by John Ellis
Yesterday morning, I read about a nurse in Ocala, Fl, who died from COVID-19 after contracting it at work. Only 56 years old, her name is Venezia Monroe. She leaves behind a grieving family and circle of friends who praise her dedication to her job. Tragically, Venezia’s story is not an isolated case, by far. According to this report released by National Nurses United, over 1,700 healthcare workers have died of COVID-19, and the report was released a month ago. Cases and hospitalizations are now rising at a previously unseen clip, the number of healthcare workers who die will undoubtedly and unfortunately go up. The report adds that many of the healthcare workers who died pleaded for adequate PPE before contracting and succumbing to the virus. Dr. Claire Rezba, who began documenting fatalities among healthcare workers from COVID-19, counts a minimum of 1,200 deaths among healthcare workers, but is quick to add, “even this number is an undercount.” You can read Dr. Rezba’s work by clicking the Twitter link below and then hitting the “follow” button; work she began after diving into the data and realizing that fatalities among healthcare workers has been undercounted by the CDC, which, at last count on October 24, has counted 763 deaths among healthcare workers. Regardless of the number, and this pandemic is far from over – remember, case rates are escalating as are hospitalizations – any deaths among frontline healthcare workers is too many. But then, just a few short hours after reading about the death of Venezia Monroe, I heard the President of the United States of America slander her, her fellow healthcare workers who have tragically died, and all other frontline workers who place themselves in harm’s way to care for our friends and loved ones afflicted with COVID-19.
During a campaign rally in Waukesha, WI, President Trump defended his response to the pandemic by claiming, “You know, doctors get more money and hospitals get more money, think of this incentive.” Throwing doctors, nurses, and other healthcare workers under the bus in an attempt to defend this country’s high fatality rate, Trump repeated the disgraceful conspiracy theory that COVID deaths in this country are overcounted owing to the greed of doctors. To put it in personal terms, according to Trump, if I get COVID-19 and die, I didn’t die of COVID but from my heart condition which is considered a comorbidity. But the greedy doctors will say I died from COVID.
Before unpacking the claim that “doctors get more money and hospitals get more money”, a conspiracy I’ve heard pushed throughout this entire pandemic by family members and friends, I want you to consider the cancer death rate in this country to see the absurdity of saying that those with comorbidities shouldn’t be counted as COVID-19 deaths. First, though, I want/need to say this: It’s disgracefully anti-life to claim or even insinuate that the months, weeks, or even days that were cut short for those with terminal cancer (or any comorbidity) who contracted COVID-19 should be dismissed in the issue of improving this country’s coronavirus stats. Incredibly disgraceful! And an anti-life dismissal that many so-called prolifers parrot. Life is precious. All life, whether on the front end or the back end. I’m anti-euthanasia for the same reason that I’m anti-abortion. If COVID-19 robs a soul of any amount of life, it’s too much time and adds to the growing reflection of how miserably this country and Trump’s administration has faced and handled this crisis.
Most of us know someone who has had, currently has, or who died from cancer. Most likely, our loved ones who are suffering from cancer have comorbidities that increases their chance of dying. If, God forbid, they do die and someone dares say, “They didn’t really die of cancer. Their hypertension-obesity-or-pick-a-combordity is the true cause of their death. Besides, owing to their combordities, their life span was going to be shortened anyway,” I predict that you wouldn’t respond well. The fact is that a sizeable percentage of our loved ones who died from cancer had combordities and a large percentage of those who are currently battling cancer have comorbidities; the majority of Americans have comorbidities, after all. I’ve combed through data and read several articles in science and medical journals about comorbitity rates in cancer patients and, while much of it is over my head, it’s clear that the medical and research communities put much time and effort into researching and providing medical care tailored for cancer patients with underlying health issues because the majority of cancer patients have comorbidities. Make no mistake, though, if and when they die, they die from cancer and not their comorbidities. Until now, during a season dominated by self-serving conspiracy theories, the notion that people didn’t die of the disease that exacerbated their comorbidities wasn’t a thing. I’ve never heard anyone challenge the cancer death rates in this country because of comorbidities.
Now, do doctors and hospitals get more money if they write COVID-19 on the death certificate? Well, yes and no, and way more no than yes. It depends on how you define “more”. The $2 trillion CARES Act passed by Congress this past Spring provides relief for hospitals suffering under the financial burden that comes with caring for COVID patients on Medicare (about 40% of patients). The CARES Act provides a 20% increase over normal medicare payouts. If the patient has be to placed on a ventilator, the amount received increases because, well, the cost to the hospitable increases drastically. It also bears mentioning that many states, like Texas, have refused to expand Medicare. As a result, those states’ hospital systems have less access to COVID related funds provided by the CARES Act. Regardless of the amount received by hospitals, it’s important to note, though, that the reimbursements are intended specifically for either COVID related healthcare treatments or lost revenue due to COVID related treatments, and according to the CARES Act, hospitals have to prove that the patient’s subsequent treatments in question are directly related to COVID. Fudging the data even a little is Medicare fraud. And the Feds do not take Medicare fraud lightly nor are they in the habit of overlooking it. Everytime someone repeats Trump’s conspiracy theory, the first part of the rebuttal should be, “That would be Medicare fraud!”
What’s more, there isn’t a documented instance of someone dying in a motorcycle crash and having COVID listed as the cause of death. And why would they? There is no federal reimbursement for crash victims who have also tested positive. At best, the hospital would have to completly fabricate the death certificat, committing fraud. We’re far enough into this that the Feds thirst for prosecuting Medicare fraud would have produced indictments that would’ve been all over the news.
One thing that hasn’t been widely reported, especially by conservative media outlets, is that hospital administrators have gone round after round with HHS for clarifications about what’s actually eligible for CARES Act reimbursements and how to report it. Not only is the sword of Damocles named Medicare fraud hanging over their heads, some of the funds have to be repaid based on a complicated algorithm. The CARES Act is a product of our convoluted and opaque Congress, after all. But back to the “more” in paid more for COVID Medicare patients. It’s simply not true that hospital systems are enriching themselves because of the pandemic.
Hospitals are losing money, many on the verge of bankruptcy. Want to know why? Because treating COVID patients is incredibly expensive, and the pandemic has pushed the money-making elective surgeries on to the back burner. Logic (and human nature) tells us that if hospitals and doctors were greedy and that this pandemic is overblown, even just a little bit, the subterfuge would go the other way. “No, you don’t have COVID. Go home, get some sleep, and take some Robutisson for that cough. Now get out of here, you’re taking up space that should be filled by a patient booked for an elective surgery.”
Anyone who Googles the financial strain on hospital systems because of COVID will have a hard time swallowing President Trump’s disgraceful lie about doctors and hospitals. Anyone who appreciates the sacrifices of our frontline healthcare workers will shoutdown the conspiracy theories dragging our doctors and nurses through the mud. The Trump administration and Trump’s supporters who’ve enabled his malfeasance during this health crisis have much to answer for. One thing that history will not look kindly on is the conspiracy theory being touted that greedy hospitals and doctors are artifically driving up death rates from COVID-19.
P.S. By way of piling on, here’s an informative article debunking any attempts to downplay COVID-19 via comparisons to the flu.
P.S.S.: Below is the concluding slide from a recent presentation at the UAB Infectious Diseases Division. I lifted it from the Twitter account of Dr. Paul Sax, Harvard/Brigham infectious diseases doctor.