On Oct. 24, 2020, President Trump held a campaign rally in my hometown of Waukesha, Wis. Thousands of mask-less citizens cramming themselves elbow to elbow for the chance to support their President was not the most dangerous thing that happened that night—it was what came out of President Trump’s mouth. “If somebody's terminally ill with cancer, and they have COVID, we report them. And you know, doctors get more money and hospitals get more money.”
Before writing this, I did not know that the CARES Act assisted hospitals financially and it is important to clarify the how and why it reimburses hospitals for the care of patients diagnosed with COVID-19. Hospitals do get specified funds for every patient with a laboratory-confirmed COVID-19 infection because the care of these patients is very costly. These costs include increased staffing requirements, PPE, intensive care admissions and longer length of stay in the hospital; a hospital cannot get funds by “making up” a COVID diagnosis.
In this climate of science denying, there is a portion of citizens in this country that does not need another reason to believe doctors are only out for their money instead of caring out their health. Unfortunately, there are good reasons for this distrust; the past pay-for-service model of reimbursement allowed for unethical physicians to preform unnecessary procedures in order to make money, unethical experiments were performed without consent on African Americans and the disabled and drug companies essentially bribing doctors to try their products are just three situations the medical community wish did not happen. The lingering distrust has evolved into the anti- vaccinating movement, and now, the anti-mask movement.
Slap in the Face
As I stated in my opening paragraph, to insinuate doctors and hospitals use a COVID-19 diagnosis and/or cause of death for financial gain is not only a slap in the face to every frontline healthcare worker caring for COVID-19 patients, it is dangerous for several reasons. First, it undermines the public’s trust in the medical community which is crucial during a pandemic. I know people, people I consider friends, who genuinely believe that doctors’ only motivation when ordering any treatment or medication is to make money off their patient. Part of the Affordable Care Act was to change the way doctors and hospitals are paid for services from quantity (how many procedures a doctor or hospital preforms) to quality (how well their patients do measured against similar hospitals). Despite physicians being unable to make money off over treating patients because it is illegal, this myth remains more than prevalent and because the President seems to believe it, others’ belief in this lie will be cemented.
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Second, it perpetuates the underlying condition versus COVID argument and shifts the focus off the real problem. Some argue that those that die of underlying conditions (cancer, heart disease, diabetes) and are also COVID positive at death should not be counted in the COVID death statistics. Is it relevant to argue, post- mortem, if hypoxia from COVID caused a fatal heart attack in someone with heart disease? Or, if a COVID infection was too much for someone with cancer to fight off? What is relevant is preventing deaths in the first place; the real problem is Americans cannot get a handle on how to do this. Instead, we want to argue over one tree when the whole forest is on fire. Unfortunately, there are few role models in leadership that listen to infectious disease experts, wear masks, and encourage their supporters to as well.
Against Science (Again)
Finally, these statements further pit those that identify as Republican against science. According to the August 2020 Time Magazine article “Why the U.S. Is Losing the War on COVID-19,” 27% of Republicans reported a “great deal of trust” in scientists as compared with 43% of Democrats. The article lists the results of another survey from June 2020 that shows “...63% of Democrats and Democratic-leaning independents said masks should always be worn, compared to only 29% of Republicans and Republican- leaning independents.” Due to this distrust of science and medicine, I have made an anecdotal observation that it is not a far stretch for many Republicans to believe that doctors and hospitals are not only out to make money of COVID-19, but also using COVID as a means to get President Trump out of office. Therefore, when the President makes statements about hospitals and doctors using COVID-19 diagnoses to make more money at a rally attended by die hard supporters who hang on every word, trusting everything he says because he is their President, COVID gets a free pass to run wild.
I am a healthcare professional, a daughter and a mother, and the last eight months have been profoundly distressing. Seeing the rally that took place in the city where I live, seeing people I know are probably my neighbors, packed together listening to a dangerous man is depressing; hearing how little respect he has for me, and for my coworkers, makes me angry. I want to make it known that your medical professionals are not out to make money off people and to say otherwise is unacceptable.
