How will different healthcare systems respond to the coronavirus crisis?
The race of the countries against the coronavirus has entered its most critical phase. Different healthcare systems are being sorely tested and the whole world will be forced to mourn a vast number of deaths, which, in the end may be worse than anything we have experienced since World War II. China earlier, European countries later and the US lastly are courageously facing this tragic global epidemic, an undesired outcome of globalization. But, were the different national healthcare systems ready to face this emergency? Who will be able to protect the largest number of citizens? The different approaches in Italy and the United States with Covid-19 is the perfect mirror to analyze the strengths and weaknesses of their healthcare systems, with a particular look at the British, who — after Brexit — are handling this on their own.
Italy, despite the brainless cuts to public healthcare over the past 20 years, still retains in Western Europe an advanced healthcare system, accessible to all without any socioeconomic discrimination. Nevertheless, mortality rates of Covid-19 are reaching impressive peaks, especially in Northern Italy, the worst affected area in the country. If the strict measures taken by the Italian government do not end up being effective, the casualties will actually outnumber those of the twenty-times-larger China. Sadly, Italian politicians’ first approach was to underestimate the problem, inviting people and productive activities not to stop. But a nation with a median age above 46 years old, it can’t be regarded as a young and healthy country. Italy, along with Germany, Greece, Portugal and Spain, leads Europe in the ageing population and in the case of a virus attacking the lungs, as Covid-19 does, the risk of a pandemic was even higher here. By the way, the initial foolish approach of Italy in tackling the new virus is now unfolding in the same way in the UK, where Prime Minister Boris Johnson kept schools and commercial activities open all the way until just two Fridays ago. In addition, two and a half weeks ago, there were even UEFA football matches played in Liverpool and Glasgow in stadiums crammed with folks.
It is also true that the British are renowned for their attitude to “Keep calm and carry on” during tragic moments, but this stubborn will of the government to wait for the enemy to grab a hold in their home territory before acting really threatens the weakest members of their own population. This approach is in accordance with liberalism to use state intervention only as a last resort, and yet the National Health Service in the UK is 100% public and it is the largest employer worldwide of healthcare systems. Nevertheless, the general opinion about the British National Health Service is not so positive, which has also been confirmed by the European Society for Medical Oncology (ESMO), which ranks the UK public healthcare among the worst in Western Europe. The worst aspects that they cite are a low index of cancer survival and the role of the general practitioner, who often serves excessively as a filter to access specialists. What could happen if this filter started being more clogged due to the fast expansion of Covid-19? A hidden invitation to resort to private healthcare? Or an egotistical Darwinian approach of natural selection? British citizens and countless expats deserve a response.
The United States and Italy
The United States, led in this epidemic by the volcanic Trump, are likely to see the virus spread all throughout the country, including the rural areas about which we talk little. Infections are increasing and people are emptying supermarkets, with an alarming arms race in the states which are more affected. Covid-19 could soon become a health bomb, given that the US is among the few industrialized nations all over the world which doesn’t have universal health coverage; in fact, the current administration is steadfast against it. Overseas, the right to be treated is a personal responsibility and not one of the state, despite the fact that Obamacare tries to broaden the opportunity to allow the poorest of the population to buy health insurance without going through an employer. But this also has the unpleasant effect of jacking up the prices of some types of policies and medicine. According to some opinions the American middle class is getting weaker over the years and in United States, concerning healthcare, the synergy between big pharma and insurance lobbies seems worth more than political views. Covid-19 should empower American citizens more than politicians, about the importance of being covered with insurance. But, as things stand today, which insurance company may secure destitute people for an unknown virus?
In the European Union, the approach is completely different. While Spain even seized private hospitals in order to make them available for the State, Germany is allocating as much public funding as possible, and Italy and its health workers are giving everything they can to beat this pandemic. Hospitals in the Lombardy region, normally the pride of Italy, are slowly collapsing due to the increase of hospitalizations requiring the ICU. The situation in Lombardy is so severe that the President of the region Attilio Fontana is equipping, similar to what happened in Wuhan, a new, temporary hospital inside two pavilions of Fiera Milanocity. It is hoped to get 400 beds in the ICU. This will be made possible thanks to private donations (Silvio Berlusconi, for example, gave 10 millions euros for the project), but it will still be run by the state. Italy is also counting on the Lazzaro Spallanzani National Institute for Infectious Diseases in Rome, a world-renowned infectious disease hospital established in 1936. Last February 2, their virologists were the first in Europe to isolate the genomic sequence of the coronavirus.
We may conclude that the differences between public or private healthcare are not just those of an easy and fast access to a referral, or concerning unevenly distributed funds. During the pandemic the fact that many VIP or sportpeople asymptomatic are having swab privately before people admitted to hospital aroused stir worldwide, by associating it as a waste of assets that public healthcare can’t afford. Anyway, when there is a race against time, there’s no need to wonder if public or private healthcare is preferable. But it certainly can reveal a lot to see how each countries’ healthcare systems can handle this pandemic. Now comes the test of whether humans are mature enough to respect staying quarantined and to understand that prevention is the first step of care. Otherwise, we will all pay the price.
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