The uninsured in U.S. raise Ebola risk

Want to stop Ebola in the U.S.? Make sure everyone gets fast care even if they don't have insurance.

By Laurie Garrett
The Chicago Tribune, Oct. 2, 2014

Fear of Ebola has been climbing steadily in the United States since Tuesday's announcement that a Liberian traveler in Dallas, Thomas Eric Duncan, was diagnosed with the disease after having been in Texas for eight days.

A month ago, a Harvard School of Public Health poll found that 39 percent of Americans thought an Ebola outbreak would come to the United States, and 26 percent felt concerned that they or a member of their family would get the disease. ...

[The case] has drawn our attention to America's unique vulnerability to contagious diseases: our health system. ...

America's special risk, not shared by our Canadian neighbors or European friends, is the 13.8 percent of Americans — about 43.3 million individuals — who still lack health insurance, and millions more whose policies entail copayments that are exorbitant for working people. These are the Americans who routinely tough out the flu, fever, aches and pains because seeking medical care is prohibitively expensive. If they become sick enough to feel desperate, the uninsured and underinsured of America go to public hospital emergency rooms for care, where waiting times in often-crowded settings can stretch on for hours. This reality is compounded by a weakened public health infrastructure: 52 health agencies, including 48 states, three territories and Washington, D.C., have reported budget cuts since 2008. ...

America's special vulnerability to Ebola is its limitations on access to health care. In times of contagion, societal risk rises with every uninsured or underinsured individual who struggles to work or goes to school with a fever and avoids bankrupting visits to health providers. ...

Laurie Garrett is senior fellow for global health at the Council on Foreign Relations and a Pulitzer Prize-winning science writer.

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