The price of health

How the COVID pandemic shifted American health care


Graphic by Zariah Arrington

Hanna Asmerom and Anjy Fadairo

The COVID pandemic shifted numerous aspects of global economics and health care. 

In the United States, however, economics and healthcare overlap more often than not. This intersection has monetarily changed medical supply chain and access for many—particularly low income Americans—forever. 


The economy and health care supply chain then vs. now

According to the Center on Budget and Policy Priorities, COVID-19 ended the largest American economic expansion on record. 

Kristin Blevins, Hockaday AP Economics teacher, said the economy pre-COVID was in good shape and had a relatively low unemployment rate.

“We certainly had been seeing a lot of growth in GDP,” Blevins said. “We’d be on this upward trajectory since the Great Recession in 2008.”

However, even during this time of American economic prosperity, healthcare access was difficult to come by for numerous Americans. 

Prior to the COVID pandemic, health care access in America was one of the most expensive in the world.

In 2019, healthcare insurance premiums were estimated to cost $7,188 per year, according to the Kaiser Family Foundation. While in 2019, the average annual cost of Norwegian healthcare was around $280 per person.

A 2016 report by the Commonwealth Fund said 33% of American adults failed to receive necessary treatment due to costs. 


Economy and Health Care Access the Height of the Pandemic and Now

According to the Brookings Institute, the COVID pandemic caused a steep drop in economic output. 

Accompanied by inflation and unemployment, by June 2020 the cost of health care quickly exceeded the pre-pandemic cost for many individuals and families, according to JP Morgan Chase.

Because of troubles finding support in the medical industry as well as troubles with receiving necessary care, many have sought alternatives to the traditional healthcare industry such as distributed care and boutique care. 


Distributed Care

“Distributed care” is the term used to describe the process of taking medical care to patients instead of patients having to go to doctors’ offices. 

According to Phillips, in some instances, distributed care is given in the form of Telehealth – where patients and caregivers communicate via electronic devices. 

In other instances, according to Orion Health, distributed care is home-based and focuses on providing hospital level care in patients’ homes as well as providing services to monitor potentially serious illnesses.

Hockaday science teacher Carol Taylor particularly draws a connection between distributed care and the elderly. 

“I think that is a smart use of our dollars in the health care system,” Taylor said. “A lot of elderly people do need to be checked up on regularly, so having nurses come to the home and check on these people is a great thing.”

Even though it has existed for numerous years, distributed health care – particularly the “telehealth” aspect – grew during COVID and continues to be used.

Because of shelter-in-place requirements and social distancing, several of the barriers that previously existed with distributed care began to crumble during COVID, according to Matt Cohlmia, Executive Director of Digital Strategy at Providence Health.

Some believe that distributed care is one of the first steps towards fixing the current “sick-care” system that prevails in American healthcare. 

While the United States has many medical advancements superior to those of other nations, the current distribution of the services available are not equitable, comprehensive, or cost-effective, according to Physicians for a National Health Program. 

This is where distributed care may come in. 

According to Orion Health, moving services into a person’s home gives distributed healthcare the potential to better healthcare quality, reduce costs that may result from in-hospital visits, and improve the overall experience for the people who receive the care. 

Boutique Medicine

Also referred to as retainer-based care, concierge practice and direct care, boutique medicine is a type of private care where doctors often require direct payment for their care instead of insurance.

 This allows doctors to charge for not only a diagnosis and treatment but also for the time spent talking with and caring for their patient.

In an article for Forbes Health, Sequita Richardson, M.D., a family medicine physician said, boutique medicine is often more attractive for doctors than traditional medicine because it allows doctors to avoid many of the complications that accompany insurance.

“Primary care on demand sounds attractive because you can get back to doing what you love to do,” Richardson said.

For patients, boutique medicine allows more time with doctors and easier access to medical services. 

While not mainstream or mentioned often in the media, boutique medicine is said to be increasing, particularly amongst doctors. 

Even though boutique medicine helps physicians manage their workload, earn more money and provide better services to patients, the system is not perfect, said Russell Phillips, director of Harvard Medical School’s Center for Primary Care in an article for the Scientific American.

Phillips also said concierge medicine can leave many patients without primary care physicians at a time of increasing shortages in primary care clinicians.

In addition to leaving some patients without a primary physician, the heightened expenses of boutique medicine excludes a large part of society that can’t afford the doctor’s specialized care.  

According to Forbes, fees of concierge care can total $1,200 to $10,000 a year.

Blevins says boutique medicine can widen economic divides that already exist in medicine today. 

“In this situation there is an incentive for good, high-quality doctors to cater to a crowd that can pay,” Blevins said. “I think that it provides different access for people who can afford it.”

Taylor thinks while this system may create disparities, it’s ultimately every doctor’s choice whether or not they choose to work in boutique medicine.

Having nurses come to the home and check on people is a great thing

— Carol Taylor, Infectious Diseases Epidemiology teacher

“Some doctors would prefer to pick up a handful of patients who they treat in their homes as opposed to seeing lots of different patients in a hospital setting,” Taylor said.