Restoring America’s health is bigger than COVID

The state of American health was precarious before COVID-19 — with high rates of chronic conditions, heart disease, obesity and behavioral health issues — and is at risk of deteriorating further. 

It is true that amid rising infection rates and the tragic loss of thousands of Americans from COVID-19 our country has come together to deliver care to people in need, protect essential workers and develop a vaccine. As we start the new year, we’re well positioned to begin immunizing the general public against the disease and limiting its spread. 

That’s great, but it doesn’t address all our health challenges. COVID-19 is just one threat we face as the new Congress convenes this month. 

In the months ahead, before vaccines are widely available, the healthcare system must find ways to care for its COVID-19 patients without sacrificing the urgently needed care of other Americans. In short, we must walk and chew gum at the same time. The people we serve are depending on us.    

We’ve made progress in several key areas in recent years. Newly released data from America’s Health Rankings, which provides an annual snapshot of our health, reveal gains in access, prevention and chronic disease management that have shown progress toward improving outcomes:

• The uninsured rate declined by more than 40 percent since 2010.
• The number of Americans receiving flu vaccines increased by 17 percent since 2016.
• More recently, rates of cardiovascular disease fell by 7 percent between 2017-2018.

Those modest improvements are encouraging, especially because they highlight strategies that we can expand and adapt across our healthcare system. They were also tenuous, with the prevalence of obesity, depression, and suicide continuing to climb in 2019. Unfortunately, COVID-19 may have only exacerbated those vulnerabilities. 

At a basic level, COVID-19 upended lives and disrupted the way people received care. Most in-person care, especially primary care and preventative screenings nearly came to a halt at the beginning of the pandemic and has still not recovered. While that’s understandable considering the circumstances, the drop-off in high value patient care is deeply concerning. 

Immunization rates for children declined by two-thirds. Cancer screenings collapsed by 80 percent. The social and economic upheaval undermined people’s normal, healthy routines by isolating them from one another and causing higher levels of anxiety and depression. Patients are delaying care by almost every measure and we know that untreated problems get worse. 

It’s difficult to anticipate the full toll COVID-19 has had and will take, but it’s huge and likely to grow in the months ahead as we navigate the repercussions of this disease. The pandemic put 10 years of hard-fought, incremental progress at risk in just 10 months. 

Our top priority must be reconnecting patients to the healthcare system. We started the year with tools needed to check COVID-19, now healthcare leaders must make every effort to reconnect patients with the care they need. We can’t afford to let delayed care escalate into a crisis. It won’t be easy though. 

There are, however, straightforward opportunities to make meaningful improvement by emphasizing universal coverage, affordability, better outcomes and a less daunting healthcare experience, like:

• Expanding access to Medicaid in the 12 states that have yet to do so and 10 which have not fully expanded access.
• Shifting care from high-cost hospital settings to lower, high-quality alternatives would save $100 billion over 10 years. 
• Investing in a diverse healthcare workforce that reflects the population it serves.
• Rewarding providers for delivering high quality, cost-effective care that improves outcomes. 

We need to build on what’s worked well. We can expand and adapt the strategies that have reinforced the forward progress we’ve seen, remove the barriers people face in getting the right care at the right time and strengthen regular pathways to care that people know and like. 

Our healthcare system faced mounting pressure before the unanticipated distress of COVID. Healthcare leaders and providers can meet those challenges by learning from the pandemic, flexing every resource available and collaborating like never before to improve the precarious state of our health and build the next generation health system that Americans deserve. 

Dr. Richard Migliori is the chief medical officer of UnitedHealth Group, which provides care to 140 million Americans