Withdrawal of COVID funding exacerbates health care disparities

On September 18, 2022, US President Joe Biden declared the end of the pandemic in the US. The remarks in a televised interview come after the US Department of Health and Human Services (HHS) announced it may stop purchasing and providing SARS-CoV-2 vaccines and antiviral treatments as early as January 2023 due to insufficient funding from Congress , which would mean people would only be able to get vaccines and treatment through their insurers or by paying themselves. However, administration officials say the president’s comments do not reflect a change in policy and that COVID-19 is still a public health emergency.
Withdrawal of low-cost or free care for COVID-19 does not take into account the 30 million Americans of all ages who do not have health insurance (2021 data), despite the role of the Affordable Care Act in helping more people afford it coverage. Without affordable access to testing, vaccines, and treatment, the uninsured are at risk of being left without the necessary protection against SARS-CoV-2 infection and severe COVID-19. In analyzes of the ethnicity of the uninsured, Hispanic adults were the most likely to lack coverage, followed by non-Hispanic blacks, non-Hispanic whites, and non-Hispanic Asian adults. Racial and ethnic minority groups have poorer overall health than their white counterparts in the US, and perhaps not surprisingly, the demographics of those who are uninsured coincide with those with poorer health outcomes. However, HHS announced it is launching an initiative to help uninsured and underinsured Americans access the COVID-19 monoclonal antibody treatment bebtelovimab, even though it is already commercially available.
The move away from government funding for COVID-19 prevention and care comes at a time when US inflation is the highest since 1981, and related increases in the cost of living and health care costs mean people are experiencing unprecedented strain on their finances. High health care costs have resulted in an estimated 98 million Americans skipping medical treatment, cutting back on other essentials, or even taking out loans to pay medical bills.
Over the past few months, the US healthcare industry has lobbied for increased federal spending in response to the pandemic and increased inflation; as a result, Medicare increased its payments to hospitals by the highest amount since 1998. While much of this funding is invaluable to facilities that are in dire need of support, such as rural hospitals, other hospitals have used these COVID-19 relief grants as a way to acquire additional facilities or practices. As larger hospitals and health systems increase their market share, the average cost of health care services provided also increases (by 6–18%) without an associated increase in the quality of care. Americans, who see their life expectancy decline from 78·8 years in 2019 to 76·1 years in 2021 — the lowest level since 1996 — are bearing the brunt of the health care sector’s focus on financial profits , paying more for poorer health.
During the pandemic, some of the most affected communities were low-income households and people of color; decisions to improve health outcomes in these groups must be implemented now, before the onset of winter and the approaching flu season. In the US, steps should be taken to make health care and preventive care more affordable and accessible to underserved communities, including increasing Medicare availability and considering price caps on health care products or services. A thorough review of existing systems is urgently needed to understand why, although the US spends more on health care (as a share of GDP) than other high-income countries, the effectiveness of health services and measures of health outcomes are so poor. With the new omicron variant SARS-CoV-2 vaccines recently approved by the US Food and Drug Administration, it could be argued that now is not the time to declare the pandemic over and stop government-funded vaccination and treatment. as this may discourage compliance with the current COVID-19 measures.

During this period of economic uncertainty, and as the world continues to respond to the acute and long-term health consequences of SARS-CoV-2 infection and COVID-19, access to adequate health care is paramount to promoting health equity in the US and beyond .

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