The novel coronavirus is forcing Americans to go it alone. This is happening in a shockingly literal way, as families scatter and freeze and shelter in place. And it is happening in a structural way too: When calamity hits, Americans tend to face the shock by themselves.
Americans are no less susceptible to disease, joblessness, and family changes than their peers in rich nations, but they are made more fragile by these crises. The country has a thinner safety net, fewer public goods, and less social insurance than other countries. The United States spends roughly what other Organization for Economic Cooperation and Development nations do on pensions, or Social Security, and more on health care, for less coverage and worse outcomes. It spends less than a third of what the average OECD country does on helping the jobless, about a third supporting families with kids, and 50 percent less on incapacity, meaning disability, sickness, or injury that might keep a person from accessing the labor market.
Perhaps the country’s most pressing problem is its high uninsured rate. Every other country as wealthy as the United States has figured out how to cover its entire population, generally at a much lower cost, too. But roughly one in 10 Americans lacks any form of health-insurance coverage, which may lead them to delay seeking out medical help when they need it. For many of those with coverage, health care is still unaffordable and inaccessible. The average American family with private coverage pays $6,015 a year for insurance, on top of what their employer pays. On top of that, the average individual has a deductible of $1,573, meaning they need to spend that much out of pocket every year before their coverage kicks in. On top of that, many plans come with required “co-insurance” payments that are applied even after a person hits their deductible. These costs discourage sick individuals with insurance from seeking care. They also saddle American families with tens of billions dollars of debt a year: Two-thirds of American bankruptcies are related to medical bills.