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Healthcare in politics, week 2
Healthcare has been hot button a political issue for decades, with fights over Medicare going back to the mid-60s. The issue has been especially fractious over the last decade with the implementation of the Affordable Care Act, which passed without a single Republican voting for it.
It's with that backdrop that we now find ourselves in the midst of what HHS declared on January 31, 2020 to be a public health emergency. COVID-19 has upended the healthcare system in ways that nobody could have foreseen; thanks, in part, to CMS waiving telehealth regulations in April, combined with the necessity of using virtual care to see a doctor, that sector has been explosive growth in just a few months.
As this is an election year, the delineations between what the two sides believe in, and their vision for how healthcare should work, will be made clear. That is what will be discussed at the Healthcare in Politics salon, hosted by Vator, HP and UCSF Healthhub, on September 30. Every week until then we will be doing a roundup of some of the biggest healthcare news and what Trump, Biden and the biggest healthcare agencies are up to:
Rather than sending information about COVID-19 patients to the Centers for Disease Control and Prevention, the Trump administration has instead ordered hospitals to send it to a central database in Washington. That includes daily reports about the patients that each hospital is treating, the number of available beds and ventilators, and other information that is used to track the spread of the disease.
"It is critical to the COVID-19 response that all of the information listed below is provided on a daily basis to the Federal Government to facilitate planning, monitoring, and resource allocation during the COVID-19 Public Health Emergency (PHE). This data will be used to inform decisions at the federal level, such as allocation of supplies, treatments, and other resources," it said in a document on the Department of Health and Human Services website.
The Trump administration says that the change is meant to make it easier to gather data and streamline it.
“Today, the C.D.C. still has at least a week lag in reporting hospital data,” Michael R. Caputo, a Health and Human Services spokesman, said in a statement.
“America requires it in real time. The new, faster and complete data system is what our nation needs to defeat the coronavirus, and the C.D.C., an operating division of H.H.S., will certainly participate in this streamlined all-of-government response. They will simply no longer control it.”
The new HHS database will not be open to the public, however, causing fear among those who rely on that data for projections about the virus, including researchers, modelers and health officials.
“Historically, C.D.C. has been the place where public health data has been sent, and this raises questions about not just access for researchers but access for reporters, access for the public to try to better understand what is happening with the outbreak," Jen Kates, the director of global health and H.I.V. policy with the Kaiser Family Foundation, told the New York Times.
Immediately following the change, data about COVID-19 disappeared from the CDC website.
Arkansas Governor Asa Hutchinson announced a statewide mask requirement on Thursday, as did Colorado Governor Jared Polis. They require that people are required to wear masks when out in public indoors, where they are not able to stay six feet apart from others. The Colorado order went into effect on July 17. The Arkansas order, which goes into effect on the July 20, will fine violators between $100 and $500.
"We have to meet the challenge together and everyone must do their part. And this is a way to enlist the support of everyone in this fight," Hutchinson said during a press conference.
“This is a responsible, bipartisan, common sense step to take,” Polis said during a news conference. “We have a choice in Colorado, either more mask wearing and more attention to social distancing or more damage to our economy and loss of life.”
With these mandates, more than half the states have now issued statewide mask requirements, though some states are still resisting such rules. Georgia governor Brian Kemp suspended all local mask mandates this week, and filed a lawsuit that challenged Atlanta's authority to require masks inside their city’s limits. Oklahoma Governor Kevin Stitt, who announced this week that he tested positive for the disease, also expressed opposition to a statewide order mandating that people wear masks.
An estimated 5.4 million American workers lost their health insurance between February and May due to job losses, according to an upcoming study from consumer advocacy group Families USA. That's 40 percent more than the 3.9 million people who lost insurance during the 2008 financial crisis.
The study found, which looked at the effects of the virus on a state-by-state basis, found that 46 percent of the coverage was lost in just five states: California, Texas, Florida, New York and North Carolina. In Texas, three our of every 10 citizen of the state is uninsured, bringing the number to 4.9 million.
Five states have experienced increases in the number of uninsured adults that exceed 40 percent, including Massachusetts, where the number rose by 93 percent.
“We knew these numbers would be big,” Stan Dorn, who wrote the study, told the New York Times. “This is the worst economic downturn since World War II. It dwarfs the Great Recession. So it’s not surprising that we would also see the worst increase in the uninsured.”
The numbers from Families USA are small in comparison to other estimates. The Kaiser Family Foundation, for example, has estimated that 27 million Americans have lost coverage by taking into account family members of the insured. The Urban Institute and the Robert Wood Johnson Foundation has projected that, by the end of the year,, 10.1 million people will have lost their health insurance.
“Helping people keep their insurance through a public health crisis surprisingly has not gotten much attention,” said Larry Levitt, executive vice president for health policy at the Kaiser Family Foundation, said. “This is the first recession in which the ACA is there as a safety net, but it’s an imperfect safety net.” Democrats want $25 billion for COVID vaccine production
Senate Minority Leader Charles Schumer of New York, and Senator Patty Murray from Washington, the top Democrat on the Senate Health Committee, released a white paper called for $25 billion in funding for COVID vaccine funding and research.
The $25 billion, which would be on top of $9.5 billion already allocated by Congress would be used, in part, to ramp up production of vials, syringes, plungers and rubber stoppers.
"COVID-19 poses an unprecedented threat to public health—in the mere months since SARSCoV-2, the virus that causes COVID-19, was detected in the U.S., more than 3.2 million individuals have been diagnosed with COVID-19 and over 135,000 people have died in the United States. According to CDC Director Dr. Robert Redfield, the actual case count is likely 10 times the confirmed case count.2 The disease has pushed public health departments, health care facilities, communities, and families to their limits. And this public health crisis has brought with it educational, social, and economic challenges the nation must respond to as well," it says.
"Ultimately, vaccines that are safe and effective, produced at scale, equitably distributed, free and accessible to everyone, and widely taken up by the population are our best hope for ending this pandemic. Furthermore, neither U.S. health security nor economic security can be achieved unless markets around the world also recover, requiring vaccines be available and administered globally. We are not safe until all countries are safe. Achieving this goal is not just about doing things fast, it is about doing them right."
The paper also calls for requiring the administration develop and implement a comprehensive strategic plan, ensuring covid-19 vaccines are available at no cost, setting rigorous standards for vaccine development and scientific review, scaling vaccine manufacturing and preventing supply chain challenges, ensuring equitable distribution of vaccines, preparing for and implementing widespread vaccine administration, and ensuring post-market surveillance and safety.
“When it comes to protecting Americans from this pandemic, we cannot afford to not get this right,” Schumer said in a statement. “Republicans must join us in this effort and include the funding and policies laid out in this proposal in the next coronavirus response bill.”
(Image source: fortune.com)
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