The significance of the Miami man who feared he might have coronavirus

The cautionary tale of the Miami man who had flu-like symptoms after a trip to China, and what his story tells us about our public-health system.
Image: The downtown Miami skyline and Biscayne Bay
The downtown Miami skyline and Biscayne Bay ahead of arrival of Hurricane Irma in Miami on Sept. 8, 2017. Miami Beach, the Florida Keys and other low-lying areas are under a mandatory evacuation order ahead of Irma.Erik S, Lesser / EPA

At first blush, this Miami Herald story may seem like a report about a local guy who caught the flu. But the closer one looks, the more interesting it becomes.

After returning to Miami last month from a work trip in China, Osmel Martinez Azcue found himself in a frightening position: he was developing flu-like symptoms, just as coronavirus was ravaging the country he had visited. Under normal circumstances, Azcue said he would have gone to CVS for over-the-counter medicine and fought the flu on his own, but this time was different.

To his credit, Osmel Martinez Azcue recognized the public-health concerns about the coronavirus outbreak, and given his symptoms and his recent China visit, he felt like the responsible thing to do was check himself into one of Miami's largest hospitals (Jackson Memorial). This is, of course, what we'd expect anyone in his position to do.

The hospital staff followed the proper protocols, took the necessary precautions, and put Azcue in a closed-off room. Fortunately, blood work found that he simply had the flu. The medical teams stood down and Azcue was discharged.

So why did this story generate national attention? A couple of reasons.

Let's start with the fact that Azcue ended up with expensive medical bills, not because he's uninsured, but because he has what the Miami Herald charitably described as a "very limited insurance plan." Or put another way, he has one of the "junk plans" the Affordable Care Act tried to eliminate, but which Donald Trump and his team are quite fond of. Consumers are attracted to the low costs of these coverage plans, right up until they get sick.

In Azcue's case, within weeks of being sent home, he started receiving thousands of dollars in medical bills -- with more likely on the way, because he was treated by some out-of-network physicians -- in addition to instructions on his medical history. Azcue's private insurer wanted him to prove that his flu wasn't related to a pre-existing condition.

Again, "Obamacare" made sure that Americans couldn't be punished for having pre-existing conditions, but under Trump's junk plans, those consumer protections are gutted.

When the White House insists the president champions those with pre-existing conditions, keep this story in mind.

As for the other angle of interest, what happens when the coronavirus outbreak spreads in the United States and many Americans -- who are either uninsured or under-insured -- avoid seeking medical care because they're concerned about bills they can't afford?

The Herald spoke to Georgetown's Sabrina Corlette, who explained, "When someone has flu-like symptoms, you want them to seek medical care. If they have one of these junk plans and they know they might be on the hook for more than they can afford to seek that care, a lot of them just won't, and that is a public health concern."

Yes, actually, it is. While many of the countries grappling with the coronavirus outbreak have universal-coverage systems, the United States does not. What's more, we also don't have a system of paid sick leave, which increases the pressure of economically vulnerable Americans to go to work, even they're unwell.

As for Azcue, he asked rhetorically, "How can they expect normal citizens to contribute to eliminating the potential risk of person-to-person spread if hospitals are waiting to charge us $3,270 for a simple blood test and a nasal swab?"

That strikes me as an excellent question. Perhaps the White House can try to offer an answer.