Coronavirus Briefing: What Happened Today

Congress tried to shield Covid-19 patients from unexpected medical charges. So why are people still receiving huge bills?


Credit…The New York Times

Congress tried in coronavirus relief packages passed this spring to shield Covid-19 patients from unexpected medical charges — and yet many patients continue to receive heartstoppingly large bills that their insurance companies won’t cover.

One patient in Philadelphia was flown between hospitals by helicopter while she was unconscious and returned home weeks later to a $52,112 bill from the air ambulance company. Another faces as much as $4,000 in medical debt after spending 10 days at an in-network hospital in Austin, Texas, because many of the doctors at the hospital were out-of-network.

Our colleague Sarah Kliff told us that patients were often charged fees by providers or companies that they didn’t choose or even realized were involved in their care. A big reason for these exorbitant charges, she said, is private equity.

Take the helicopter ride, for example. Private-equity firms have poured money into air ambulance companies after courts exempted air ambulances from any state price regulation.

“From a private equity point of view, it’s actually an amazing investment,” Sarah told us. “Prices that can go as high as you want, plus customers who can’t negotiate those prices. Like, if you need an air ambulance, you need an air ambulance, and you can’t call someone else and you can’t negotiate.”

Sarah told us that private-equity money was flowing into these areas of health care where patients have little or no say, including emergency room doctors and anesthesiologists. Firms buy the companies that staff doctors in hospitals, and then they raise prices or go out-of-network.

Last year, a plan to ban these surprise bills was popular, bipartisan and backed by the White House. But it fell apart at the last minute after the private-equity firms that own many medical providers poured millions into advertisements opposing the plan.

While many of us are awaiting news of a vaccine, dozens of companies and academic groups are focusing on an alternate defense: monoclonal antibodies. President Trump recently received an infusion of an antibody cocktail made by Regeneron and called it a “cure.”

Apoorva Mandavilli, who covers science and global health for The Times, told us that these antibodies — distilled from the blood of patients who have recovered from the coronavirus — were most likely to be effective for treating the elderly or immunocompromised. They also work way faster than vaccines.

“If you imagine a situation like a nursing home where they discovered one case, you can give monoclonal antibodies to the other people in that nursing home as a preventative measure,” Apoorva said.

A dark horse in the race to develop an antibody treatment is Prometheus, a ragtag group of scientists working in academic labs, the United States Army Medical Research Institute of Infectious Diseases, and an antibody company called Adimab.

While Prometheus’s antibody is not expected to be in human trials until late December, it aims to be effective for up to six months. That’s much longer than those made by Regeneron and Eli Lilly that fade in the body within weeks. On Tuesday, news broke that a government-sponsored clinical trial of Eli Lilly’s antibody treatment had been paused because of a “potential safety concern.

With prices that begin at about $15,000 per year, it’s possible that these antibodies will be a realistic treatment option only for rich individuals, even within the United States, and there hasn’t been much discussion about who should have access to the treatment.

“There’s been a lot of talk about who will get the vaccine first, how will the government decide the allocation — there has been none of that discussion for monoclonal antibodies,” Apoorva said.

Here’s a roundup of restrictions in all 50 states.

I’ve had the great opportunity to bond with my very soon to be 18-year-old son. My other kids are still on a swim team. While they swim, I take a walk with my son and my dog to a beautiful park area near the pool that we never get to visit. He’s turning 18 in a month, headed to college next year. I would never have had this bonding opportunity with him if it wasn’t for Covid.

— Heather Reeder, Sun Prairie, Wis.

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Jonathan Wolfe and Dani Blum