国会议员逼疾控中心提供免费的 Covid-19 检测

美国此前公布的感染人数可能远远偏低，原因是很多人未得到及时检测，包括很多人可能不敢去检测、怕花钱。来自加州的民主党议员 Katie Porter 在国会质询中，逼迫 CDC 主任 Robert R. Redfield 当场承诺，援引现有法律赋予他的权力，为所有可能感染了 Covid-19 新冠病毒的美国人提供免费检测。这段质询非常精彩。一块小白板，简单的算数题，锲而不舍的几个追问，有可能就拯救了成千上万人命。美国民众应该感谢这位议员。

Katie Porter 引用的法典为 42 CFR § 71.30，授权 CDC 为控制传染病提供免费的检测、治疗、隔离。法典原文在这里。假如检测收取高昂的费用，很多低收入的美国人将不敢或无法去做检测，给自身以及周围的社区带来危害。

CDC 的热线电话为：1-800-CDC-INFO (1-800-232-4636)。

I did the math: a full battery of coronavirus testing costs at minimum $1,331.
I also did the legal research: the Administration has the authority to make testing free for every American TODAY.
I secured a commitment from a high-level Trump official that they’d actually do it. pic.twitter.com/RmolCtmNbG

— Rep. Katie Porter (@RepKatiePorter) March 12, 2020

下面是 Real Clear Politics 整理的质询全文，提问的是国会议员 Katie Porter (D-CA 45)，回答的分别是美国卫生部负责应急反应的助理部长 Robert Kadlec 和疾控中心主任 Robert R. Redfield。

PORTER: Dr. Kadlec for someone without insurance do you know the out-of-pocket cost of a complete blood count test?

KADLEC: No, ma’am, not immediately.

PORTER: Do you have a ballpark?

KADLEC: Out of–with a co-pay, ma’am?

PORTER: No, the out-of-pocket. Just the typical cost.

KADLEC: I do not, ma’am.

PORTER: Okay. These CB–eight CBC typically cost about $36. What about the out-of-pocket cost for a complete metabolic panel?

KADLEC: Ma’am, I would have to pass on that as well.

PORTER: Do you have any idea? Do you want to take a ballpark?

KADLEC: I would say $75.

PORTER: Okay, $58.

KADLEC: Getting closer.

PORTER: How about flu a, the flu a test?

KADLEC: Ma’am, again I would take a guess at about may be $50.

PORTER: $43. Flu–this is like the price is right. Flu be?

KADLEC: Too high again. I would probably say $44.

PORTER: That is good. How about the cost of an ER visit for someone identified as high severity and threat?

KADLEC: I’m sorry, ma’am, what was the question again?

PORTER: How about the cost of an ER visit for somebody identified as having high severity or high threat?

KADLEC: High severity – might ma’am, that is probably about $3000, $5000.

PORTER: That is $1151.

KADLEC: Too high again.

PORTER: This all totals up to $1331. That is assuming they are kept in isolation. Isolation can add up for one family already $4,000, and fear of these costs are going to keep people from being tested from getting the care they need and from keeping their communities safe. We live in a world where 40 percent of Americans cannot even afford a $400 unexpected expense. We live in a world where 33 percent of Americans put off medical treatment last year and we have a $1,331 expense, conservatively, just for testing for the coronavirus.

Dr. Redfield do you want to know who has the coronavirus and who doesn’t?

REDFIELD: Yes.

PORTER: Not just rich people but everybody who might have a virus?

REDFIELD: All of America.

PORTER: Dr. Redfield are you familiar with 42 CRF 71.31–30, excuse me? 42 CRF 71.30? The code of federal regulations that applies to the CDC, 42 CFR 71.30?

REDFIELD: I think if you could frame what it talks about that would help me. I’m–I don’t–

PORTER: Okay. Dr. Redfield I–I am pretty well known as a questioner on the hill for not–not tipping my hand. I literally communicated to your office last night and received confirmation that I was going to be asking you about 42 CFR 71.30. This provides the director may authorize payment for the care and treatment of individual subject to medical exam quarantine, isolation and conditional release.

REDFIELD: I know about in my office to tell me that. I just didn’t know the numbers ma’am, Congresswoman.

PORTER: Great, so you are familiar. Dr. Redfield will you commit to the CDC right now using that existing authority to pay for diagnostic testing free to every American regardless of insurance?

REDFIELD: Well, I can say that we are going to do everything to make sure everybody can get the care they need.

PORTER: Nope, not good enough. Reclaiming my time. Dr. Redfield you have the existing authority. Will you commit right now to using the authority that you have invested in you under law that provides in a public health emergency for testing, treatment, exam, isolation without cost? Yes or no?

REDFIELD: What I am going to say is I’m going to review it in detail with CDC and the department–

PORTER: Know. I am reclaiming my time. Dr. Redfield respectfully I wrote you this letter along with my colleagues Rosa DeLauro and Lauren Underwood. Congresswoman Underwood and Congresswoman DeLauro. We wrote you this letter one week ago. We quoted that existing authority to you and we laid out this problem. We asked for a response yesterday, the deadline and the time for delay has passed. Will you commit to invoking your existing authority under 42 CFR 71.30 to provide for coronavirus testing for every American regardless of insurance coverage?

REDFIELD: What I was trying to say is that CDC is working with HHS now to see how we operationalize that.

PORTER: Dr. Redfield I hope that that answer weighs heavily on you because it is going to weigh very heavily on me and on every American family.

REDFIELD: Our intent is to make sure every American gets the care and treatment they need at this time of this major epidemic and I’m currently working with HHS to see how the best operationalize it.

PORTER: Dr. Redfield you don’t need to do any work to operationalize. You need to make a commitment to the American people so they come in to get tested. You can operationalize the payment structure tomorrow.

REDFIELD: I–I think you are an excellent questioner so my answer is yes.

PORTER: Excellent. Everybody in America hear that. You are eligible to go get tested for coronavirus and have that covered regardless of insurance. Please if you believe you have the illness, follow precautions, call first, do everything the CDC and Dr. Fauci God bless you for guiding Americans in this time. Do not let a lack of insurance force in this crisis.

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