The long-term cost of Long Covid
Cases are rising again, and so are number of people suffering from its long-term effects. It's already taking a toll on the economy.
Well over 100 million U.S. adults have contracted Covid since the beginning of the pandemic with an estimated 13% of patients suffering from its long-term effects. The most common symptoms among this very large group are chronic fatigue, breathing difficulties and “brain fog” — the loss concentration and memory.
Little attention has been paid to the impact this suffering is having on health care spending, which is once again growing at a faster clip than the rest of the economy. An early study conducted by David Cutler at Harvard conservatively estimated Long Covid treatment had cost $528 billion through the end of 2022. More than two years later, that spending would be far higher.
Even less attention has been paid to its impact on the broader economy. That same study estimated Long Covid reduced earnings by nearly a trillion dollars among its sufferers, which would make the disease a significant contributor to the relatively slow economic growth we’ve seen over the past two years.
A new study released today in JAMA seeks to quantify the financial impact on working-age adults from Long Covid. It found people reporting long-term effects from the disease experienced greater unemployment, reduced work hours and were more likely to experience activity impairment at work compared to those whose disease resolved quickly without long-term effects.
“The substantial employment and economic burdens … underscore the need for targeted policy interventions and greater workplace support structures to ensure that the sizable U.S. workforce that may have Long Covid is able to contribute to economic activity and to avoid personal economic hardship,” the study authors concluded.
The study, conducted at eight academic medical centers, followed 3,663 people who contracted Covid during the first two years of the pandemic for at least six months after they recovered. More than a quarter (27.1%) of the participants reported having symptoms of Long Covid with nearly half of them reporting a waxing and waning of their symptoms.
The lingering effects of the disease proved devastating to their work lives. Those with either resolved or current Long Covid were nearly three times more likely to be unemployed compared to those who suffered no after-effects from the disease. More than 40% of Long Covid sufferers (current or resolved) had reduced work hours compared to just 14% of those without it.
And as far as productivity was concerned, those with Long Covid were 44% more likely than those without it to ask for shorter hours or less demanding work. As a consequence, the Long Covid group was five times more likely to face economic stress in their daily lives compared to those without it.
The bottom line: The media, following the lead of the federal government, has largely moved on from reporting on the ongoing effects of the Covid pandemic. That ignores ongoing physical and economic impact it is having on well over 13 million Americans.
In other research news:
As part of its ongoing investigation of UnitedHealth Group, STAT this week offered a persuasive takedown of UHG-backed research claiming Medicare Advantage generates superior health outcomes for seniors compared to traditional Medicare.
The lead anecdote in the story analyzes a study published in JAMA earlier this year showing physician groups in two-sided risk payment arrangements with MA plans generated better outcomes for seniors compared to fee-for-service physician groups. MA beneficiaries had fewer ER visits and hospital admissions, and showed better results on 18 or 20 quality and health resource use measures, the study showed.
The study’s chief author, Ken R. Cohen, is an employee of Optum, the UnitedHealth subsidiary that now employees about 90,000 physicians or about 10% of the U.S. physician workforce. Its second author, Boris Vabson, this year left his post at Harvard Medical School to join the Center for Medicare and Medicaid Services (CMS) to work on insurance reform issues under Dr. Mehmet Oz and Robert F. Kennedy Jr. Its third author, Jennifer Podulka, is an employee of America’s Physician Groups (APG), 9 of whose 74 board members work for an Optum-owned physician group.
The STAT investigation reports that APG president Susan Dentzer, the former journalist and Health Affairs editor who now earns over $700,000 a year, sang the praises of the study at one of its recent meetings, whose main sponsors included UnitedHealth. Physicians affiliated with MA plans “know how to handle risk, which is not a natural act for many physicians,” Dentzer told STAT. The studies “amply demonstrate our hypothesis that these capabilities developed by our groups translate into far better outcomes for patients in terms of quality and utilization.”
STAT submitted the study to 13 outside experts, many of whom receive funding from Arnold Ventures, a philanthropy that opposes MA in part because it cost the government far more than the traditional program. “The overwhelming consensus was that UnitedHealth’s research was flawed and inconclusive about any of the benefits Cohen and others claim,” STAT reported.
The outside experts found:
The patients found to have better health outcomes in the risk-based Medicare Advantage contracts were generally healthier, whiter, and significantly more likely to enroll in plans that restricted which doctors they could see;
The 17 physician groups that contributed data to the study were not chosen at random; and
The data for the study were not publicly available to other researchers.
“Insurers are only making the data available in cases where they believe they have a favorable story to tell,” health economist Matt Fiedler at the Brookings Institution told STAT. “The research record gets distorted.”
The STAT investigation went on to document numerous situations where UnitedHealth-funded research was deployed in lobbying campaigns to protect MA plans on Capitol Hill and to debunk studies criticizing Medicare Advantage overpayments by CMS.
Unfortunately, the STAT stories in its Health Care’s Colossus series about UnitedHealth are behind a very high paywall. When awards season rolls around, I hope it wins all the honors it deserves.
This whole piece is spot on. Long covid is devastating and the costs to the whole economy and to families has been glazed over like yesterday’s news. Medicare Advantage Plans milk the system and pass on the costs of the treachery the payers engage in to produce profits off of the Medicare Trust to all taxpayers while denying tests, care, services, rehabilitation and common medications to their “beneficiaries”.
Thanks for this Merrill. I have LC and it is debilitating and demoralizing. I have no hopes that RFK Jr. on down in HHS will do anything. I doubt wizardly Dr. Oz in CMS will push for research, or that the Department of Labor will call attention to the costs.