Could the Covid-19 Pandemic Collapse the U.S. Healthcare System?

February 27, 2020

Disregard these second-order effects at your own peril.

A great many systems that are assumed to be robust are actually fragile. Exhibit #1 is the global financial system, of course, but Exhibit #2 may well be the healthcare system globally and in the U.S.

Observers have noted that the number of available beds in U.S. hospitals is modest compared to the potential demands of a pandemic, and others have wondered who will pay the astronomical bills that will be presented to those who are treated for severe cases of Covid-19, as the U.S. system routinely generates bills of $100,000 and up for a few days in a hospital. Costs of $250,000 or more per patient for weeks of intensive care treating Covid-19 cannot be dismissed as "impossible."

Beyond the possibility that the logistics and costs of care will overwhelm the system, there are numerous and highly consequential second-order effects to consider. As you may recall from recent posts here: first order, every action has a consequence. Second order, every consequence has its own consequence.

Second-Order Effects: The Unexpectedly Slippery Path to Dow 10,000 January 31, 2020

Could the Coronavirus Epidemic Be the Tipping Point in the Supply Chain Leaving China? January 28, 2020

Second-order effects of the pandemic colliding with America's dysfunctional healthcare system include:

1. People avoiding care because they can't afford it. Academic studies have shown that high deductibles make patients reluctant to seek care, even when they need it.

This second-order effect will exacerbate the contagion and endanger those suffering from severe symptoms.

2. Potential shortages of medications due to an over-reliance on supply chains in China. The number of unknowns far exceeds the number of knowns in this situation, so complacent assumptions may be misplaced.

3. U.S. healthcare's obsession with maximizing profits by any means available has transformed healthcare from a calling to just another burnout job in the Corporate America profit-maximizing grinder. A long time general practitioner (physician) recently explained the consequences of this transformation should the pandemic engulf the U.S.:

"The risk of wholesale healthcare system failure from a stress even a fraction of what is experienced in China is deeply, deeply under appreciated. The transition of medicine from calling to career is nearly complete-- as is the removal of any mentors who might teach otherwise.

If Corona hit my community 20 years ago, at a time where all the administrators and most of the staff of our 200 bed hospital lived in town, my partners and would've sucked it up and did our best, even at the risk of our life. I'm not boasting or saying we're heroes, it's just that that was the way we were trained. White coats were only for the broadest shoulders. And you were taught that the risks of taking care of sick people was part of the deal.

Our patients were our neighbors. They counted on us. Such respect as we were given was due to the fact that we were their healthcare resource. The leadership and medical staff of the hospital would have done what we could to make it work. And yet here were a number of independent pharmacies and health supplies we could rely on if things got tough.

Then a combination of secondary effects and political influence purchased by deep pocketed competitors put most of the independent clinicians in an untenable place and all left or were absorbed.

Today, though the same organization owns the hospital, none of the management lives in town. Like most health systems, the owners are more is more interested in data collection and foot traffic than healthcare--and it shows. The inpatient doctors are all hospitalists who live far out of town. All the other docs in town now work for the same organization, but they haven't been welcome in the hospital for years. Few of the nursing staff live nearby.

If a real pandemic hits, that hospital will well and truly fail--there's no other word for it. Docs and nurses won't show up. It's not their friends or family or kid's teacher or pastor at risk. While we wouldn't have liked it, we would've risked our health for our community. These professionals are not going to risk their life for a job. The senior management will try to keep it together for the sake of their careers, but the next tier will quickly bag it. Again, it's just a job. The corporate supply chain is so fragile and there are now so few community resources that the hospital as a care system will quickly break down.

As you have discussed, just because a thing is difficult to measure doesn't mean it's not important. The engagement of my partners and I with our community hospital was a critical loss--and that loss of 'robustness' won't be fully understood until the system is stressed.

In my community at least, it won't take much stress for the rot to be revealed."

Disregard these second-order effects at your own peril. Just as unsustainable speculative bubbles burst, unsustainable systems break down once systemic stresses rise above very low levels.

My COVID-19 Pandemic Posts
My recent books:

Audiobook edition now available:
Will You Be Richer or Poorer?: Profit, Power, and AI in a Traumatized World ($13)
(Kindle $6.95, print $11.95) Read the first section for free (PDF) .

Pathfinding our Destiny: Preventing the Final Fall of Our Democratic Republic ($6.95 (Kindle), $12 (print), $13.08 ( audiobook ): Read the first section for free (PDF) .

The Adventures of the Consulting Philosopher: The Disappearance of Drake $1.29 (Kindle), $8.95 (print); read the first chapters for free (PDF)

Money and Work Unchained $6.95 (Kindle), $15 (print) Read the first section for free (PDF).
If you found value in this content, please join me in seeking solutions by becoming a $1/month patron of my work via .

(Kindle $6.95, print $12.95)

Will you be richer or poorer? What does the future hold for you--and for the world?

Supposedly we're all getting richer, but many of us feel we’re becoming poorer. Why?

This book tackles three critical questions:

What if everything we don’t measure is worth more than financial wealth? Our obsession with financial capital is blinding us to a traumatizing global decline in other forms of wealth.

Will artificial intelligence (A.I.) make us all richer? What if A.I. will only enrich the few who own the platforms and technology?

Is our economic model dooming us? We’re told we all benefit as the super-rich get even richer, but what if the status quo only benefits those in power at the expense of everyone else--and our planet?

Though we may not be politically powerful, we are far from powerless. This book will help you identify the things that truly matter, and accumulate capital that benefits you and your family--and our planet.

Read the first section for free in PDF format.

Will You Be Richer or Poorer?: Profit, Power and A.I. in a Traumatized World (15% discount in October, Kindle $5.95, print $10.95)

Recent entries:

Could the Covid-19 Pandemic Collapse the U.S. Healthcare System? February 27, 2020

The Economic Cataclysm Ahead February 26, 2020

How Many Cases of Covid-19 Will It Take For You to Decide Not to Frequent Public Places? February 25, 2020

No, The Fed Will Not "Save the Market"--Here's Why February 24, 2020

When Will We Admit Covid-19 Is Unstoppable and Global Depression Is Inevitable? February 23, 2020

When Bubbles Pop, Only the First Sellers Escape Being Bagholders February 21, 2020

Covid-19: Global Retrenchment Will Obliterate Sales, Profits and Yes, Big Tech February 20, 2020

Omens, Portents, Karma and the Mandate of Heaven February 19, 2020

The World Is Awash in Oil, False Assurances, Magical Thinking and Complacency as Global Demand Careens Toward a Cliff February 18, 2020

COVID-19 Pandemic: The Complacent Are Clueless February 17, 2020

The Fed Has Created a Monster Bubble It Can No Longer Control February 16, 2020

The Violent Collision of Market Fantasy and Viral Reality February 14, 2020

Our "Come to Mao" Reckoning and the Next Cultural Revolution February 13, 2020

China's Fatal Dilemma February 11, 2020

Controlling the Narrative Is Not the Same as Controlling the Virus February 9, 2020

The Pandemic Isn't Ending, It's Just the Beginning of Global Disorder and Depression February 7, 2020

Pandemic, Lies and Videos: What Were We Thinking? February 6, 2020

When China's Supply Chains Break, so Will the Delusion the U.S. Economy Is Invulnerable February 5, 2020

Projecting "Wave 2" and "Wave 3" of the Coronavirus Pandemic February 4, 2020

Brace for Impact: Global Pandemic Already Baked In February 3, 2020
January 2020 entries

Archives 2005-2019

Contributions/subscriptions are acknowledged in the order received. Your name and email remain confidential and will not be given to any other individual, company or agency. All contributors are listed below in acknowledgement of my gratitude.

Thank you, Robin M. ($5/month), for your most generous pledge to this site -- I am greatly honored by your support and readership.

Thank you, Michael R. ($5), for your very generous contribution to this site -- I am greatly honored by your support and readership.

go to Kindle edition

Of Two Minds Site Links

home musings my books archives books/films policies/disclosures social media/search Aphorisms How to Contribute, Subscribe/Unsubscribe sites/blogs of interest original music/songs Get a Job (book) contributors my definition of success why readers donate/subscribe to Of Two Minds mobile site (Blogspot) mobile site (

Full Website