From taking a helicopter to a military hospital with a specialized suite, to receiving experimental drugs made available to fewer than 10 people, Trump’s experience with Covid-19 has been very different from that of an average 74-year-old American.
Trump has enjoyed top Covid-19 care, literally “fit for kings,” that could cost ordinary Americans millions, reports The Guardian.
The US president ignored the disparities he shares with the average Americans after returning to the hospital on Monday night, and in a video from the White House said of Covid-19: “Don’t be afraid of it.”
Here’s a look at how different the experience of catching Covid-19 is for the most powerful 74-year-old in the US compared with most of his fellow citizens:
Diagnosis
First, the simple step to realizing someone has the illness involves testing. Trump has had that regularly, something most 74-year-olds do not.
As a white male, Trump was less likely to test Covid-19 positive. Although testing rates are similar across racial and ethnic lines, Hispanic patients were 2.5 times more likely to test positive and Black and Asian patients almost 2x likely to test positive compared with white patients, according to Kaiser Family Foundation (KFF).
This simply shows how people of color face increased barriers to testing and in turn, treatment.
Care
People who test positive with Covid-19 are usually asked to monitor their symptoms at home, despite their age.
Trump was able to hitch a helicopter ride to, most likely, the top military hospital in the world once he tested positive. And at the White House, the president would be receiving “outstanding” care from a team of well-equipped, dedicated medical staff.
He has access to an at-home clinic with exam rooms and hospital equipment, including supplies to perform emergency lifesaving procedures. If an emergency arises, he can also turn to his fleet of helicopters to get him to the hospital in a matter of minutes.
“The president has access to the best specialists, the best medical care and really any medical countermeasure that he would ever want. That is not the medical care most people have in the United States, or in the world,” The Guardian quoted Dr Krutika Kuppalli, infectious disease specialist at Medical University of South Carolina, as saying.
If a 74-year-old is admitted to a hospital, they could, like the president, have access to the antiviral drug remdesivir.
But unless they enroll in a clinical trial, they won’t get access to the experimental antibody treatment Trump is receiving.
Regeneron Pharmaceuticals, which makes the antibody cocktail, said it had been made available to fewer than 10 people outside of a clinical trial.
After Trump’s oxygen levels fell, he received a steroid reserved for people in more severe stages of Cocid-19. Trump’s doctors are yet to clarify whether he was treated with the steroid, dexamethasone, because his illness was more severe than they have described or for a different reason.
Trump is the only person in the world known to be taking that combination of medication treatments. And typically, people are not discharged from the hospital while taking an injectable, experimental drug. “The fact that he’s able to do that shows how different his care is compared to other people,” Kuppalli said.
Costs
The American president does not have to worry about the cost of his healthcare, despite paying only $750 in taxes in 2017, because free healthcare is one of the perks of being the president.
The other 74-year-olds are like looking at government health insurance, Medicare – for adults 65 and older – to cover their costs. Those who are not covered by it either have employer-sponsored health insurance or are not eligible for it because they are not citizens or green card holders.
After being admitted to the hospital, if a 74-year-old patient has basic Medicare, they would be subject first to the $1,408 deductible, the cost they have to pay before insurance kicks in. Most Medicare beneficiaries have additional coverage which reduces these costs, but 6.1 million people just have the basic package.
If someone with the basic package must stay in the hospital longer than the president, for more than 60 days, they must also pay a whopping $352 for every additional day in the hospital.
It is not entirely free for people with Medicare supplements. Add-ons to the program can cost older adults up to $461 in monthly premiums and what is covered depends on what supplement they have.
Like Trump, most 74-year-olds would not need to worry about the cost of treatments such as supplemental oxygen. Much of the other care he is receiving, however, would not be covered for most older adults.
Tricia Neuman, executive director of KFF’s program on Medicare policy, said it would be highly unusual for Medicare to cover an air ambulance, experimental drugs like the Regeneron antibody cocktail or remdesivir if it was being administered at home (it should be covered in the hospital).
Medicare patients would, unlike the president, have to pay for the over-the-counter drugs he is taking including vitamin D, zinc, melatonin, and aspirin.
Outcomes
Despite the unique level of care Trump has access to, at the end of the day, he is still a 74-year-old man, which puts him at high risk of suffering severe respiratory problems because of his Covid-19 infection.
People between 65 and 74 are also 90 times more likely to die from Covid-19 than people between 18 and 29, according to the Centers for Disease Control and Prevention.
The rates are worse for Black and Hispanic patients. Across age group and sociodemographic factors, they have twice as high a death rate as white patients, according to KFF.
Kuppalli said the president’s existing health vulnerabilities, along with his decision to withhold information about his symptoms, raise questions about his fitness for office.
Kuppalli said: “This is somebody who could really have many challenges in the next few years as president, and his ability to execute his functions as president as result of the long-term symptoms of the disease.”
