Telemedicine gives patients more ways to access health care

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Photo: Marcy Sanchez/U.S. Army

Before the arrival of the novel coronavirus, telemedicine — allowing patients to have contact with a health care provider over a web interface or via a phone call instead of through a face-to-face appointment — was not widely used. Insurers and government health programs severely limited the circumstances in which they would pay for a virtual visit, and relatively few providers had figured out the logistics of offering telemedicine.

That changed abruptly when the risk of contracting COVID-19 caused people to avoid as many in-person interactions as possible, including trips to the doctor, therapist or other health care provider. …

New research should spur us to redouble our efforts to reduce air pollution

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New evidence suggests exposure to air pollution increases the death rate from COVID-19. Photo: Baiterek Media via bigstockphoto.

Several recent studies have suggested that air pollution may make coronavirus (COVID-19) infections more severe. These findings fit with previous research documenting how air pollution damages our bodies and makes us more vulnerable to infectious diseases. This new research should spur us to redouble our efforts to reduce air pollution.

Evidence from several countries suggests that exposure to air pollution increases the death rate from COVID-19. A Harvard study found that areas of the U.S. with higher levels of fine particulates had higher death rates from COVID-19. The study’s authors estimate that even moderately higher long-term levels of fine particulate pollution correspond to an 8 percent higher death rate from COVID-19. A study in England observed a correlation between levels of nitrogen oxides and ozone and COVID-19 mortality. (Neither of these two studies has yet been peer reviewed.) Researchers studying COVID-19 in Italy observed that regions where COVID-19 has been most lethal are also places that suffer from some of the worst air pollution in Europe. They point out that air pollution inflames the lungs, which may leave patients more vulnerable. …

State and federal policies, including some specifically aimed at COVID-19 patients, don’t fully protect patients from surprise bills

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Fear of big medical bills can deter people from seeking care, harming their health and potentially the health of those around them. (Photo credit: everydayplus via Shutterstock)

An unfortunate but common feature of the U.S. health care system is surprise billing — an unexpected charge not covered by insurance even though the patient received care at a facility or from a doctor they believed to be within their insurance network. The coronavirus pandemic is creating more situations in which patients might receive care from an out-of-network provider, and state and federal policies, including some specifically aimed at COVID-19 patients, don’t adequately protect patients from receiving surprise bills. The nation should expand surprise billing protections to include all patients, now and after the coronavirus pandemic ends.

Surprise billing is a problem for both consumers’ finances and their health. The average surprise bill is for $1,500, more money than many Americans have on hand. Fear of big medical bills can deter people from seeking care, harming their health and potentially the health of those around them. For example, a recent poll found that one in seven Americans would avoid seeking medical care even if they experienced classic symptoms of COVID-19 because they feared how much treatment would cost. …

The pandemic will have far-reaching impacts on the health care system’s structure, costs and insurance

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The coronavirus pandemic will have far-reaching impacts on health insurance. Photo: Valeriya via istockphoto

As someone who often works on health care issues, I’ve been watching the novel coronavirus crisis with an eye to what it means for our overall health care system. Obviously, the immediate flood of patients threatens to overwhelm health care workers and impairs their ability to provide the care we’re accustomed to. But the coronavirus will also have far-reaching impacts on the health care system’s structure, costs and insurance. Exactly what those changes are will not be known for a while — but I’ve been exploring likely scenarios. …

Our communities can avoid a worst-case scenario amidst COVID-19

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A firetruck in Santa Rosa’s Fountaingrove neighborhood after the 2017 Tubbs Fire. Photo: Santa Rosa Fires via Flickr CC BY-NC 2.0.

On Tuesday evening last week, my cell phone blared with an emergency alert. Here in Sonoma County, in northern Calif., the only time my phone has made that horrifying sound in the past was to warn me about evacuating ahead of a wildfire. This time, it was a “shelter-in-place” notice to slow the spread of the novel coronavirus (COVID-19).

Though the right response to wildfire often involves fleeing and the correct response to COVID-19 is to stay home, successful responses to public emergencies require a communal effort and rely on mutual trust that our individual commitments to do the hard thing will protect us all. …

We need to reduce air pollution, rather than move away from it

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Photo: A clear blue sky above Lake Sonoma. Franco Folini via Flickr, CC BY-SA 2.0.

When my husband and I decided to move from Baltimore to northern Calif. when our son was two years old, we weren’t thinking about air quality. My husband had a new job opportunity that would allow us to live closer to family, and so we settled in Sonoma County, on the northern edge of the San Francisco Bay Area. We see grandparents, uncles, aunts and cousins frequently, and our son has thrived.

As I’ve worked on air quality issues in recent years, I’ve come to realize that perhaps one of the biggest benefits of our cross-country move is that we reduced our exposure to air pollution. Air quality in Santa Rosa is much better than in Baltimore. According to the recent analysis I did for Trouble in the Air, Santa Rosa had 38 days of elevated air pollution 2018, versus 102 days in Baltimore. That means we had a bit more than a month’s worth of days with elevated ozone and/or fine particulate pollution, versus more than three months’ worth if we had been living in Baltimore. …

On May 19, 2015, a rupture in an onshore pipeline transporting oil from drilling platforms in the Santa Barbara Channel to onshore refineries spilled 120,000 gallons of crude oil near Refugio State Beach, west of Santa Barbara, California. The Santa Barbara Fire Department initially responded to a report of a petroleum smell, and the response grew to include 1,300 responders from local, county, state and federal agencies. The spill forced the closure of both El Capitan and Refugio state beaches — El Capitan State Beach for over one month and Refugio State Beach for almost two. Oil from the spill was found at beaches in Los Angeles County, 80 miles away. The spill killed nearly 100 mammals and more than 200 birds, and affected a range of marine life, including brown pelicans, California sea lions, elephant seals and dolphins. …

I recently spent 45 minutes calling my health care provider’s billing office, my insurer and the medical group that handles most bills for my insurer, trying to straighten out a billing problem caused when the insurer rejected an expense that should have been approved. Many phone calls later, I figured out that the provider had submitted the bill to the insurer instead of the medical group. Neither the insurer nor the medical group wanted to deal with this problem, though, so it fell to me to call the provider to tell them where to send the bill.

This is the third time this year that I’ve spent a chunk of time untangling insurance and billing issues for my, and my family’s, medical care. Multiply my experience by that of millions of Americans, and we collectively must spend millions of hours on the phone and online each year with insurers and providers to obtain insurance coverage, schedule appointments, straighten out incorrect bills, and clarify insurance details. Many of these activities are a direct result of how complicated our system of providing and paying for care is. …

A comment on the power of advertising

We’re surrounded by advertising. Every day, we see billboards, TV ads, advertisements in magazines and corporate sponsors at all sorts of events. Much of the time we don’t notice these ads, much less think about how they shape our desires and encourage us to want things we otherwise wouldn’t want.

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Credit: U.S. government work. U.S. EPA via Flickr.

A recent ad stuck out, though, and made marketing’s effect on my desires apparent. One of the underwriters on an NPR station in my area is Hint Water, which has the tagline “mouthwatering water.” Why do I need water that is mouthwatering? When I’m thirsty, my body conveniently alerts me, and I can get water for pennies per gallon by turning on the faucet at the sink. If clean, cold water doesn’t appeal to me, then I probably don’t need water. …

When I first started hearing about efforts to ban single use plastic bags — the kind at the grocery store check-out — I admit I thought it was a bit of a silly idea. Sure, single use plastic bags contribute to the problem of microplastics that are found throughout our oceans and environment, but compared to other problems facing the environment, like global warming, the problem of single-use plastics seemed inconsequential.

I’ve come around, though, to realize that efforts to reduce plastic grocery bags, plastic straws and foam take-out containers not only address the plastics problem but may open routes to address bigger issues. Campaigns to ban or reduce single-use plastics have engaged members of the public who might not otherwise have spoken out about an environmental problem. …


Elizabeth Ridlington

Senior policy analyst with Frontier Group. Focused on fracking, climate, health care costs, biking.

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