Healthcare Costs and Unvaccinated Patients

[guest1168940]

Several articles from Forbes and others have reported the costs of healthcare of unvaccinated individuals is burdened almost entirely by private entities and the public in the billions.  A waiver (when your hospitalized most of the bill is covered) used by most insurers for hospitalizations is now being declined by some or will stop at the end of the year if unvaccinated. The urgent and long term costs such as ecmo (80k per week I believe it’s higher), post lung transplant, loss of wages if the family breadwinner will and have presented a financial and moral dilemma for Americans. The insurance companies and health care facilities will most likely never deny care but certainly this has come to light as we go into the third year of the pandemic. I am interested in others opinions about how society should or should not bear the brunt of free choice. Thank you.

[Guest219794]

1 minute ago, subee said:

But when moronic anti-vaxxers go bankrupt, we ALL have to pay for their bad choice.  Most other diseases that fill hospital beds don't have a simple, cheap and safe antidote to the problem.  At the very least, they should be paying higher premiums (and if their employer has to pay their premiums, pass it on to the moron).  But most of these people are simple and relatively poor and you can't get water from a stone.

Exactly my point.  

On the surface, it seems to make sense for insurers to drop those who choose to be high risk.   But until we start rationing care based on vaccination status, all this does is shift the financial burden.  

Where I work, a large portion of unvaccinated patients don't pay for insurance or healthcare.  Vaccination status has a whole lot to do with education levels, which correlate with financial status.  Many of the highly vocal vaccination critics are both well insured, and vaccinated.  

So- of course insurance companies would like to drop the unvaccinated.  But, somebody will pay.

[Susie2310]

On 12/23/2021 at 5:19 AM, lMCRN said:

I am interested in others opinions about how society should or should not bear the brunt of free choice. Thank you.

This brings up the point of how free, really, is an individual's choice.

 Social factors such as poverty and not having received a higher education have been shown to affect a person's decision as to whether or not to receive the Covid 19 vaccine.  These factors, which may be outside a person's ability to remedy, also influence many other life/health choices that affect an individual's health, some of which have consequences for the health of the community.

I understand you are questioning whether an individual's health insurance (whether individual insurance, insurance from their work, or from a program such as Medicare or Medicaid) should pay for their hospital care for their Covid 19 treatment if they have chosen not to be vaccinated, or in the case of a person who is uninsured and unvaccinated, whether they should receive publicly funded hospital care for Covid 19 if they chose not to vaccinate.  I assumed you were referring to people who have chosen for personal reasons not to be vaccinated, not people for whom the vaccine is medically contraindicated.

If everyone was to bear the brunt of choosing not to be vaccinated and was expected to pay out of pocket for all of their hospital expenses related to Covid 19, most people would simply go broke/bankrupt and hospitals would receive reduced income, which would affect their ability to provide services.  More people would die of Covid 19 and those who need to receive hospital care for other problems such as heart attacks, strokes, etc., could find it harder to access care.

[Guest219794]

33 minutes ago, Susie2310 said:

This brings up the point of how free, really, is an individual's choice.

 Social factors such as poverty and not having received a higher education have been shown to affect a person's decision as to whether or not to receive the Covid 19 vaccine.  These factors, which may be outside a person's ability to remedy, also influence many other life/health choices that affect an individual's health, some of which have consequences for the health of the community.

I understand you are questioning whether an individual's health insurance (whether individual insurance, insurance from their work, or from a program such as Medicare or Medicaid) should pay for their hospital care for their Covid 19 treatment if they have chosen not to be vaccinated, or in the case of a person who is uninsured and unvaccinated, whether they should receive publicly funded hospital care for Covid 19 if they chose not to vaccinate.  I assumed you were referring to people who have chosen for personal reasons not to be vaccinated, not people for whom the vaccine is medically contraindicated.

If everyone was to bear the brunt of choosing not to be vaccinated and was expected to pay out of pocket for all of their hospital expenses related to Covid 19, most people would simply go broke/bankrupt and hospitals would receive reduced income, which would affect their ability to provide services.  More people would die of Covid 19 and those who need to receive hospital care for other problems such as heart attacks, strokes, etc., could find it harder to access care.

True.

Financially, the only thing that would makes sense would be to stop providing expensive, resource intensive levels of care to the unvaccinated regardless of the individual financial/insurance circumstances.   Even if we provided everything we are doing right now, but just stop intubating the unvaccinated, we would free up a huge amount of resources.  "Self pay"', Medicare, or NBA star.  No vax=no vent. Ask any ICU nurse what their unit would like like without ventilated unvaccinated patients.

It works mathematically.  How bad will this have to get before we are ready to do something like this?

The other option will be essentially go into MCI mode.  In a normal incident, the sickest get the most resources.  A mass casualty incident is basically defined by patient needs outnumbering rescuer resources.  In that case, the sickest are left to die in order to save the most.

This approach, which is called Crisis Standards of Care is apparently being used in some places. Under these standards, if the vaccinated patient has a 10% chance of survival, and the unvaccinated patient has a 15% chance of survival, that patient gets the resources, and the vaccinated corpse goes to the morgue.

 

[subee, MSN, CRNA]

4 minutes ago, hherrn said:

True.

Financially, the only thing that would makes sense would be to stop providing expensive, resource intensive levels of care to the unvaccinated regardless of the individual financial/insurance circumstances.   Even if we provided everything we are doing right now, but just stop intubating the unvaccinated, we would free up a huge amount of resources.  "Self pay"', Medicare, or NBA star.  No vax=no vent. Ask any ICU nurse what their unit would like like without ventilated unvaccinated patients.

It works mathematically.  How bad will this have to get before we are ready to do something like this?

The other option will be essentially go into MCI mode.  In a normal incident, the sickest get the most resources.  A mass casualty incident is basically defined by patient needs outnumbering rescuer resources.  In that case, the sickest are left to die in order to save the most.

This approach, which is called CFor risis Standards of Care is apparently being used in some places. Under these standards, if the vaccinated patient has a 10% chance of survival, and the unvaccinated patient has a 15% chance of survival, that patient gets the resources, and the vaccinated corpse goes to the morgue.

 

For a measly 5% chance, I'd take the vaxxed patient  and send the unvaxxed one to the morgue:)  This isn't a good analogy since vaxxed patients have a much better chance of being discharged to their houses rather than to the morgue.  In this argument, the other variables would have to be wildly disparate like in age or health status to change my stance.  If all of the variables were even close, I'd give the admission to the vaxxed person and the unvaxxed can  take their chances at home.  More covid patients are dying at home in my city.  There is no on left to care for them.  Our positivity rates have started to fall, but not the number of deaths.

[guest1168940]

6 hours ago, hherrn said:

In response to the OP-

The real question is whether this will effect behavior.  

 

That’s exactly what several of the articles predicted, a percentage of those who still choose to not vaccinate will because of possible medical bills not because of possible death from covid. 

[Guest219794]

2 hours ago, lMCRN said:

That’s exactly what several of the articles predicted, a percentage of those who still choose to not vaccinate will because of possible medical bills not because of possible death from covid. 

Sounds good.

[JBMmom, MSN, NP]

17 hours ago, hherrn said:

Ask any ICU nurse what their unit would like like without ventilated unvaccinated patients.

Yes, in my ICU we have 1/3 of our vents taken up by unvaxxed COVID patients right now. But we also have a couple overdose patients, one who has been intubated numerous times before, we've got a self inflicted GSW in a failed suicide attempt, we've got a COPD exacerbation in a patient who smokes three packs a day. So, which of these patients, who made lifestyle choices that got them there, is REALLY taking the vent from a stroke victim or cardiac arrest? They all are. And I don't know about insurance status but three have been unemployed for many years, so not likely to be insured either. 

[subee, MSN, CRNA]

2 hours ago, JBMmom said:

Yes, in my ICU we have 1/3 of our vents taken up by unvaxxed COVID patients right now. But we also have a couple overdose patients, one who has been intubated numerous times before, we've got a self inflicted GSW in a failed suicide attempt, we've got a COPD exacerbation in a patient who smokes three packs a day. So, which of these patients, who made lifestyle choices that got them there, is REALLY taking the vent from a stroke victim or cardiac arrest? They all are. And I don't know about insurance status but three have been unemployed for many years, so not likely to be insured either. 

But imagine of that 1/3 vent patients weren't there because they were vaccinated?  So much money and hardships that didn't have to happen.  The mental health ones are sad to read.  I assume that the 3 pack a day smoker has MH issues also.  I don't know why we don't have the courage to stop putting people on vents who aren't ever going to come off. IMHO, part of it is patients care for by residents who are too inexperienced to make a judgement.  

[toomuchbaloney]

https://www.kff.org/coronavirus-covid-19/issue-brief/unvaccinated-covid-patients-cost-the-u-s-health-system-billions-of-dollars/

$16 billion from July to November 2021...six months.  We're entering our 3rd year of this pandemic. 

I got a Christmas text from an old friend today.  His business began manufacturing the parts for ventilators during covid and they have made a bunch of money in the process.  He also believes that we can't trust the government to tell us the truth about the pandemic and is adamantly opposed to the vaccinations.  It's pretty sad. 

[guest1168940]

On 12/25/2021 at 8:12 PM, toomuchbaloney said:

https://www.kff.org/coronavirus-covid-19/issue-brief/unvaccinated-covid-patients-cost-the-u-s-health-system-billions-of-dollars/

$16 billion from July to November 2021...six months.  We're entering our 3rd year of this pandemic. 

I got a Christmas text from an old friend today.  His business began manufacturing the parts for ventilators during covid and they have made a bunch of money in the process.  He also believes that we can't trust the government to tell us the truth about the pandemic and is adamantly opposed to the vaccinations.  It's pretty sad. 

So a person that is benefitting from the increased need for vents from covid is strongly opposed to vaccinations, now I have heard everything similar to an infectious disease nurse (anti-vaccine) posting on the vaccine mandate thread that the mandates will cause extreme impacts on at her facility. Wheww 

[Stacie McClellan]

On 12/23/2021 at 6:10 PM, JBMmom said:

I think we have villified non-immunized COVID patients as if they are the only patients that made a poor lifestyle choice leading to expensive medical care. I work in the ICU and rarely do we have a healthy patient that endures a random trauma or situation that brings them to us. 

We have noncompliant diabetics, we have CHF patients weighing 400+ pounds, we have alcoholics and drug abusers, we have patients that are not compliant with psychiatric medications, we have dialysis patients that skip treatments and end up with hypertensive emergencies,, patients with COPD that refuse to quit smoking, etc. These patients COULD all avoid hospitalization if they made better choices. 

I realize this is different because of the acute drain on resources given the number of people affected, but I don't think they are necessarily more responsible for their situation than many others. 

The thing about this argument is that there is no fast, easy way to prevent CHF, diabetes or COPD like the vaccination for Covid. If you had a 3 shot regimen to prevent them most of the people affected would be lining up in droves to get it. The fact that there is a safe, quick, easy and effective way of preventing Covid makes this different from lifestyle diseases. 
 

I’m obese and diabetic. Have battled my weight for years. If it could go away with 3 shots I’d be thrilled to take them so I would no longer have these issues and wouldn’t use healthcare resources. 

[JBMmom, MSN, NP]

37 minutes ago, Stacie McClellan said:

I’m obese and diabetic. Have battled my weight for years. If it could go away with 3 shots I’d be thrilled to take them so I would no longer have these issues and wouldn’t use healthcare resources.

Very good point.