsured and coming in and ending up with a lengthy hospital stay?
Forman: Yeah, so it’s not clear to any of us precisely how well the first, now almost four, COVID bills that have passed Congress are going to protect the average individual, who may or may not be underinsured or uninsured. We know that testing is covered in most cases, and even that, by the way, from the hospital point of view is not being reimbursed yet.
Hospitals are still sort of footing that bill at a time when their cash flows are significantly compromised. But I think that individuals are potentially being exposed to their full deductibles and I don’t think hospitals are in their best position to be able to forgo collecting those dollars.
And so we’re back to a situation where our very fragile health-care system that, you know, has never served everybody particularly well in an egalitarian way is probably putting people on the lower quarter—not even the lowest part of society, but the lowest quarter of society—at great risk. I mean, about one in four people in this country is either uninsured or underinsured. And those individuals are at greatest risk right now.
Hamblin: I’ve seen numbers reported from $20,000 into the $70s for hospital stays. And like you mentioned, there’s sometimes some room for hospitals to not collect or to lower the charges if people are unable to pay. But as you said, many don’t feel they’re in a position to do that right now, because elective procedures and other revenue streams are gone. Do you think that a number like that is influencing people’s willingness to come in and get tested and treated, when they see that this might set them back in ways that would bankrupt them?
Forman: I think that’s always present for this population. When somebody is under- or uninsured and they have any symptom, whether it’s of appendicitis or chest pain or a stroke, and they know they may be on the hook for a hospital bill, I think they always have this concern. And I think we’re just seeing it in a much more stark way, because as you point out, the average length of stay for a COVID-19 admission is 6.2 days. At least where I am, I think that’s the average length of stay right now.
And by the way, that’s the average length of stay including people who die. So it’s probably longer for people who live. And once you start factoring that in, the numbers you mentioned are perfectly reasonable, not affordable but reasonable, in the sense that I think $20,000 is sort of the lower limit of what probably a charge would be for a COVID admission and far higher than that for people that are in the ICU for several days. Far, far higher.