The country’s most fragile are about to face their worst moment yet.
Medical transport companies like ours see thousands of America’s most vulnerable daily. They’re the severely diabetic, the blind, the elderly, and the mentally ill—people with no one to shuttle them to their doctors.
These peoples’ lives are already marked by isolation. And if they were cut off from the world before COVID-19, they are even more so now after nine months of social distancing and a new surge making it even more challenging for those with comorbidities to get care.
State budgets are bleeding red. With unemployment and business failures up, tax collections have nowhere to go but down. State and local revenues will slide 5.5% this year and 5.7% next year, according to Brookings Institution projections in September. Throw in new rounds of shutdowns, and it’s about to get worse.
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After the federal government’s initial cash infusion to medicine and the economy, Washington’s urgency has diminished. Some leaders are reluctant to aid suffering states, fearing the money will go to cover past, less-urgent initiatives, rather than the crisis of the moment.
Talk of austerity once again echoes through the halls of Congress.
Short-sighted view of dollars and cents
It’s at moments like these the fragile tend to suffer most. Medicine and social services compose huge chunks of government budgets, making them inviting targets for cuts. The vulnerable can’t compete with the armies of lobbyists pressing other needs.
But to cut funding now isn’t simply an issue of compassion. It’s a short-sighted view of dollars and cents.
Imagine being ill, destitute, and physically or psychologically unable to navigate the basics of self-care. You’d have little or no access to the internet — making telemedicine almost useless. You’d also be at high risk of the coronavirus surging throughout your community.
For these reasons and more, the vulnerable delay care. They skip sessions with psychiatrists. Ration their insulin. Ignore symptoms until they’re too painful to bear. It doesn’t take long before preventive medicine turns into a full-blown emergency.
That’s when they’ll be thrust upon hospital systems, which are already in crises of their own, with worker shortages and packed ICUs. A trip to a clinic for an urgent medical problem can become a hospital stay, with an average price of $11,700, according to the most-recent information data from the U.S. Department of Health and Human Services. Doctors and nurses needed to battle COVID-19 are pulled away for emergencies that never had to be.
After discharge, America’s most vulnerable citizens still need help when they arrive home.
Someone needs to ensure they’re getting meals, taking medicine, and wounds are being treated before sepsis sets in. If not, these often-uninsured patients boomerang back to the hospital in a matter of days. And the hospital, already suffering financially from reduced surgeries and other non-emergency care, is stuck with unpayable bills.
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To ignore all this, in the name of austerity, is to jettison everything we know about medicine. The greater the patients’ health on the front end, the greater the outcomes and the cost savings on the back.
We should keep this in mind as leaders begin to eye spending cuts for medicine and social services. Admittedly, states are in a bind. There’s no money to spare.
Yet the vulnerable can’t simply be closeted away and told to wait for better times as services are cut. If we allow politicians to slash government spending, our most fragile citizens’ health and wellbeing will quickly reach the crisis point.
State and local governments, plus taxpayers, will be paying a whole lot more on the back end than we’re saving today. Meanwhile, the price to our humanity will be incalculable.
Kenneth Wilson is the Chief Operating Officer of LogistiCare.