Roosevelt Institute | Cornell University

Preventing the Pandemic: Implications of Ebola in the U.S.

By Charles PatonPublished October 21, 2014

How is the United States preventing a widespread outbreak of Ebola within its borders?

By Charles Paton, 10/21/2014

The 2014 outbreak of Ebola began back in March when the World Health Organization recorded an Ebola outburst in Guinea. Despite the gravity of the situation being experienced in Africa, most of the United States remained apathetic to the virus and its victims. It was not until the virus' first appearance on U.S. soil in Texas that attention rapidly shifted toward the possibility of a homeland outbreak. Although many experts are convinced that living conditions and health systems in the U.S. are not conducive to a large-scale outbreak, the possibility of such an occurrence still exists. So it is important to examine how our economy and health systems, specifically the Affordable Care Act (ACA), would be able to withstand such an event.

Arguably the largest indirect economic impact Ebola would have on the U.S. would be the generation of a culture of fear. Even though Ebola can only be transmitted through the direct contact of bodily fluids, people are poor assessors of risk and are likely to respond to the lethal nature of the virus with hypersensitivity. After just one incidence of the virus, some parents in Texas already pulled their children from school. Imagine more cases started sporadically appearing around Texas and the rest of the country; parents would detain their children and begin stock piling essential living supplies. Needless to say, early defecters would spur a positive feedback loop in which increasing numbers of parents would follow their lead.  Although little research has been published on the economic costs of these events as a result of Ebola, a good proxy is a study conducted by Hammond on similar occurrences during the H1N1 outbreak back in 2009. He suggested that closing public school systems for four weeks would cost the nation between $10 and $47 billion. Though the odds that the outbreak would reach this level are negligible, Hammond's study does highlight the importance of taking a firm position in controlling its spread.

Financing Ebola treatment is another significant issue; however, a victim must be diagnosed before remediation efforts can begin. This is perhaps the stage that renders the U.S. most susceptible to an outbreak. According to Laurie Garrett, the 13.8 million people who currently remain uninsured under the ACA are the greatest threat for an outbreak. Compared to their insured counterparts, the uninsured are much less likely to seek timely medical attention after discovering the initial flu-like symptoms. This provides an extended period of time during which they can spread the virus to others, vastly increasing the risks of a large-scale outbreak. Government intervention, she suggests, is crucial to ensuring that people experiencing Ebola-like symptoms are prioritized and given the care they require.

The large influx of patients into hospitals and special treatment centers would also place a tremendous burden on our health systems. As it stands, individuals with ACA approved insurance plans may not qualify for reimbursement. Insurance experts currently believe that the ACA will not cover treatment procedures for the infected. The long period required for quarantine and expensive experimental drugs, they suggest, would be classified as "long-term" care, a segment that is not covered under most insurance plans. A separate insurance policy, purchased in accordance with the regular insurance policy, would be necessary to guarantee insurance reimbursement. As a result, Americans who contracted the disease would be responsible for covering the "lifesaving" treatments, leading to even more financial instability and turmoil.

Although barring all flights from regions infected with the virus may be a little extreme, we should consider improving the screening process at the airport to ensure other carriers of the disease are intercepted before they are exposed to the public. Similarly, we should take a more proactive stance in providing assistance to Ebola-ridden countries. Humanitarian arguments aside, the costs of relief efforts to combat the spread of Ebola from other countries would be far less than the costs to contain it in our own.