As an Emergency Department nurse working for one of the most profitable health care systems in New York I have a rather large deductible. I addition to the fact that I must contribute a larger share of my income just to have it. Not to mention the fact that fewer and fewer doctors accept my health insurance leading to a larger co-pay for routine visits. My primary care physician no longer takes my insurance. My health insurance is a vestige of the plan I had when I started some 13 years ago. One would think that those who are on the front lines of medicine, taking care of the sickest people in the city would have some of the best health care. Not so. Not so at all.
2
Oh I think cost sharing does indeed have a clear purpose - to discourage people from making doctor visits, because doctor visits cost the insurance company money.
5
Dr Carroll, what are the “high-cost” options that people should be paying more for?
How can I know as a patient if treatment is high-value or low-value?
4
Thank you so much for this essay. Cost sharing in the form of deductibles, copays, and coinsurance is nothing more or less than a way private insurance can hide its cost to the consumer. It is increasing at a more rapid rate than premiums themselves.
It also promotes the basic business model of for profit insurance: care unused equals profit. Out of pocket often disincentivizes personal and public health, as insurers were forced to recognize when they excluded coronavirus testing.
No one who needs emergency surgical care or a high tech cancer treatment is going to delay that care because of a deductible. Only about 10% of the national health care budget is spent on primary care: all you have accomplished with deductibles is to discourage prevention. Ban it!
8
Young people are the ones most likely to choose a large deductible as it reduces the cost of the premium. They figure they rarely get sick so why pay high premiums? Now we know. Can you imagine having to satisfy a $6,000 deductible (not unusual) so you can take a young child to the doctor? Truly outrageous and unwise, especially now.
2
Remember that a huge number of employers who provide health coverage are self-funded. That means the employer is footing the bill and the carrier is only processing claims without any financial responsibility — or potential profit from denying care.
These self-funded employers can design their own plans to give first-dollar coverage for what they deem appropriate. Too often, inertia and bad advice get in the way of good decisions.
Still looking for someone who can tell me a good reason for putting a payment barrier between a person dependent on insulin and their insulin.
7
The main purpose of cost sharing is to help insurance companies to be more profitable.
13
These are excellent points. However, they presume insurance is issued to benefit a persons health or even the health of a population. Private insurance is not intended to do that. The purpose of private health insurance is to generate a financial profit for shareholders. Period. Nothing else.
A government run insurance program is there to better the health of individuals and the population. Not to create a profit. Period.
That is why these ideas only have a chance if we create a health coverage program of the people for the people - a gov't program. It doesn't mean the government owns and runs everything; just that the insurance program you speak of and the payment policies you discuss are government run. Like a Medicare for All program. Yep, that'd solve the problem you describe - and many more.
18
“Cost sharing” will be the real problem if coronavirus becomes more prevalent. Everyone, and I mean everyone who has insurance has a policy that costs them something to get medical care of any kind. There’s your co-pay. Deductibles range from as little as $1,500 (rare) up to $7,500. Oh, and then that 20% or more that really socks you. And the clock started ticking January 1. Very few people have used up their deductible. So a stay in the hospital in ICU, or even just an ER visit with a coronavirus test will be out of pocket. And so everyone who is exposed will be left with a big bill. Talk about tanking the economy.
8
@Office manager
wrote
"Everyone, and I mean everyone who has insurance has a policy that costs them something to get medical care of any kind. "
If you mean a fee for each medical service, Dr. visit, not true. I am covered by Medicare, and have an additional Medigap Plan F to cover any co-pays, co-insurance or deductibles for Medicare Part A or B charges.
So beyond the $177 I pay every month for Medigap Plan to BCBS I do not pay anything extra.
Sad that all Americans can't enjoy Medicare for All.
From what I can see the "unnecessary" testing is anything that doesn't give an immediate diagnosis. My child has had test after test trying to find out what is wrong with him. Some tests show issues that sent us one direction, other tests came back clean preventing us from going down the wrong path. We are fortunate that we could afford to run all these tests and find an answer. I have met many parents like me with the ability to afford their child's care until they get a diagnosis and treatment. I have also met many parents that know something is wrong or suspect it and can't afford the visit to the specialist much less testing or treatment.
6
Health insurance is certainly a key issue related to Covid-19, though most elderly Americans are covered to partially (not entirely) by MediCare.
Elsewhere in today’s NYT: “The State Department on Sunday advised Americans against traveling on cruise ships, warning that they presented a higher risk of coronavirus infection and made U.S. citizens vulnerable to possible international travel restrictions, including quarantines.”
My wife and I are in our 70’s so today I called regent cruise line to cancel our upcoming cruise to the Baltic. I was informed that our $4,000 deposit would not be refunded but instead put in a “Reassurance Account” to be applied to a future cruise that must be booked within a year.
No one knows if the coronavirus will be gone in a year, my wife and I are getting older and less mobile, and based on recent events we have zero confidence in the ability of Regent and other cruise lines to keep their ships from becoming floating Petri dishes.
Indeed, based on my conversation with Regent today I can confirm that cruisers (especially the elderly) are at higher risk of contracting coronavirus and totally likely not to receive refunds.
Exposure to coronavirus is frightening and disruptive whatever one’s age, so think twice—or 3 or 4 times—before booking with Regent or any other cruise line; they do not refund deposits even when their trips are scheduled to stop in countries with confirmed coronavirus cases and government recommends not taking cruises.
6
@Mon Ray
If you paid for this cruise deposit, with a credit card you may be able to "charge back" the $4000. The cruise company may cancel the cruise anyway, so the service was never provided.
Worth a try. Dispute the charge, saying the service was never provided.
1
I am a newly dx asthmatic from my no smoking building's smoking violators. I can't afford any of the inhalers, and my part D plan mail order simply held all of the scripts I did request and never processed them. As a result, I gave up. I no longer take any prescription meds, and I stopped seeking medical "care" because of the many obstacles the hospital-based system placed on even getting to an appointment, let alone receiving treatment which resulted in any improvement. I am imprisoned in my stinking apartment and sit within 6 feet of a room air purifier. My quality of life is near zero. But it was not improved when I sought care and treatment. The whole thing is built to cause and amplify patient suffering so that the for-profit entities thrive.
3
"A better model might target people who choose high-cost options, increasing their cost sharing. Under a reference pricing system, for instance, insurers commit to pay the full cost for some lower-cost (but high-quality) care, and patients must pay the difference if they decide to go to providers that cost more."
Yes, reference pricing would also put pressure on providers to lessen excess procedures and tests, if they want to keep attracting cost-conscious patients. Coupled with price transparency, this would actually let that mythical market work better. The whole idea of massive deductibles as a way to have people "have skin in the game" was an illogical premise at the get-go, when patients don't know what medical care costs and can't shop around.
8
My Medicare Supplement plan is more than 6k yearly. I run the numbers every year and every year it is still “cheaper” than any other way. It covers everything Medicare doesn’t pay including deductibles and co-pays, even on prescriptions, but the drain on my finances is crushing. If I ever wanted to move to another state I would lose it. I have too many issues not to have a supplement.
The American health insurance industry is just that, an industry. Their lobbyists seem to have more power and influence and money than our government itself. All they care about is profit. Patients are faceless and incidental, to them as well as our legislators. Cost sharing is one-sided and cruel, and guess who bears the brunt of that?
16
@JKI if you move to another state, you are guaranteed access to another supplement regardless of your health. I agree with you on the cost. It’s pricy but the best option.
@JKI
When you say Medicare Supplement plan, I assume you mean a Medicare Advantage plan.
Which basically is Private Insurance, with a limited network, subsidized by CMS.
I don't know why seniors pick these plans. My wife and I have Original Medicare with a Medigap Plan F from BCBS. So we pay an extra $177 a month for this Medigap coverage, which covers Part A and Part B deductibles, and Part B excess charges. We NEVER have any co-pays or deductibles for any Medicare covered procedure.
I highly recommend the book,
"Medicare Demystified", by Dr. Ronald Kahn to understand these complex types of Medicare plans.
2
@Dtl If it's a medicare supplement, the coverage should be the same in other states. There is no g'teed right to a new plan if you move. It is possible that it is a "select" supplemental plan that will not cover the Part A deductibles at out of network hospitals. There is a g'teed right to a new plan if you move from the service area. More likely based on it covering "everything medicare doesn't pay..including prescriptions" is that it is employment related or the author is very confused ( not unusual). As for the possibility of it being a Medicare Advantage plan, not likely at $500 a month.
We are not all medical doctors. How should we know if a lab test or treatment is "worth it?" When you're loaded into an ambulance due to a heart attack or stroke, do you stop the emergency responder to ask, "Excuse me, can you give me the cost breakdown of the two nearest hospitals so I can tell you which one to take me to?" Any health care strategy that relies on sick individuals to consider cost above care is immoral. When someone is sick, their first thought should be "How do I get the care that I need?" not "How do I get the care I need at a reasonable price, assuming it's a worthwhile exercise?" Unbelievable.
18
I believe that any plan the politicians come up with will take into the financial welfare of insurance companies ,big pharma and hospitals before the general public.
It's a high-roller nation out there
11
It's almost like the politician pushing for Medicare For All might be on to something. Hopefully primary voters are thinking about this given the CNN polling showing that either candidate is likely to beat Trump!
9
Before I qualified for Medicare, figuring out the balance between premiums and deductibles was an annual chore.
A $3000 deductible and a premium that would be more than half the cost of my rent? Or a $5000 deductible with a slightly lower premium? Either way, I couldn't afford to use the insurance.
This is real life outside the affluent bubble, and I was better off than many other people I knew, such as the friend who was in chronic pain from both back problems and bad teeth but couldn't afford to get either treated.
Deductibles are just another link in the insurance industry's never-ending quest to rake in ever-increasing premiums and avoid paying out benefits. I actually had a policy with small copays but no deductibles in the 1990s, and the insurance companies did just fine.
If private insurance companies were abolished, I would feel sorry for the low-ranking employees (a bit more sorry than corporate executives felt when they sent the rank-and-file jobs in the garment, furniture, shoe, steel, and appliance industries to the Third World), but I would have no sympathy at all for the vultures at the top.
24
@Pdxtran They would lose their job, but at least they wouldn't lose their medical insurance.
8
Cost sharing is an attempt to decrease access to care for non-emergent/non-urgent cases. This is very common. Colds, mild body aches, etc often overwhelm urgent care/PCM offices. Patients often want antibiotics immediately when they get sick despite it likely being viral. They then fill out negative patient satisfaction surveys that then dings the physician or provider.
In a single payer system, this care would be decreased by triage. Only those needing to be seen immediately would, and the rest would probably get better before needing to be seen. This is also called rationing. Patients just need to understand that the impact and affect of both copays and single payer are the same. The only difference is who tells the patient no. You can see this in the UK where wait times for PCM and non-urgent care are long. I would love to have those silly surveys go away, but alas the trend is toward pt satisfaction and not outcomes or good medicine. Cue the discussion about 20% of care being unnecessary. I see this every day.
6
It seems to me that the healthcare system in the US is something that only the CEOs of the insurance companies might like, and cannot, for the life of me, understand how anyone else would not want universal care. My workplace pays something like $26K/year for me and my family to have insurance; I contribute another ~$6K/year, and still, it is considerably cheaper for me to drive across the border to purchase my medicines than to buy them in a US pharmacy. On top of that, is the fact that whenever I go to see a doctor, I have to pay a copay of $40, and after a couple of visits, I get an utterly incomprehensible bill telling me that I have to pay more because of my deductible, blah blah blah... it is complete madness... but since we are the greatest country in the land, the land of the free and so on, well, I suppose things could be much worse.
13
Or how about Medicare for All? Radical, I know.
16
This epidemic should be treated exactly the same as the Sabin Oral Polio Vaccine in the 50's. It is in the interest of all people to have free testing, treatment and eventually vaccination.
Every man, woman and child received the 3 doses on separate days and was administered at the schools to make sure everyone had access.
Keep It Simple Stupid applies here.
19
Even over here in Europe, I can hear the U.S. health care providers (doctors, hospitals, insurance companies, etc.) licking their chops at the thought of all the money they're going to make due to the virus. They've probably renamed it "the cashcow virus." Everything about the U.S. system is mercenary: premiums, deductibles, co-pays, on and on. Americans live under the tyranny of the health care industry and seem unwilling to force changes that would make their lives better. Oh well..
25
I think I just had an experience with "reference pricing" when trying to book an MRI. An insurance agent called me as part of their "informed choice program" to encourage me to book at another in network place that was cheaper though less convenient. I ended up paying less but had to wait longer to get the MRI, wasted a good chunk of time getting my results where they needed to go, and oh, learned that the insurance agent gave me wrong information about my deductible and the prices for services. Informed choice indeed.
22
@Laurabat I had the same experience with an MRI. I spent half a day on the phone with the insurance company and on their website to locate a facility that might save me some money, as I knew that the facility owned by the local mega-hospital system was exorbitant. In the end, the supposed 'estimate' the insurance company provided bore no relationship whatsoever to the ultimate cost and the deviation was not trivial. It was off by several hundred dollars. Dealing with the health insurance system in this country is itself detrimental to health.
10
@Laurabat
I decided to pay out of pocket for an MRI. I got it done the day after seeing the Dr. It was the same facility and read by the same Dr.s as I would have gotten through insurance. It was half of what I would pay through insurance with their "special price".
A single payer system will only be less expensive if measures are taken to introduce real capitalism, with competition, into the hospital industry and pharmaceutical companies.
If real reforms to those rapacious industries, which are a huge drag on our economy, it won't matter if its Medicare for All or old fashioned private insurance.
3
This makes sense. So why are insurance companies not offering these kinds of plans, creating incentives for doctors to prescribe/recommend based on cost-benefit considerations?
2
Deductibles are counterproductive by discouraging early treatments, leading to more expensive treatments later, and to a much higher risk of serious consequences. In a pandemic like the current Coronavirus one, both deductibles and co-pays are incredibly counterproductive. We're all in this together, and those most likely to be deterred by cost include many with lots of contact with the public - food servers, nursing home aides, transport workers, cleaners ... which greatly increases the risk to everyone.
18
Ever since Obamacare came into effect, my insurance was weakened, and my co pays jumped. My annual deductible is a joke. I just paid $300 for an inhaler for my son. I am not alone. Something needs to be done. The insurance companies, and medical industry are all in great shape and many of us are not.
24
@The Realist Individual health insurance has increased in price each year since long before 2010 when the A.C.A (Obamacare) became law. Your imagination that health insurance inflation only started after 2010 is entirely false.
22
Not imagination Stu. Real experience. I have been around the block more than once. It's worse now.
2
@The Realist I don't doubt your experience (my experience has mirrored yours) only your time frame. You say "since Obamacare" as if that's the problem....when in fact it was because health insurance was skyrocketing in cost, covering less, and limiting choices that lead to passage of Obamacare. The GOP assault on its implementation -- with NO "replace" options ever attempted -- has exacerbated the problems.
23
There is no perfect system. To insinuate that an epidemic justifies socialized medicine is a poor argument. NY has already announced it will cover all. The federal government has announced that it will cover the cost of anyone who cannot afford it and the CDC has been saying it will cover costs as well. Private insurers are considering covering the costs for testing in lieu of the epidemic to encourage people to go to their doctor.
The point is that institutions are bending in lieu of the crisis.
1
@Deb
In other words, we're relying on socialized medicine -- government agencies to "cover the costs" -- during thus medical crisis. (Do find time, Deb, to check the meaning of "in lieu of.")
18
@Deb
No 26 million uninsured Americans "justifies socialized medicine".
Every other Industrialized First World country does it. Why can't we?
And simply paying for the first, diagnostic COVID-19 test, isn't enough. What about the Americans (not covered by Medicare) who are hospitalized? They will be bankrupt, and so will their families.
5
My high deductible plan is $2000 per year lower than the PPO plan (savings in my pocket) and I am putting money into the HSA account every year.
A doctor visit (urgent care or even ER) may be a few hundred dollars. You are much better off under a high deductible plan if you don't have a chronic condition, take the savings you pocketed and go see a physician.
People buy 4 new tires for their car every day (can be a $400 or more expense).
4
Health deductible are needed but they should be affordable.
If you eliminate co payments and deductibles you encourage the abusers of the system like hypos and other people who love to live in the doctors office and run up the cost for the average person.
If you make them onerous especially for the poor, you deny them needed care.
3
@Paul
Except overutilization is not the primary driver of excessive costs in US health care Paul. Sure, it may be a minor issue but our high prices are high due to profit, administration and overhead. Other countries don't really use less health care on average, they just pay less for it.
9
@Marta thank you for you reply. You are right but it all adds up. Our system is abused three ways.
1-Billionaire's making billions off of it, including what you say.
2-Hypos and others abusing it, people who never go to doctors and then get deathly ill.
3-Outright criminal thieves who rip of the system.
2
As long as profit is the goal of healthcare, health will always take second place. Deductibles are a moral aberration. Shame on us for allowing the greed boys to make wellness a farce.
62
the age of COVID-19 is the right time for ALL Americans to boycott ALL medical care for the rest of the year - just accept each of our minus-medical-fates on a national scale, and the upheavals caused in the medical-industrial-complex will accomplish much, much more than the total of all the temporaneous political posturing we are suffering from in addition to all of our medical conditions
4
"There's a risk in cost sharing: It may deter people from getting needed care."
Ya think?
41
Can we just admit that our “system” is an indirect practice of eugenics and that if you fall ill you need to die? Because that is exactly what the system feels like. Be rich, be healthy or be dead...
37
A large portion of our country is at the mercy of the insurance
industry who in many ways deter people from seeking
medical care.
Both my wife and I are on supplemental insurance coverage.
which Medicare doesn’t cover.
It’s growing concern for many, I sure many people are
having too weigh seeking medical support vs. what they can pay.
18
"There’s a risk in cost sharing: It may deter people from getting needed care." That should be painfully obvious!
Perhaps the primary reason for deductibles, copays, narrow networks and the other mechanisms of cost-sharing is to deter people from getting care, in order to increase insurance companies' profits. That is more likely to prevent people from getting necessary care than unnecessary care, and thus endanger public health as a whole, but that's just collateral damage.
Medicare for All as envisioned by Bernie Sanders and others is not a "radical" idea. It's a necessary one.
46
@Slim Harpo Marxist - During the debate about the ACA, I still remember Sen. Orrin Hatch and other Republicans basically claiming that if someone else pays part of the bill, Americans will engage in 'recreational health care," i.e., going to the doctor just because it's fun and free.
8
@Slim Harpo Marxist Bingo. You pay the premiums month after month but don't use any care. Gravy for the C-suite.
6
@MegWright Yes, that's my idea of a good time. Sitting around other sick people just for the heck of it. And losing pay or sick time to boot.
7
This article was released by the AP two days ago:
Oregon has reached an agreement with private health insurance companies to waive co-payments, co-insurance and deductibles for Oregonians who undergo testing for COVID-19 at a facility that's within their insurance network, Gov. Kate Brown announced.
The agreement also will apply to a vaccine for the virus if one becomes available, she said in a statement Thursday. The state is pursuing the same agreement with self-insured health plans and also seeking clarification from the federal government about exceptions to cost-sharing for Medicare Advantage plans, and health savings account-eligible high-deductible health plans, she said.
“No one should have to ask if getting a COVID-19 test is something they can afford. I hope this agreement sets a framework that other states can follow nationwide," Brown said in the statement.
28
@macduff15
The interesting piece of this is that the folks that most need to know probably won't get the message that their care may be covered. Like immigrants who will avoid the census even with some assurances being made they won't be targeted. Any major outbreak creates a situation where our private insurance based system is inherently flawed. Throw in the fact that every state will have their own approach but we have open boarders between states. Perfect storm to illustrate whats wrong with free markets controlling access to healthcare.
11
“A better model might target people who choose high-cost options, increasing their cost sharing.”
And how are we supposed to know how much anything is going to cost? It’s pretty much impossible to find that information right now. Plus the model would give patients who are already strapped for time and money even more healthcare homework! I could even see people skipping necessary care entirely to avoid being “penalized”.
46
I was shocked to learn that in the US, it is the insurance company, not the Dr. that decides which insulin the patient is to have, how much they may have, the number of test strips they may have per month, etc.
How is this even legal? Practicing medicine without a license is a crime, isn’t it?
69
@Thomas - When our friend was going through chemo for cancer, his insurance company refused to pay for the doctor's #1 recommendation. Instead, they'd only pay for a different, cheaper drug. Our friend, who had significant assets, offered to pay for the cost difference between the #1 and #2 drug, was told that he'd get the #2 choice or nothing.
We'll never know whether the #1 choice would have been better. He didn't live long enough to find out.
41
@Thomas
In the United States patients are cost centers, and all that the insurance companies care about is eliminating those costs as much as possible. I don't care if you are talking about public, private, or work plans.
I worked for two of them.
10
@Thomas My insurance company wanted me to pay over $100K for medically necessary surgery that I had obtained pre-certification for, and this was after my paying all my premiums, a $3000 deductible and seemingly endless co-pays. I was at the point of retaining a lawyer (at my own expense) when they finally realized that they were probably not going to prevail in court and relented. Insurance companies in America do whatever they think they can get away with.
15
What is at the heart of these problems starts with a values decision, mixed with politics and the profit motive.
Values: There is clearly a great divide between those who want to see "all" ( substantially all) people in the country be covered for necessary medical and preventive care.
Generally those who support a version of universal care see the costs to be covered by pooling dedicated taxes.
There is a huge insurance industry profiting from gatekeeping to various services. And a medical industry where "leadership" mostly engages in figuring out how to game the rules made by insurers to maximize revenue. Their" competition" doesn't provide better care or lower prices.
And we have not been able to get differing political adherents to the same room, forget about the same table, to actually discuss questions of delivery, negotiation of prices, and, the most emotional issue, prioritizing delivery of service if there are going to be some limitations ( there are ALWAYS limitations).
The whole Rube Goldberg apparatus - with so many moving parts adding no benefit at all to our welfare - needs reform and new thinking - - but we seem farther from resolution of any of the issues than we are from a Mars landing.
33
@cheryl All correct, but why don't you, and virtually everyone else who correctly describes our contentious, self-serving, profit-driven biomedical enterprise, identify the great divide of "values" as belonging primarily to Conservatives (i.e. Republicans) on one side and Progressives (i.e. Democrats) on the other. Supporting the value structure of healthcare as the province of political parties is what we continuously witness, but tend to skip over in these discussions. As if cost-sharing and other medical values were unrelated to which political party we tend to support. Yes, Democrats have stumbled -- Obamacare is imperfect. Yet its "value" as "affordable medical care insurance" is clearly the value of one political party, while being anathema to the other. The Rube Goldberg apparatus reflects an early 19th-century rugged individualist, uniquely American value that didn't work then, and is downright destructive now.
15
In all the other advanced countries where there is universal coverage, the government authority which pays most of the bills, also determines the price it will pay for drugs, procedures, tests and visits. The bulk of the US working population gets its care through their employers. The employers do not have any say over charges or billing. In the uniquely opaque US healthcare system, which is supposedly run like a free market operation, but in practice runs more like a mafia racket, the employers contract out their employees to insurance companies to negotiate rates with the providers. The insurance companies do not have their interests aligned with the employers. In a given year, insurance companies have an incentive to hold down costs to maximize their take, but beyond that, they just are just a pass through conduit for charges. More than half the US healthcare cost is overheads, because everybody has to negotiate with everybody else what to pay or how much they are owed. With Medicare and Medicaid, the payers have some control over rates, but they too are subject to meddling by politicians who can be influenced by lobbying. The employers and insurance companies also have a strong incentive to cherry-pick younger, healthier people and somehow foist the older, sicker ones on the state.
31
Do people actually have to pay (or copay) for a COVID19 test in the US?! I’m a US expat, living in Israel, and our socialized health care is not perfect. But with COVID19, you can really see the benefit of such a system. My spouse and I came back from Spain 10 days ago. After we were back, the health ministry decided that people who came back from Spain would be added to the list of those who have to self-isolate for 14 days from the day of return. So we are now in self-isolation. We had an online form to report ourselves. (For those not ’net-savvy, there is a number to call.) My spouse did have a cold with a cough, so he called 101, the medical emergency number, now also being used for COVID-19 issues, to report his symptoms. The next day someone called him back and they sent a paramedic in a space suit to test my spouse in our home, and he gave directions of what we need to do, until we get test results. He gave my spouse a mask (no charge - nothing in this story has any charge) to wear to protect me, in case he is infected. That night, close to 11PM, he got a call that his test result was negative. Still need to isolate, but no mask needed, and we don’t need to stay in separate rooms. He got another call 2 days later confirming the negative result and asking how he is. We each got calls yesterday from our HMO checking up on us - did we develop any symptoms, etc. (No.) Ha’Aretz reported that the cost to the gov’t is 50 shekels a test. Not a lot to protect the public, right?
63
Sounds like a fine healthcare system. Color me, aging US citizen, envious.
5
@Dfkinjer Not in Washington State . The insurance commissioner ordered an emergency order for private and public insurers to cover tests. A copy of that order ( from the Washington government website is linked below : https://www.insurance.wa.gov/sites/default/files/documents/emergency-order-number-20-01.pdf
2
@Dfkinjer
Yes, really they are expected to pay and it is similarly really easy to see why that, combined with no sick leave or other social welfare benefits is likely to result in a disaster of epic proportions.
If only the rich would realize that diseases like the Coronavirus doesn’t differentiate between the haves and have-nots, and that it wasn’t some poor social service using Mexican who brought the disease here, but it is likely to be some poor Mexican taking care of them. This disease comes from the cruising and travels to China on business class rich, a fact that the rich are ignoring which is why Trump is still spending money on a vanity wall rather than turning those funds into free covid19 test kits.
8