
Cartoon – It’s all about Re-Branding in this Economy


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Seven months since the first coronavirus case in the country was reported, the United State’s total infection count passed the 4 million milestone Thursday, according to a tally from The New York Times, a brutal marker as cases continue to rise in most of the country and calls for masking increase.
The number of total fatalities attributed to the virus has exceeded 143,000, the Times reported.
On Wednesday, a record-breaking 12,807 new cases was enough to tip California’s total number past that of New York, once the world epicenter of the pandemic (though its per capita infection rate remains less than New York at its peak).
Nationwide daily virus deaths topped 1,000 fatalities Wednesday for the first time since May.
The troubling numbers come as calls for widespread use of face masks grows, with President Donald Trump, who has in the past downplayed the garment, calling their use “patriotic” in a tweet this week.
Labor Department numbers released Thursday showed unemployment claims over the past week have jumped for the first time since March, rising by upwards of 100,000 to total 1.4 million.
Around 230 million Americans are under a form of public masking mandate where they live, amounting to some 70% of the country, according to a Forbes analysis. A politically-charged garment for some, Americans on both sides of the aisle seem to be accepting of face masks mandates—a Politico/Morning Consult poll released this week found that 72% of voters surveyed would support a state mask mandate where they live, though Democrats identified as “strongly support[ing]” such an order roughly twice as much as Republicans, according to the survey.
President Donald Trump and inched closer to voicing support for masking during his first coronavirus briefing in months on Wednesday, saying, “Whether you like the mask or not, they have an impact, they’ll have an effect—and we need everything we can get,” Forbes reported.

Elective procedures are in a strange place at the moment. When the COVID-19 pandemic started to ramp up in the U.S., many of the nation’s hospitals decided to temporarily cancel elective surgeries and procedures, instead dedicating the majority of their resources to treating coronavirus patients. Some hospitals have resumed these surgeries; others resumed them and re-cancelled them; and still others are wondering when they can resume them at all.
In a recent HIMSS20 digital presentation, Reenita Das, a senior vice president and partner at Frost and Sullivan, said that during the pandemic, plastic surgery activity declined by 100%, ENT surgeries declined by 79%, cardiovascular surgeries declined by 53% and neurosurgery surgeries declined by 57%.
It’s hard to overstate the financial impact this is likely to have on hospitals’ bottom lines. Just this week, American Hospital Association President and CEO Rick Pollack, pulling from Kaufman Hall data, said the cancellation of elective surgeries is among the factors contributing to a likely industry-wide loss of $120 billion from July to December alone. When including data from earlier in the pandemic, the losses are expected to be in the vicinity of $323 billion, and half of the nation’s hospitals are expected to be in the red by the end of the year.

Doug Wolfe, cofounder and managing partner of Miami-based law firm Wolfe Pincavage, said this has amounted to a “double-whammy” for hospitals, because on top of elective procedures being cancelled, the money healthcare facilities received from the federal Coronavirus Aid, Relief, and Economic Security Act was an advance on future Medicare payments – which is coming due. While hospitals perform fewer procedures, they will now have to start paying that money back.
All hospitals are hurting, but some are in a more precarious position than others.
“Some hospital systems have had more cash on hand and more liquidity to withstand some of the financial pressure some systems are facing,” said Wolfe. “Traditionally, the smaller hospital systems in the healthcare climate we face today have faced a lot more financial pressure. They’re not able to control costs the same way as a big system. The smaller hospitals and systems were hurting to begin with.”
LOWER REVENUE, HIGHER COSTS
Some hospitals, especially ones in hot spots, are seeing a surge in COVID-19 patients. While this has kept frontline healthcare workers scrambling to care for scores of sick Americans, COVID-19 treatments are not reimbursed at the same level as surgeries. Hospital capacity is being stretched with less lucrative services.
“Some hospitals may be filling up right now, but they’re filling up with lower-reimbursing volume,” said Wolfe. “Inpatient stuff is lower reimbursement. It’s really the perfect storm for hospitals.”
John Haupert, CEO of Grady Health in Atlanta, Georgia, said this week that COVID-19 has had about a $115 million negative impact on Grady’s bottom line. Some $70 million of that is related to the reduction in the number of elective surgeries performed, as well as dips in emergency department and ambulatory visits.
During one week in March, Grady saw a 50% reduction in surgeries and a 38% reduction in ER visits. The system is almost back to even in terms of elective and essential surgeries, but due to a COVID-19 surge currently taking place in Georgia, it has had to suspend those services once again. ER visits have only come back about halfway from that initial 38% dip, and the system is currently operating at 105% occupancy.
“Part of what we’re seeing there is reluctance from patients to come to hospitals or seek services,” said Haupert. “Many have significantly exacerbated chronic disease conditions.”
Patient hesitation has been an ongoing problem, as has the associated cost of treating coronavirus patients, said Wolfe.
“When they were ramping up to resume the elective stuff, there was a problem getting patients comfortable,” he said. “And the other thing was that the cost of treating patients in this environment has gone up. They’ve put up plexiglass everywhere, they have more wiping-down procedures, and all of these things add cost and time. They need to add more time between procedures so they can clean everything … so they’re able to do less, and it costs more to do less. Even when elective procedures do resume, it’s not going back to the way it was.”
Most hospitals have adjusted their costs to mitigate some of the financial hit. Even some larger systems, such as 92-hospital nonprofit Trinity Health in Michigan, have taken to measures such as laying off and furloughing workers and scaling back working hours for some of its staff. At the top of the month, Trinity announced another round of layoffs and furloughs – in addition to the 2,500 furloughs it announced in April – citing a projected $2 billion in revenue losses in fiscal year 2021, which began on June 1.
Hospitals are at the mercy of the market at the moment, and Wolfe anticipates there could be an uptick in mergers and consolidation as organizations look to partner with less cash-strapped entities.
“Whether reorganization will work remains to be seen, but there will definitely be a fallout from this,” he said.
https://mailchi.mp/9075526b5806/the-weekly-gist-july-24-2020?e=d1e747d2d8

It was a week of unhappy milestones in the nation’s battle with the coronavirus. On Thursday, the US crossed the threshold of 4M confirmed COVID cases, just 15 days after it hit the 3M cases mark. That’s three times as fast as it took to go from 2M to 3M cases, with daily new case counts now hovering near 70,000.
As the virus proliferates across the country, California has now overtaken New York as the epicenter of the outbreak, with more than 422,000 total cases reported since the beginning of the pandemic, versus New York’s 413,000.
Of greater concern, the daily US death toll from COVID stayed stubbornly above 1,000 for most of the week, the highest it’s been since late May. More Americans are currently hospitalized with COVID than at any time since the middle of April, with the Gulf Coast states showing some of the highest per-capita hospitalization rates in the country. For good reason, Secretary of Health and Human Services (HHS) Alex Azar officially renewed the Trump administration’s declaration of a public health emergency for another 90 days, clearing the way for the nation’s hospitals to receive more emergency financial assistance in battling the virus, and for continued relaxation of regulations that have allowed them to provide care virtually, and in non-traditional settings.
Meanwhile, as part of its Operation Warp Speed initiative to accelerate the development of a COVID vaccine, the Trump administration inked a $1.95B deal with pharmaceutical firm Pfizer and a German biotech company, BioNTech, to purchase 100M doses of the vaccine those companies are developing, with an option to buy an additional 500M doses. That’s in addition to contracts already in place to purchase 100M doses of a vaccine from Novavax, and 300M doses from AstraZeneca.
Americans would have free access to the Pfizer vaccine under the new arrangement, with the government subsidizing the entire cost of each dose, estimated to be about $19.50. Similar deals struck by the British government with AstraZeneca and GlaxoSmithKline carry a much lower per dose price tag—between $4 and $10—raising concerns of “profiteering” by pharmaceutical companies in the US vaccine hunt.
The forward purchasing of millions of doses, coupled with rapid progress on vaccine development (at least 25 of the 150 potential vaccines being developed are already in human trials), raises hopes that help is on the way in our battle with the virus. On Friday, however, top White House science advisor Dr. Anthony Fauci said that he doesn’t expect a vaccine to be “widely available” to the American public until the second half of next year. Until then, our hand-to-hand combat with the virus—using non-pharmaceutical interventions such as mask wearing, social distancing, hand hygiene, testing, and contact tracing—must intensify, particularly in light of increasingly worrisome data on the spread and impact of the disease.
US coronavirus update: 4.0M cases; 144K deaths; 48.8M tests conducted.
America has to be ready for mail voting to avert an election crisis

Valid concerns have been raised about mail voting. In New York, the local election boards have taken weeks to count primary ballots received in the mail as a result of the coronavirus, leaving several races for Congress still unresolved. The problems have been blamed on the late decision to send out the absentee ballot applications, outdated ballot counting machines, and the sheer number of mail ballots. The New York case raises a serious alarm with the 2020 election approaching and many states considering more reliance on mail voting in the midst of the pandemic.
Adding to this sense of urgency, President Trump has declared, without evidence, that mail voting is an open invitation to fraud and will be used unfairly against him this fall. He has tweeted that mail voting would make this the “most rigged” election in history. Setting aside the fact that states have relied on absentee and mail voting to hold secure elections for many years, the stumbles in New York and the irresponsible fear mongering by Trump raise the potential of a very real crisis come this fall.
Consider the national disruption surrounding the 2000 election, which was decided for George Bush after a recount in Florida, a month of legal battles, and a controversial split Supreme Court decision. After you add the factor of a second wave of coronavirus cases in the fall and a sitting president shouting “rigged!” to the rafters, and you can understand why some analysts worry that the period following the 2020 election may be one of the most disruptive contests in our modern history.
A crisis foretold, however, can be a crisis averted. Instead of wringing our hands over the recent problems with mail voting in New York, we have to learn from them and from the multiple states that have implemented mail voting systems without problems or fraud. Then states can make common sense preparations to ensure the process goes as quickly and smoothly as possible to prevent a potential election crisis in November.
The fact that election boards were overwhelmed by an influx of absentee ballots in New York must be the rallying cry for dedicating more resources to efficiently implement mail voting systems. Reducing funds available for mail voting initiatives, as some Trump supporters have advocated, in this era when many people have to rely on these ballots or literally risk death, will only serve to suppress voting, which may be the point.
Consider the case of Ohio for a glimpse of what a proactive mail voting initiative looks like. At the urging of Governor Mike DeWine, Republican and Democratic lawmakers unanimously approved their all mail voting primary that was successfully concluded in April. Governors and state legislatures across the country have to learn from Ohio, and additional federal funds have to be made available to assist the efforts.
All those claims that mail ballots are subject to rampant tampering is not evidence that they are, and it suggests the need to educate voters on the issue. Members of the Armed Forces have relied on absentee voting with mail ballots since the Civil War. Trump himself has voted absentee by mail. Meanwhile, three states allow ounties to conduct elections completely by mail if they choose, five other states conduct elections almost entirely by mail, and more than two dozen other states permit their residents to cast absentee ballots by mail without having to provide a reason.
Over 250 million votes have been cast using mailed ballots since 2000, according to the Vote at Home Institute, and yet exhaustive analysis has identified only a tiny fraction of cases of fraud. None of those states that hold their elections almost entirely by mail has seen voter fraud scandals. The bipartisan group Vote Safe, chaired by former Governor Tom Ridge of Pennsylvania and former Governor Jennifer Granholm of Michigan, notes that several studies have consistently proven that mail ballots are secure and do not advantage one political party over the other. The team rightly emphasizes that the goal of ensuring the safety of voters as they exercise their rights during a raging pandemic is not a partisan issue.
Whether we improve our voting systems or defund them, the use of mail ballots will inevitably be much greater in the 2020 election than in years past. We can prepare for this eventuality and find innovative ways to deal with the challenges that arise, or we can shift our gaze from another crisis foretold and suffer the major consequences come November.

Winston Churchill noted that democracy is the worst form of government, except for all other forms that have been tried. In the midst of a pandemic across the country that has already claimed the lives of tens of thousands of Americans, exercising our right to vote by mail instead of in person may also seem like the worst solution, except for all other options.