When the Coronavirus pandemic reached Wisconsin and the Governor issued his statewide shutdown order of non-essential business in late March, most businesses and individuals were not adequately prepared for this historic crisis.
Nearly three months later, access to testing has improved dramatically, the growth rate of new cases has stabilized, and we are all adjusting to this “new normal” in our own ways. This period of transition provides a unique opportunity to take stock of how our lives, our businesses, and our healthcare system have adapted to the challenges of the day and identify lessons that can help us moving forward.
Perhaps the most apparent lesson is that we all need to interact with others for social, material, and emotional support. Isolation increases stress levels and hurts our physical and mental health. Financial uncertainties and additional family care responsibilities make isolation even more difficult to bear.
We also learned that although technology allows us to communicate from almost anywhere, it is an imperfect replacement for personal contact. Some individuals transitioned to working from home with little difficulty. Many others did not have this option or had to juggle remote work with new tasks like helping with shopping for an elderly parent or acting as substitute teacher and daycare provider for a young child. The question of how remote work affects productivity will not be answered anytime soon, but it clearly requires a high level of independence and personal responsibility for individuals to both take care of themselves and their families and get their work done.
Personal responsibility is also critical for remote medicine, or telehealth, to be effective. Doctors can do a lot by seeing and talking to a patient via phone or video, but some conditions will require the patient to visit a healthcare facility for testing or imaging. In a traditional office visit this is often done immediately on-site. Virtual visits may require an in-person follow-up, which requires more commitment from the patient than simply walking down the hall.
Healthcare facilities in our community have done a marvelous job of maintaining access to care. Rather than being overwhelmed as was feared, health systems saw a tremendous drop in patient volume and revenue due to the suspension of elective procedures. While great strides have been made to ensure that patient visits are now as safe as possible, fear is still keeping many from receiving the care they need. When this fear subsides providers will be very busy addressing the backlog, with the caveat that the millions of Americans who have lost their jobs need to maintain insurance coverage that provides access to healthcare.
Given that the shutdown strained or busted the budgets of countless businesses, nonprofits, and governments, many consumers are expecting large increases in health benefit premiums. However, although testing and treatment for COVID-19 was an unexpected expense, the overall reduction in patient volume created enormous surpluses for many insurers. Some are even granting premium holidays to balance revenues with expected expenditures. Those that don’t may be forced to issue rebates to policyholders under the Affordable Care Act’s Medical Loss Ratio requirement. Expect renewal increases to be modest this year and more sizable in 2021 after the claims for postponed care are processed.
Taking time to reflect on the past months presents an opportunity to reconsider what we value and how we achieve our goals. This may lead to more rapid change in the healthcare system. Supply chains for critical items like personal protective equipment and pharmaceuticals may be re-shored, and bulk purchasing may create efficiencies by removing intermediaries who do not create value.
No matter what policy choices are made as a result of this crisis, I am optimistic that this experience will leave us stronger, wiser, and more resilient.
