A large racial divide exists in the concern over ability to pay for COVID-19 treatment

https://www.healthcarefinancenews.com/news/large-racial-divide-exists-concern-over-ability-pay-covid-19-treatment

Nonwhite adults say they’re either “extremely concerned” or “concerned” about the potential cost of care.

People of color are far more likely to worry about their ability to pay for healthcare if they are diagnosed with COVID-19 than their white counterparts, according to a new survey from nonprofit West Health and Gallup.

By a margin of almost two to one (58% vs. 32%), nonwhite adults report that they are either “extremely concerned” or “concerned” about the potential cost of care. That concern is three times higher among lower-income than higher-income households (60% vs. 20%).

The data come from an ongoing survey about Americans’ experiences with and attitudes about the healthcare system. The latest findings are based on a nationally representative sample of 1,017 U.S. adults interviewed between June 8 and June 30.

There’s also a disturbing trend when it comes to medication insecurity. Overall, 24% of U.S. adults say they lacked money to pay for at least one prescribed medicine in the past 12 months, an increase from 19% in early 2019. Among nonwhite Americans, the burden is growing even more quickly. Medication insecurity jumped 10 percentage points, from 21% to 31%, compared with a statistically insignificant three-point increase among white Americans (17% to 20%).

WHAT’S THE IMPACT?

All of this results in what Tim Lash, chief strategy officer for West Health, called a “significant and increasing racial and socioeconomic divide” in Americans’ views on the cost of healthcare and the impact it has on their lives. When polling started in 2019, one in five Americans were unable to pay for prescription medications within the past 12 months. That number now stands at one in four. The bottom line is that the situation is getting worse.

Amid broad concern about paying for the cost of COVID-19 or other medical expenses, health insurance benefits are likely more important than ever to U.S. workers. The survey found that 12% of workers are staying in a job they want to leave because they are afraid of losing healthcare benefits, a sentiment that is about twice as likely to be held by nonwhite workers as white workers (17% vs. 9%).

However, Americans step across racial lines in their overwhelming support for disallowing political contributions by pharmaceutical companies, and for government intervention in setting price limits for government-sponsored research and a COVID vaccine.

Nearly 9 in 10 U.S. adults (89%) think the federal government should be able to negotiate the cost of a COVID-19 vaccine, while only 10% say the drug company itself should set the price. Similarly, 86% of U.S. adults say there should be limits on the price of drugs that government-funded research helped develop.

Regarding the influence of pharmaceutical companies on the political process, 78% of adults say political campaigns should not be allowed to accept donations from pharmaceutical companies during the coronavirus pandemic.

THE LARGER TREND

Concerns over payment aren’t the only race-related disparities found in healthcare. Dr. Garth Graham, the vice president of community health at CVS Health, said during AHIP’s Institute and Expo in June that although African Americans make up 13% of the U.S. population, they account for about 24% of COVID-19 deaths.

He attributed some of the driving factors for these particular COVID-19-related disparities to the social determinants of health, the over-predominance of African American and Latino frontline workers, and the higher incidence-rates of chronic illness such as diabetes and hypertension in minority groups.

On June 19 – Juneteenth, as it’s known for many Black Americans – 36 Chicago hospitals penned an open letter declaring that systemic racism is a “public health crisis.”

“Systemic racism is a real threat to the health of our patients, families and communities,” the letter reads. “We stand with all of those who have raised their voices to capture the attention of Chicago and the nation with a clear call for action.”

 

 

 

 

Administration’s talking health care again, with 2020 in mind

https://www.politico.com/news/2020/07/26/trumps-health-care-again-with-2020-election-381473?utm_source=ActiveCampaign&utm_medium=email&utm_content=Republicans+Roll+Out+%241+Trillion+Coronavirus+Relief+Plan&utm_campaign=TFT+Newsletter+07272020

Tell us: How has Trump handled healthcare in his first 100 days ...

Polls show voters say Joe Biden would handle the issue better. And Trump is running short on options to make concrete changes before November.

President Donald Trump is suddenly talking about health care again.

He signed several executive orders on drug pricing on Friday. He vowed to unveil some new health plan by the end of next week, although he hasn’t provided specifics or an explanation of how he’ll do it. His aides are touting a speech in which Trump will lay out his health care vision. White House counselor to the president Kellyanne Conway has been calling Trump “the health care president.”

Yet it’s unlikely to amount to much in terms of policy ahead of the election. There’s almost no chance Congress will enact any legislation on the issue before November and policy specialists say the executive orders in question will make changes only at the margins — if they make any changes at all. Trump has also previously vowed to roll out a grand health care plan without following through.

That leaves Trump with mostly rhetorical options — even if he insists otherwise — cognizant that voters consistently rank health care as a top priority and say Joe Biden, Trump’s presumptive 2020 rival, would handle the issue better than the president. Meanwhile, Trump is running for reelection having not replaced Obamacare or presented an alternative — all while urging the Supreme Court to overturn the decade-old health law. And millions of Americans are currently losing their health insurance as the coronavirus-gripped economy sputters.

“I think politically, the main objective will be to have something he can call a plan, but it will be smaller than a plan. Just something that he can talk about,” said Drew Altman, president and CEO of the Kaiser Family Foundation, a nonpartisan health policy organization. “But it’s almost inconceivable that anything can be delivered legislatively before the election.”

Trump has long stumped on his pledges to kill Obamacare, the law his predecessor implemented that expanded Americans’ access to health insurance, set baseline standards for coverage, introduced penalties for not having insurance and guaranteed coverage for preexisting conditions. But conservatives say the law introduced too many mandates and drove up costs.

But after winning election in 2016, Trump failed to overturn the law in Congress — or even offer an agreed upon alternative to the law — despite holding the majority in both chambers on Capitol Hill. Democrats then retook the House in the 2018 midterms, essentially ending any chances the law, formally known as the Affordable Care Act, would be repealed.

Even some conservatives said the ongoing failure to present a concrete replacement plan is helping the Democrats politically.

Republicans, said Joe Antos, a health expert at the conservative American Enterprise Institute, “spent basically 2010 to today arguing that the ACA is no good. After 10 years, clearly there are some problems with starting all over again. I haven’t detected very strong interest, at least among elected officials, in revisiting that.”

But the coronavirus pandemic has added pressure to address health care costs, and Trump has lagged behind Biden on his handling of the issue in polls. Fifty seven percent of registered voters recently polled by Quinnipiac said Biden would do a better job on health care than Trump, while only 35 percent approved of Trump’s handling of health care as president. And on the issue of affordability, a CNBC poll found 55 percent of battleground voters favored Biden and the Democrats, compared with 45 percent who preferred Trump and the Republicans.

“At this point, there are two huge issues, jobs and the economy, and health care, i.e., the coronavirus. If anything that’s simply been magnified,” said David Winston, a Republican pollster and strategist. “Given the fact that it’s one of the top issues, it’s not like there’s a choice but to talk about it. If candidates aren’t making statements and proposing solutions around that, it’s a requirement. Both candidates have to address it.”

Biden has campaigned on expanding Obamacare while also promising to implement a “public option” similar to Medicare, which is government-run health insurance for seniors. On drug pricing, he and Trump embrace some of the same ideas, like allowing the safe importation of drugs from other countries where they are cheaper. Biden also supports direct Medicare negotiation of drug prices, a Democratic priority that Trump supported during the 2016 campaign before reversing course.

“Donald Trump has spent his entire presidency working to take health care away from tens of millions of Americans and gut coverage for preexisting conditions,” said Andrew Bates, a Biden campaign spokesman. “If the Trump campaign wants to continue their pattern of highlighting the worst possible contrasts for Donald Trump, we certainly won’t stop them.”

The Trump administration insists it can point to several health care victories during Trump’s term.

Trump frequently notes the removal of the penalty for Americans who do not purchase insurance as a major victory, falsely claiming it is equivalent to overturning Obamacare.

Trump also signed an executive order last year to fight kidney disease to encourage home dialysis and increase the amount of kidney transplants, and he expanded telehealth medicine during the pandemic.

More recently, the U.S. Court of Appeals for the District of Columbia upheld a Trump administration rule expanding the availability of short-term health plans, which Trump has touted as an alternative to Obamacare but Democrats deride as “junk.” The plans are typically cheaper than Obamacare coverage because they don’t provide the same level of benefits or consumer protections for preexisting conditions.

A federal judge in June similarly upheld another Trump administration rule requiring hospitals to disclose the prices they have negotiated with insurers. Price transparency in the health care system has long been a significant issue, with Americans rarely having clarity over how much their treatments will cost ahead of time. Trump called the win “bigger than health care itself,” in an apparent reference to Obamacare. It’s unclear whether transparency will force down health care prices, and hospitals opposing the rule have appealed the judge’s decision.

And on Friday at the White House, Trump held an event to sign four executive orders aimed at slashing drug pricing. The move aimed to tackle a largely unfulfilled signature campaign promise — that he would stop pharmaceutical companies from “getting away with murder.”

“We are ending the sellouts, betrayals and broken promises from Washington,” Trump said Friday.“You have a lot of broken promises from Washington.”

But the orders appeared largely symbolic for now, as they were not immediately enforceable, contained notable caveats and may not be completed before the election anyway. For instance, an order requiring drugmakers to pass along any discounts directly to seniors requires the health secretary to confirm the plan won’t result in higher premiums or drive up federal spending. But the White House had shelved that plan last summer over worries the move might hike seniors’ Medicare premiums ahead of the election and cost taxpayers $180 billion over the next decade.

Conway disputed that Trump had not made progress on issues like drug pricing.

“President Trump is directing the development of therapeutics and vaccines, has delivered lower prescription drug costs, increased transparency in pricing for consumers and is committed to covering preexisting conditions and offering higher quality health care with lower costs and more choices,” she said.

Yet a number of Trump’s other health care initiatives have faced hurdles — especially amid the coronavirus pandemic.

The opioid crisis, which the president had touted as a top priority and campaigned on in 2016, is getting worse. Drug overdose deaths hit a record high in 2019 and federal and state data shows they are skyrocketing in 2020.

“The overdose epidemic will not take a back seat simply because Covid-19 has hit us hard, and that needs to be reflected in policy,” said Andrew Kessler, founder and principal of Slingshot Solutions, a behavioral health consulting firm.

The president’s plan to end HIV by 2030 has similarly receded during the pandemic. And Trump’s proposal on improving kidney care — an issue that affects roughly 15 percent of American adults — is still in its early stages and will not be finalized until next year.

 

 

 

U.S. Coronavirus Pandemic Status: It’s about to get a lot worse

https://www.axios.com/coronavirus-pain-getting-worse-cd329f4c-9962-4f40-b401-7a7ac1a393cf.html

The pain of the coronavirus is about to get a lot worse - Axios

For months now, American workers, families and small businesses have been saying they can’t keep up their socially distanced lives for much longer. We’ve now arrived at “much longer” — and the pandemic isn’t going away anytime soon.

The big picture: The relief policies and stopgap measures that we cobbled together to get us through the toughest weeks worked for a while, but they’re starting to crumble just as cases are spiking in the majority of states.

Next week, the extra $600 per week in expanded unemployment benefits will expire. And there’s no indication that Congress has reached a consensus on extending this assistance or providing anything in its place.

  • But nearly half of the U.S. population is still jobless, and millions will remain jobless for the foreseeable future. There are 14 million more unemployed people than there are jobs, per the Economic Policy Institute.
  • Nearly a third of Americans missed a housing payment in July — and that was with the additional $600. Plus, most Americans have already spent the stimulus checks they received at the beginning of the pandemic.
  • “We should be very concerned about what’s going to happen in August and beyond” — starting with a spike in evictions, Mathieu Despard, who leads the Social Policy Institute at the Washington University in St. Louis, tells Axios.

Expect more furloughs and layoffs as more small businesses are pushed off the pandemic cliff.

  • By economists’ estimates, more than 100,000 small businesses have permanently closed since the pandemic began.
  • For those that are hanging on, loans from the Paycheck Protection Program (PPP) have not been enough, and the back and forth between re-opening and then closing again as states deal with new case waves has been devastating. In fact, rates of closure have started increasing, the New York Times reports, citing Yelp data.
  • The big firms aren’t immune either. Just last week, behemoths like United Airlines, Wells Fargo, Walgreens and Levi’s either cut jobs or told workers their jobs were at risk, Axios’ Dion Rabouin writes.

And the question of whether schools will reopen looms.

  • Since schools sent kids home in March, and most summer camps didn’t open their doors for the summer, working parents have been dealing with a child care crisis — attempting to do their jobs, care for their kids and homeschool all at once — and hoping that the stress will be temporary.
  • The situation is more dire for low-income families with kids who rely on school lunches or for single parents who are juggling work and parenting without any help.
  • Now the public heath crisis hasn’t abated, and school districts are running out of time to figure out what the fall will look like. Some, starting with Los Angeles, have already decided to go online.

The bottom line: “It’s the uncertainty that is anxiety-inducing,” says Despard. “If you give people a time horizon and say, ‘Look you have to get through these next 8 weeks of extreme shutdown,’ they’ll do it. Now it’s like, ‘How much longer?'”

 

 

 

 

 

Texas has the highest uninsured rate in the U.S., with 29 percent of adults uninsured as of May

https://www.beckershospitalreview.com/rankings-and-ratings/states-ranked-by-uninsured-rates.html?utm_medium=email

COVID-19 Health: Rate of Uninsured Americans by City - Self

Texas has the highest uninsured rate in the U.S., with 29 percent of adults uninsured as of May, according to a report from Families USA. 

The report compared uninsured rates in 2018 to rates in May 2020 using data from the U.S. Bureau of Labor Statistics and the Urban Institute. Every state saw an increase in the number of uninsured, and the total number of uninsured in the U.S. climbed 21 percent.

The increase was due in part to layoffs tied to the COVID-19 pandemic in recent months. Nearly 5.4 million Americans lost health insurance coverage from February to May of this year due to job losses, according to the report.

Below is the total percentage of all uninsured adults in each state and the District of Columbia as of May. 

Texas: 29 percent

Florida: 25 percent

Oklahoma: 24 percent

Georgia: 23 percent

Mississippi: 22 percent

Nevada: 21 percent

North Carolina: 20 percent

South Carolina: 20 percent

Alabama: 19 percent

Tennessee: 19 percent

Idaho: 18 percent

Alaska: 17 percent

Arizona: 17 percent

Missouri: 17 percent

Wyoming: 17 percent

New Mexico: 16 percent

South Dakota: 16 percent

Arkansas: 15 percent

Kansas: 15 percent

Louisiana: 14 percent

Virginia: 14 percent

California: 13 percent

Colorado: 13 percent

Illinois: 13 percent

Indiana: 13 percent

Maine: 13 percent

Montana: 13 percent

New Jersey: 13 percent

Oregon: 13 percent

Utah: 13 percent

Michigan: 12 percent

Nebraska: 12 percent

Washington: 12 percent

West Virginia: 12 percent

Delaware: 11 percent

Maryland: 11 percent

New Hampshire: 11 percent

North Dakota: 11 percent

Ohio: 11 percent

Connecticut: 10 percent

Hawaii: 10 percent

Kentucky: 10 percent

New York: 10 percent

Pennsylvania: 10 percent

Wisconsin: 10 percent

Iowa: 9 percent

Rhode Island: 9 percent

Massachusetts: 8 percent

Minnesota: 8 percent

Vermont: 7 percent

District of Columbia: 6 percent

 

 

UnitedHealth Group posts $6.6B in Q2 profit amid COVID-19 care deferrals

https://www.fiercehealthcare.com/payer/unitedhealth-group-posts-6-6b-q2-profit-amid-covid-19-care-deferrals?utm_medium=nl&utm_source=internal&mrkid=959610&mkt_tok=eyJpIjoiTldOaVpEUTJOMk0yTWpNNSIsInQiOiJJcFROOCtmWDU4TEhnT0FkTFFCTHZmRHpVWHBJV015M0QzQSswV3llT2liQzFsXC9wM1VYXC8yT2xsREdQVVh1WnhvNHk3TEdHNEtrTlZcL2s5WXlWZXZVMjR1TUdPZEgrNnVPOTVuYUNJSVo5VmFhT05XQlZYYmlJTHE2ekhwZENDdCJ9

The outside of UnitedHealth Group's headquarters

UnitedHealth Group reported $6.6 billion in profit for the second quarter, beating Wall Street projections.

That’s also a significant increase in profit compared to the second quarter of 2019, where the healthcare giant brought in $3.3 billion, according to its earnings report (PDF) issued Wednesday.

UnitedHealth’s mid-year profits sit at $10 billion, compared to $6.8 billion in the first half of 2019.

The insurer also reported $62.1 billion in revenue for the quarter, an increase year-over-year but a number that fell short of analysts’ expectations. UnitedHealth brought in $60.6 billion in revenue in the second quarter of 2019.

Through the first half of 2020, UnitedHealth has earned $126.6 billion in revenue, up from $120.9 billion in the first six months of 2019.

The insurer attributes the unexpectedly high profit to large amounts of care deferral due to the coronavirus pandemic and said it’s likely to see that offset in future quarters as elective procedures and other services resume.

In the earnings release, CEO David Wichmann touted the company’s efforts to combat the pandemic in the second quarter.

“Our 325,000 dedicated team members, including the 120,000 clinicians serving on the front lines of care, have tirelessly responded to COVID-19 with agility, innovation and compassion,” Wichmann said in a statement.

“We moved swiftly to assist the people we serve and their care providers, including the provision of $3.5 billion in proactive voluntary customer assistance and accelerated care provider funding. We remain committed to taking further actions to address any future imbalances as a result of the pandemic,” he said.

Though COVID-19’s full impact on finances remains unclear, UnitedHealth maintained its full-year earnings guidance of between $15.45 and $15.75 per share.

 

 

 

 

5.4 million Americans lost health insurance

https://www.axios.com/newsletters/axios-vitals-285240f4-9110-4c86-ad7e-e0c37085a957.html?utm_source=newsletter&utm_medium=email&utm_campaign=newsletter_axiosvitals&stream=top

Medicare for All (@AllOnMedicare) | Twitter

Roughly 5.4 million adults in the U.S. lost their health insurance from February to May after losing their jobs, according to a new estimate from Families USA, a group that favors the Affordable Care Act.

Why it matters: There are more adults under 65 without insurance in Southern states, which are the same states setting new records for single-day coronavirus infections along with rising hospitalizations, Axios’ Orion Rummler writes.

What they found: 3.9 million adults lost health insurance over one year during the Great Recession, per Families USA’s analysis. It only took four months in this current crisis for an estimated 5.4 million Americans to lose health insurance.

  • More than 20% of adults in Georgia, Florida, South Carolina, North Carolina, Mississippi, Oklahoma and Texas were without insurance as of May.
  • All of these states have set new records in the past two weeks for their highest number of coronavirus infections in a single day, per data from the COVID Tracking Project.
  • 46% of adults who lost coverage due to the pandemic came from five states: Florida, New York, Texas, California and North Carolina.

The backdrop: 21 million Americans were unemployed in May, according to the Bureau of Labor Statistics’ nonfarm payrolls report.

 

 

 

 

Trump admin seeks relaxed grandfathered ACA health plan rules that up out-of-pocket costs

https://www.healthcaredive.com/news/trump-admin-seeks-relaxed-grandfathered-aca-health-plan-rules-that-up-out-o/581463/

Paying for Health Insurance Out of Pocket Maximum, OOP Health ...

Dive Brief:

  • The Trump administration proposed a rule Friday to allow some group health plans grandfathered under the Affordable Care Act to raise out-of-pocket costs for enrollees but still allow them to have health savings accounts. Such plans must not discriminate against enrollees with pre-existing conditions, but are exempt from many other ACA regulations. If they violate any rules regarding costs or structure they lose their grandfathered status and are required to follow all the mandates of the landmark 2010 law.
  • The proposed rule, issued by the U.S. Department of Labor, would relax some of the complex inflation and pricing calculations grandfathered plans must follow. The department admitted that the change could lead to higher deductibles and other out-of-pocket costs for the estimated 23.1 million enrollees in such grandfathered plans.
  • The rule stems from a 2017 executive order issued by President Donald Trump that allows regulatory changes to be made in response to perceived economic burdens imposed by the ACA. However, the Labor Department conceded in its Federal Register publication of the proposed rule that the current rules for grandfathered health plans probably weren’t that burdensome.

Dive Insight:

The administration has made no secret of its ire for the ACA and is actively trying to overturn it at the U.S. Supreme Court. A release explaining the changes notes fixed cost-sharing for high-deductible health plans would be raised, and “an alternative method of measuring permitted increases in fixed-amount cost sharing” has been introduced that “would allow plans and issuers to better account for changes in the costs of health coverage over time.”

The formal 76-page proposal, published in the Federal Register on Sunday, said premiums might go down as a result of the changes, but there were no estimates provided or circumstances where that might occur.

Moreover, the proposed rule also noted that the change could lead to more people foregoing healthcare because their out-of-pocket costs might become unaffordable.

The Labor Department also noted that there have been so few fluctuations in the state of grandfathered health plans in recent years that it was likely the current regulations were not overly burdensome in the first place.

Public comments will be solicited until mid-August before a final rule is issued.

Sen. Patty Murray, D-Wash., and ranking member of the Senate Health, Education, Labor, and Pensions Committee, wasted little time late last week blasting the proposal.

“Regardless of what the president wants to believe, we’re in the middle of a pandemic that is devastating families’ health and finances,” Murray said in a statement.

 

 

 

 

Pre And Post Coronavirus Unemployment Rates By State, Industry, Age Group, And Race

https://www.forbes.com/sites/mikepatton/2020/06/28/pre-and-post-coronavirus-unemployment-rates-by-state-industry-age-group-and-race/#65c42c6555eb

Unemployment by State-May 2019 to May 2020

The coronavirus has decimated the U.S. economy and benched nearly 40 million American workers. In the past several days, the U.S. has logged its highest number of new Covid-19 cases since the pandemic began. These combined with other factors, which we will discuss, is jeopardizing the future employment of millions of workers and the viability of thousands of businesses. Here’s how unemployment has increased for every state, industry, age group, and race, and why.

Unemployment by State

The coronavirus and subsequent stay at home orders hit the labor force especially hard. As states attempted to reopen, a resurgence in the virus is causing many businesses to close again, some by choice, others by government mandate.

Nevada has been hit the hardest as the unemployment rate in the Silver State rose from 4.0% in May 2019 to a whopping 25.3% in May 2020. Nevada’s economy is heavily reliant on leisure and hospitality, which had the brunt of the job losses. Hawaii, the second hardest hit state saw unemployment rise from 2.7% in May 2019 to 22.6% in May 2020. Which is the only other state with unemployment above 20% in May 2020? Michigan, where unemployment rose from 4.2% to 21.2% year over year. What state has fared best? Nebraska, which also has one of the most diverse economies of all states. Deriving nearly 50% of its total GDP from five different industries, unemployment in the Cornhusker State rose from 3.1% to a modest 5.2% from May 2019 to May 2020. Unemployment numbers for all states are shown in the following chart.

Unemployment by Industry

As mentioned in the previous section, the states that have fared best either have a more diverse economy or do not rely heavily on industries that have been hardest hit by the coronavirus. The most negatively affected is the leisure and hospitality industry where unemployment rose 618% from a low of 5.0% in May 2019 to a staggering 35.9% in May 2020. At a distant second, but still reeling, is the wholesale and retail trade industry, which saw unemployment rise from 4.2% to 15.1% during the same period. The rest of the industries are listed in the following chart.

Unemployment by Industry-May 2019 to May 2020

Unemployment by Age Group

Businesses need two things to exist: workers and customers. Without customers, there is no need for workers or the business for that matter. Some businesses require highly skilled workers while others operate well using unskilled labor. It is this unskilled labor group that has been hardest hit.

The greatest rise in unemployment is among workers under age 25. This is likely due to three factors. Younger workers typically have fewer marketable skills, less work experience, and less seniority. Many of these workers are in industries that have felt the greatest pain. Unemployment rates by age group are contained in the following chart.

Unemployment by Age Group-May 2019 to May 2020

Unemployment by Race/Ethnicity

Question: Prior to Covid-19, was unemployment among blacks / African Americans at a record low as President Trump has claimed? Using the available data, which extends back to January 1972, the answer is yes. This new record low was achieved in October and November of 2019 when unemployment among black or African American workers fell to 5.1%. The previous record low was 5.2% in December 1973. The current rate is 16.8%, which is less than the highest rate of 20.7% logged in December 1982. The most recent high in unemployment for this group was 19.3% in March 2010. It has been steadily declining since then. Numbers for White, Asian, and Hispanic or Latino and black or African American workers are listed in the following chart.

Unemployment by Race or Ethnicity-May 2019 to May 2020

Businesses need workers, workers need businesses, and both depend on customers. Since the pandemic began, consumer demand has fallen sharply. With the probability that a vaccine will not be available until early 2021 at the soonest, plus a disregard for recommended safety protocols by many individuals, namely wearing masks and social distancing, it is highly unlikely that the economy will return to normal for several years.

Will the president continue to hold rallies? Will he set an example by wearing a mask? Will the protests and violence continue? Will other large gatherings continue? Unless Americans make a collective and conscious choice to mask up and social distance, we will be forced to live in a depressed economy for longer than necessary. The choice is up to us.

 

 

 

 

 

U.S. Healthcare System vs. Socialized Medicine during the Pandemic

https://www.commondreams.org/news/2020/06/25/why-socialized-system-medicare-all-beats-profit-healthcare-one-chart-covid-19?fbclid=IwAR1qT_AI5KFreoEKOqQfvdWUHPyW80fa2Iefxb5Ul5wJQtf8rSvZXkL8RHM

 

“All countries successfully combatting this virus have robust public health systems, which provide for coordination of effort.”

A recent rise in cases of Covid-19 and the overt failure of the for-profit healthcare system throughout the pandemic in the U.S. are making the case for Medicare for All, advocacy groups and activists say, as countries with socialized systems see their infection rates decline.

“All countries successfully combatting this virus have robust public health systems, which provide for coordination of effort,” remarked a popular healthcare advocate who uses the @AllOnMedicare handle on Twitter.

Calls for the U.S. to adopt a single-payer heathcare system have increased as the pandemic has raged around the country. Cases and deaths in the U.S are now the highest in the world, a result critics blame on both the private healthcare system and the mismanagement of the crisis by President Donald Trump.

Public Citizen’s health care policy advocate Eagan Kemp told Common Dreams that the current for-profit healthcare system that has driven millions of Americans in to bankruptcy and leaves millions more without care will only continue to exacerbate the pain of the outbreak. 

“While no health care system can completely protect a country from Covid-19, the U.S. has failed to respond for a number of reasons, not least of which is a for-profit health care system where Americans are too afraid to go to the doctors for fear of the cost,” said Kemp. “Far too many Americans will face medical debt and even bankruptcy if they are lucky enough to survive getting Covid-19, something unheard of in all other comparably wealth countries.”

As University of Massachusetts professor Dean E. Robinson wrote in a piece that appeared at Common Dreams earlier this month, the coronavirus is impacting people of color at a disproportionate rate in cities and communities nationwide—a dynamic that bolsters the call for a universal Medicare for All program to help close those gaps.

“The obvious and immediate need of Black and other working class populations caught in the teeth of the pandemic is the right to health care treatment without the burden of cost,” wrote Robinson. “Even before the pandemic, lower-income, Latino, and younger workers were more likely to be uninsured. Undocumented workers had the highest rates of uninsurance.”

On June 18, Ralph Nader in an opinion piece for Common Dreams expressed his hope that the ongoing pandemic would make essential workers in the health field “the force that can overcome decades of commercial obstruction to full Medicare for All.”

 

 

 

 

Re-examining the delivery of high-value care through COVID-19

https://thehill.com/opinion/healthcare/502851-examining-the-delivery-of-high-value-care-through-covid-19#bottom-story-socials

Re-examining the delivery of high-value care through COVID-19 ...

Over the past months, the country and the economy have radically shifted to unchartered territory. Now more than ever, we must reexamine how we spend health care dollars. 

While the COVID-19 pandemic has exposed challenges with health care in America, we see two overarching opportunities for change:

1) the under-delivery of evidence-based care that materially improves the lives and well-being of Americans and

2) the over-delivery of unnecessary and, sometimes, harmful care.

The implications of reallocating our health care spending to high-value services are far-ranging, from improving health to economic recovery. 

To prepare for coronavirus patients and preserve protective equipment, clinicians and hospitals across the country halted non-urgent visits and procedures. This has led to a substantial reduction in high-value care: emergency care for strokes or heart attacks, childhood vaccinations, and routine chronic disease management. However, one silver lining to this near shutdown is that a similarly dramatic reduction in the use of low-value services has also ensued.

As offices and hospitals re-open, we have a once in a century opportunity to align incentives for providers and consumers, so patients get more high-value services in high-value settings, while minimizing the resurgence of low-value care. For example, the use of pre-operative testing in low-risk patients should not accompany the return of elective procedures such as cataract removal. Conversely, benefit designs should permanently remove barriers to high-value settings and services, like patients receiving dialysis at home or phone calls with mental health providers.   

People with low incomes and multiple chronic conditions are of particular concern as unemployment rises and more Americans lose their health care coverage. Suboptimal access and affordability to high-value chronic disease care prior to the COVID-19 pandemic was well documented  As financially distressed providers re-open to a new normal, hopeful to regain their financial footing, highly profitable services are likely to be prioritized.

Unfortunately, clinical impact and profitability are frequently not linked. The post-COVID reopening should build on existing quality-driven payment models and increase reimbursement for high-value care to ensure that compensation better aligns with patient-centered outcomes.

At the same time, the dramatic fall in “non-essential care” included a significant reduction in services that we know to be harmful or useless. Billions are spent annually in the US on routinely delivered care that does not improve health; a recent study from 4 states reports that patients pay a substantial proportion (>10 percent) of this tab out-of-pocket. This type of low-value care can lead to direct harm to patients — physically or financially or both — as well as cascading iatrogenic harm, which can amplify the total cost of just one low-value service by up to 10 fold. Health care leaders, through the Smarter Health Care Coalition, have hence called on the Department of Health and Human Services Secretary Azar to halt Medicare payments for services deemed low-value or harmful by the USPSTF. 

As offices and hospitals reopen with unprecedented clinical unmet needs, we have a unique opportunity to rebuild a flawed system. Payment policies should drive incentives to improve individual and population health, not the volume of services delivered. We emphasize that no given service is inherently high- or low-value, but that it depends heavily on the individual context. Thus, the implementation of new financial incentives for providers and patients needs to be nuanced and flexible to allow for patient-level variability. The added expenditures required for higher reimbursement rates for highly valuable services can be fully paid for by reducing the use of and reimbursement for low-value services.  

The delivery of evidence-based care should be the foundation of the new normal. We all agree that there is more than enough money in U.S. health care; it’s time that we start spending it on services that will make us a healthier nation.