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检测新冠病毒需要花多少钱?美国人仍有很多疑问

检测新冠病毒需要花多少钱?美国人仍有很多疑问

Daria Solovieva 2020年03月21日
即便是有保险的人士进行检测,也还有很多细节问题要厘清。

随着联邦政府近期措施的出台,以及许多私人倡议的实施,COVID-19病毒测试数量开始提升,但有关谁能够获得测试,谁为病毒测试以及可能需要的后期治疗买单,这些措施多大程度上可以阻遏COVID-19在美国各地的传播,依然是问题多于答案。

周日在白宫的记者招待会上,副总统迈克·彭斯再次强调,这些措施将会帮助到所有的美国人,但他没有提供具体细节。上周他曾宣布“所有的保险公司”同意“豁免所有新冠病毒测试的定额手续费部分,并将保险的所有福利计划都覆盖到新冠病毒的治疗。”

“随着测试的推广,我们很高兴地看到,国会与政府携手来确保成本问题永远不会成为任何人获得病毒测试的障碍,”彭斯在情况介绍会中说。“目前所有的新冠病毒测试都是免费的,每个美国人都能免费获得测试,包括没有保险的美国人。”

保险商承担病毒感染爆发所带来压力的投入程度,以及联邦政府和各州对抗疫的支持程度,还有待观察。

据白宫称,蓝十字蓝盾、安泰、信诺、休曼纳和联合健康公司将参与其中。目前为止,大多数保险公司承诺豁免COVID-19病毒测试的定额手续费部分,但对治疗的定额手续费部分尚未豁免。《财富》杂志联系了白宫提到的所有保险公司,大多数只提供了在线声明或者邮件评论。信诺没有予以回复。

比如,蓝十字蓝盾的COVID-19病毒防疫指引称,保险覆盖范围“将与被保险成员健康利益的标准条款相一致” 。

有些公司还覆盖了远程医疗的定额手续费部分。“如果商业被保险人在实际就医前接受了远程医疗服务, 依照我们提供的未来90天内零定额手续费远程医疗服务保险覆盖,他们不需要支付定额手续费部分,”上述文字源自安泰的邮件声明。

即便是有保险的人士,也还有很多细节问题要厘清。

“新冠病毒才不管你是有保险的,还是没保险的,是民主党人还是共和党人,也不论你是黑人还是白人,”生物科技高管丹娜·格雷森说。她是自1月中旬以来就呼吁采取更严格防控措施的群体中的一员。“这不是一种只会攻击富人或有保险人士的病症。我们看到了受感染的人数在加速上升,而我们几乎很少测试。”

对于大多数通过雇主公司获取保险计划的美国人来说,其境遇很大程度上要看联邦政府即将决策实施的新法案和要求。众议院周六通过了《家庭第一新冠病毒应对法案》,包括一些测试条款和为工人提供财务支持的条款。参议院将在本周审议。

这一法案包括建立“无成本为消费者提供新冠病毒诊断测试的要求,扩大失业人员的利益保障,以及暂时性地提高医疗补助力度。”尽管多数被感染者的症状较轻,但还是有一定比例的受感染者需要住院治疗、呼吸器及其他支出。

“有保险但自费部分较高的人,自费部分恐怕会成为一种障碍,因为他们可能需要支出数百甚至数千美元,”乔治敦大学公共政策麦考特学院的医疗保险改革中心联合主任萨布里娜·克莱特说。“众议院的法案会帮助到这些人,手段是要求保险商和雇主豁免费用共摊,不光是测试,还有急诊和门诊。”

对大约三千万没有保险的美国人来说,财务上的不确定性可能更大。

最直接的影响和阻遏因素是许多人无法获得测试。白宫成功安排测试的报道,与许多病人的体验是脱节的,这些有潜在病兆的人因不符特定条件而被医疗机构拒绝测试,但他们可能携带病毒,并可能给其他人带来风险。

圣芭芭拉菲尔丁研究生院的博士生妮可·巴德里纳斯,就被加州弗里蒙特的帕拉奥图医疗基金会拒绝病毒测试,尽管她当时已显示出一些症状。

“他们说不会对我进行测试,因为我不属于高风险,”巴德里纳斯说,“我被告知,我不符合某些测试条件,比如呼吸困难。”

即使她跟八十多岁的父母一起居住,她还是被拒绝测试。

“他们告诉我,在家里时戴上口罩,并远离父母,”她说,带着一种挫败感,她已放弃了去测试的想法。“呵呵,真是太好了,我已经跟他们在家一个礼拜了。”

在医院门诊处,医生告诉她,如果开始有呼吸困难问题,就回来就医。

很明显,白宫夸大了上周病毒测试的安排速度和范围。特朗普竞选团队全国发言人凯雷·迈克伊纳尼在3月12日的推文中说,“已经分发了一百万个测试设备,本周末将会分发四百万个,”美国总统也发推文重申了这一点。

根据疾控中心3月17日发布的数据,疾控中心实验室总计已进行了4255份测试,公共卫生实验室测试了27623份。

在遭受COVID-19病毒冲击的国家中,如果按每百万人的测试比例排名,美国排在倒数位置。美国测试的人数不到法国的一半,而法国人口比美国少得多。

据《商业内幕》报道,尽管测试能力有限,但一些高净值病人可以在家获得病毒测试,这是由比如大卫·纳扎里安等特约医生提供的“家政电话”服务的一部分。一些名人比如海蒂·克鲁姆可以获得在家测试还分享到社交媒体,引发了强烈反应,人们感慨“有钱有名望的”就可以获得这种服务。

彭斯在周日的记者招待会上重申,所有的新冠病毒测试将是免费的,但很多责任会落到各个州以及私人公司身上去落实。

有些州,比如马萨诸塞、宾夕法尼亚和加利福尼亚州,已经强制要求豁免COVID-19测试和治疗的定额费用部分。

周一伦敦帝国理工学院发表的一篇报道指,研究者估计COVID-19将感染美国人口的81%,死亡人数光是在美国就将高达220万,如果没有及时采取措施缓解疫情的话。全美各地的护理机构和接线中心的电话都被打爆了。

“我们当然很担心,”注册护士杰森·菲利普说,他在过去几天见证了日常接电话数量的成倍上升。许多人打电话来询问基本信息,以及在何地以何种方式可以获得测试。

“我感觉在加州南部,有很多人应该马上接受测试,以帮助公共卫生系统的防疫努力,但我们实在太忙了,”菲利普说,“我们能做的就是与病人电话预约好,并叫他们在获得医疗指示之前自行隔离。”

他也很担心基本的防护用品和口罩的短缺。

“由于这第一波的社区感染期间的疾病传播和隔离措施,我们将失去很多医疗工作人员,”菲利普说。

标普指数内的保险公司上周有一份分析报告称,谁来承担COVID-19病毒爆发的大部分成本,或许也要看当前措施的有效程度。

“大多数有保险的人士,尤其是机构或雇主保险计划内的人,在今年后半期之前,不会达到他们自费部分的上限,”标普分析师在3月12日发表的一份报告中写道,“所以,如果能在今年上半年遏制COVID-19的传播,有保险的人士会承担治疗成本的大部分。不过,如果到下半年病毒还持续传播,而有保险人士已达到成本共摊的要求,保险公司将直接承担医疗费用的更大部分。”

有些社区和一些其他国家,已经行动起来解决潜在的经济困难问题,甚至由于疾病爆发导致的破产问题,但对于没有医疗保险的工人们的医疗保障条款细节,还是很有限。

已有一些卫生领域的专家敦促联邦政府扩大联邦条款覆盖范围,降低医疗补助门槛,采取诸如“创建一页式申请书,让人们持续获得补助,而不需要不断地进行机构认可”或者允许“各个州临时性地增加医疗补助可获得性,扩大资格要求的收入范围,突破现有的收入限制。”

最不可能被测试的很多人,比如身体最虚弱的人士和接触人多的行业人士比如食品服务人员,直到那时才会获得病毒测试。

“如果你没有保险——要么是买不起保险,要么是你没有工作——如果你去做病毒测试,你恐怕要费很大劲才能获得免费测试,因为测试能力是如此之低,”格雷森说。“要么你测试完了,面对一张数千美元的收费单傻了眼,如果测试结果是阳性你就不能返工。那为什么要去测试呢?不会去的,没有动力。”(财富中文网)

译者:宣峰

随着联邦政府近期措施的出台,以及许多私人倡议的实施,COVID-19病毒测试数量开始提升,但有关谁能够获得测试,谁为病毒测试以及可能需要的后期治疗买单,这些措施多大程度上可以阻遏COVID-19在美国各地的传播,依然是问题多于答案。

周日在白宫的记者招待会上,副总统迈克·彭斯再次强调,这些措施将会帮助到所有的美国人,但他没有提供具体细节。上周他曾宣布“所有的保险公司”同意“豁免所有新冠病毒测试的定额手续费部分,并将保险的所有福利计划都覆盖到新冠病毒的治疗。”

“随着测试的推广,我们很高兴地看到,国会与政府携手来确保成本问题永远不会成为任何人获得病毒测试的障碍,”彭斯在情况介绍会中说。“目前所有的新冠病毒测试都是免费的,每个美国人都能免费获得测试,包括没有保险的美国人。”

保险商承担病毒感染爆发所带来压力的投入程度,以及联邦政府和各州对抗疫的支持程度,还有待观察。

据白宫称,蓝十字蓝盾、安泰、信诺、休曼纳和联合健康公司将参与其中。目前为止,大多数保险公司承诺豁免COVID-19病毒测试的定额手续费部分,但对治疗的定额手续费部分尚未豁免。《财富》杂志联系了白宫提到的所有保险公司,大多数只提供了在线声明或者邮件评论。信诺没有予以回复。

比如,蓝十字蓝盾的COVID-19病毒防疫指引称,保险覆盖范围“将与被保险成员健康利益的标准条款相一致” 。

有些公司还覆盖了远程医疗的定额手续费部分。“如果商业被保险人在实际就医前接受了远程医疗服务, 依照我们提供的未来90天内零定额手续费远程医疗服务保险覆盖,他们不需要支付定额手续费部分,”上述文字源自安泰的邮件声明。

即便是有保险的人士,也还有很多细节问题要厘清。

“新冠病毒才不管你是有保险的,还是没保险的,是民主党人还是共和党人,也不论你是黑人还是白人,”生物科技高管丹娜·格雷森说。她是自1月中旬以来就呼吁采取更严格防控措施的群体中的一员。“这不是一种只会攻击富人或有保险人士的病症。我们看到了受感染的人数在加速上升,而我们几乎很少测试。”

对于大多数通过雇主公司获取保险计划的美国人来说,其境遇很大程度上要看联邦政府即将决策实施的新法案和要求。众议院周六通过了《家庭第一新冠病毒应对法案》,包括一些测试条款和为工人提供财务支持的条款。参议院将在本周审议。

这一法案包括建立“无成本为消费者提供新冠病毒诊断测试的要求,扩大失业人员的利益保障,以及暂时性地提高医疗补助力度。”尽管多数被感染者的症状较轻,但还是有一定比例的受感染者需要住院治疗、呼吸器及其他支出。

“有保险但自费部分较高的人,自费部分恐怕会成为一种障碍,因为他们可能需要支出数百甚至数千美元,”乔治敦大学公共政策麦考特学院的医疗保险改革中心联合主任萨布里娜·克莱特说。“众议院的法案会帮助到这些人,手段是要求保险商和雇主豁免费用共摊,不光是测试,还有急诊和门诊。”

对大约三千万没有保险的美国人来说,财务上的不确定性可能更大。

最直接的影响和阻遏因素是许多人无法获得测试。白宫成功安排测试的报道,与许多病人的体验是脱节的,这些有潜在病兆的人因不符特定条件而被医疗机构拒绝测试,但他们可能携带病毒,并可能给其他人带来风险。

圣芭芭拉菲尔丁研究生院的博士生妮可·巴德里纳斯,就被加州弗里蒙特的帕拉奥图医疗基金会拒绝病毒测试,尽管她当时已显示出一些症状。

“他们说不会对我进行测试,因为我不属于高风险,”巴德里纳斯说,“我被告知,我不符合某些测试条件,比如呼吸困难。”

即使她跟八十多岁的父母一起居住,她还是被拒绝测试。

“他们告诉我,在家里时戴上口罩,并远离父母,”她说,带着一种挫败感,她已放弃了去测试的想法。“呵呵,真是太好了,我已经跟他们在家一个礼拜了。”

在医院门诊处,医生告诉她,如果开始有呼吸困难问题,就回来就医。

很明显,白宫夸大了上周病毒测试的安排速度和范围。特朗普竞选团队全国发言人凯雷·迈克伊纳尼在3月12日的推文中说,“已经分发了一百万个测试设备,本周末将会分发四百万个,”美国总统也发推文重申了这一点。

根据疾控中心3月17日发布的数据,疾控中心实验室总计已进行了4255份测试,公共卫生实验室测试了27623份。

在遭受COVID-19病毒冲击的国家中,如果按每百万人的测试比例排名,美国排在倒数位置。美国测试的人数不到法国的一半,而法国人口比美国少得多。

据《商业内幕》报道,尽管测试能力有限,但一些高净值病人可以在家获得病毒测试,这是由比如大卫·纳扎里安等特约医生提供的“家政电话”服务的一部分。一些名人比如海蒂·克鲁姆可以获得在家测试还分享到社交媒体,引发了强烈反应,人们感慨“有钱有名望的”就可以获得这种服务。

彭斯在周日的记者招待会上重申,所有的新冠病毒测试将是免费的,但很多责任会落到各个州以及私人公司身上去落实。

有些州,比如马萨诸塞、宾夕法尼亚和加利福尼亚州,已经强制要求豁免COVID-19测试和治疗的定额费用部分。

周一伦敦帝国理工学院发表的一篇报道指,研究者估计COVID-19将感染美国人口的81%,死亡人数光是在美国就将高达220万,如果没有及时采取措施缓解疫情的话。全美各地的护理机构和接线中心的电话都被打爆了。

“我们当然很担心,”注册护士杰森·菲利普说,他在过去几天见证了日常接电话数量的成倍上升。许多人打电话来询问基本信息,以及在何地以何种方式可以获得测试。

“我感觉在加州南部,有很多人应该马上接受测试,以帮助公共卫生系统的防疫努力,但我们实在太忙了,”菲利普说,“我们能做的就是与病人电话预约好,并叫他们在获得医疗指示之前自行隔离。”

他也很担心基本的防护用品和口罩的短缺。

“由于这第一波的社区感染期间的疾病传播和隔离措施,我们将失去很多医疗工作人员,”菲利普说。

标普指数内的保险公司上周有一份分析报告称,谁来承担COVID-19病毒爆发的大部分成本,或许也要看当前措施的有效程度。

“大多数有保险的人士,尤其是机构或雇主保险计划内的人,在今年后半期之前,不会达到他们自费部分的上限,”标普分析师在3月12日发表的一份报告中写道,“所以,如果能在今年上半年遏制COVID-19的传播,有保险的人士会承担治疗成本的大部分。不过,如果到下半年病毒还持续传播,而有保险人士已达到成本共摊的要求,保险公司将直接承担医疗费用的更大部分。”

有些社区和一些其他国家,已经行动起来解决潜在的经济困难问题,甚至由于疾病爆发导致的破产问题,但对于没有医疗保险的工人们的医疗保障条款细节,还是很有限。

已有一些卫生领域的专家敦促联邦政府扩大联邦条款覆盖范围,降低医疗补助门槛,采取诸如“创建一页式申请书,让人们持续获得补助,而不需要不断地进行机构认可”或者允许“各个州临时性地增加医疗补助可获得性,扩大资格要求的收入范围,突破现有的收入限制。”

最不可能被测试的很多人,比如身体最虚弱的人士和接触人多的行业人士比如食品服务人员,直到那时才会获得病毒测试。

“如果你没有保险——要么是买不起保险,要么是你没有工作——如果你去做病毒测试,你恐怕要费很大劲才能获得免费测试,因为测试能力是如此之低,”格雷森说。“要么你测试完了,面对一张数千美元的收费单傻了眼,如果测试结果是阳性你就不能返工。那为什么要去测试呢?不会去的,没有动力。”(财富中文网)

译者:宣峰

As COVID-19 testing is poised to ramp up following the federal government’s recent measures and the rollout of a range of private initiatives, there are still more questions than answers about who will be able to access these tests, who will pay for them or any potential treatment, and how successful these measures will be in deterring the spread of the coronavirus across all parts of American society.

Speaking at the White House press conference on Sunday, Vice President Mike Pence once again stressed that the measures will support all Americans, but offered few details. Last week, he announced that “all the insurance companies” agreed “to waive all copays on coronavirus testing and extend coverage for coronavirus treatment in all of their benefit plans.”

“As we expand testing, we’re so pleased that Congress joined with our administration to make sure that cost is never going to be a barrier to anyone getting a coronavirus test,” Pence said at the briefing. “Now all coronavirus testing is free, and it’s free for every American, including uninsured Americans.”

The full extent of the insurers’ commitment to shoulder the burden of the outbreak, and the level of support from the federal and state level, remains to be seen.

Blue Cross Blue Shield, Aetna, Cigna, Humana and UnitedHealth Group were among the attendees at the event, according to the White House. So far most insurance companies have committed to waiving co-pays for COVID-19 testing only, not for treatment. Fortune reached out to all insurers named by the White House, and most referred to an online statement or offered comments via e-mail. Cigna did not respond to a request for comment.

For example, Blue Cross Blue Shield’s COVID-19 guidance says coverage “will be consistent with the standard provisions of the member’s health benefits.”

Some are also covering telemedicine co-pays. “If a commercial member sees a telemedicine provider for their follow-up visit, there are no co-pays as part of our zero co-pay telemedicine offering available for the next 90 days,” according to an e-mailed statement from Aetna.

Even for those with insurance, there are still a lot of details to be worked out.

“Coronavirus doesn’t care if you’re insured, uninsured, Republican, Democrat, black, or white,” said Dena Grayson, a biotechnology executive who was among a group of voices calling for tougher measures since mid-January. “This is not a disease that only hits rich people or insured people. We can see that the number of cases is accelerating, and we’re barely testing.”

For the majority of Americans who have their insurance plans through their employer, a lot of it depends on the new bill and the requirements the federal government will decide to put in place. The House of Representatives passed the Families First Coronavirus Response Act on Saturday, which includes some provisions for testing and financial support for workers. The Senate will be reviewing it this week.

The bill includes establishing “requirements for providing coronavirus diagnostic testing at no cost to consumers, expanding unemployment benefits, and temporarily increasing Medicaid assistance.” While for many the symptoms may be mild, a portion of those infected may require hospitalization, ventilators, and other costs.

“[For] people with insurance but high deductibles, the concern is that those deductibles will be a barrier because they could face hundreds or even thousands of dollars,” said Sabrina Corlette, codirector of the Center on Health Insurance Reforms (CHIR) at Georgetown University’s McCourt School of Public Policy. “The House bill would address those folks by requiring insurers and employers to waive cost-sharing, not just for the tests but for the emergency room visit or an office visit as well.”

The financial uncertainties are potentially even bigger for about 30 million of Americans who are not insured.

The most immediate concern and deterrent for many is access to testing. There is a disconnect between reports of a successful testing rollout from the White House and the experiences of many patients with potential symptoms being turned away because they don’t meet specific criteria, yet may still be carriers and present a health risk to others.

Nicole Badrinath, a doctoral student at Fielding Graduate University in Santa Barbara, was denied a coronavirus test despite displaying symptoms at Palo Alto Medical Foundation in Fremont, Calif.

“They said they will not test me because I was not high-risk,” Badrinath said. “I was told I was not meeting the requirements like shortness of breath.”

She was denied the test even though she lives with her parents who are in their late eighties.

“I was told to wear the mask at home and to stay away from them,” she said, frustrated and giving up on the idea of getting a test. “That’s fantastic. I’ve been at home with them for the last week.”

At the doctor’s office, she was told to come back if she started having breathing issues.

It’s clear that the White House overstated the speed and scope of testing last week. Trump campaign national spokesperson Kayleigh McEnany said in a tweet on March 12 that “1 million tests have already been distributed, with 4 million distributed by the end of the week,” an assertion that was retweeted by the U.S. President.

According to data published by the CDC as of March 17, a total of 4,255 tests have been run by CDC labs and 27,623 by public health labs.

When comparing the rate of testing per million people, the United States is in the bottom pack of the countries impacted by COVID-19. The U.S. has administered less than half the volume of tests France has, a country with a much smaller population.

Despite limited testing capacity, some high-net-worth patients have been able to access in-home tests as a part of the “house calls” offered by concierge doctors such as David Nazarian, Business Insider reported. Celebrities like Heidi Klum also shared being able to access a test, invoking a reaction on social media about how the “rich and famous” have access to these provisions.

Pence reiterated in Sunday’s press conference that all coronavirus testing will be free, but a lot of the responsibility will likely fall on the states and private companies to enforce.

Several states like Massachusetts, Pennsylvania, and California are moving to mandate waiving co-pays both for COVID-19 testing and treatment.

In a report published by Imperial College London on Monday, researchers estimate COVID-19 could infect 81% of the U.S. population and as many as 2.2 million could die in the U.S. alone if severe, immediate measures are not taken to mitigate the epidemic. The volume of calls to nurses and call centers is surging across the country.

“We’re definitely concerned,” said registered nurse Jason Phillips, who has witnessed the tripling of his daily volume of calls over the past few days. A lot of people are calling in for basic information, he noted, as well as how and where to get tested.

“There were many people I feel should have been tested right away to help the public health effort in Southern California, but our hands were tied,” said Phillips. “The best we could do was to set up the patients with a telephone appointment and to ask them to self-quarantine until receiving instruction from a provider.”

He is also concerned about the shortages of basic protective equipment and masks.

“We’re going to lose whole groups of health care workers due to illnesses and quarantines during this initial wave of community infections,” Phillips said.

Who will carry the bulk of the costs of the COVID-19 outbreak might also depend on how effective current measures are, an analysis of the insurance companies last week by S&P suggested.

“Most insured individuals, especially in group or employer plans, don’t meet their deductible limits until later in the year,” S&P analysts wrote in a report published March 12. “So if the spread of COVID-19 is limited to the first half of the year, the insured will bear a greater proportion of treatment costs. However, if COVID-19 continues to spread later in the year, when insured individuals have met their cost-sharing requirements, the insurer will bear more of the medical costs directly.”

While some communities and other countries are moving to address potential financial hardships and even bankruptcies that may result from the outbreak, the details on health care provisions for workers without health insurance remain very limited.

There are other health care experts who are urging the federal government to expand federal provisions and ease Medicaid enrollment by taking measures like “creating a one-page application form and keeping people continuously enrolled without the need for constant recertification” or allowing “states to temporarily increase Medicaid eligibility higher up the income scale in all states beyond their current income limits.”

Until then, a lot of people from the most vulnerable and most exposed sectors, such as food-service workers, may be the least likely to get tested.

“If you don’t have insurance—either you can’t afford insurance or you’re not working—if you did go to get tested, you’re going to have a tough time getting a test that’s free, because the capacity is so low,” Grayson noted. “Then you get stiffed for a bill that’s a couple thousand bucks, and you can’t go back to work if you’ve tested positive. So why would you get tested? You wouldn’t, there is no incentive.”

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