Checking Up On Health: November 30, 2020

Medical Monday: A weekly post of healthcare- and technology-related policy news, views and commentaries.

Many Thanksgiving family gatherings were canceled because of COVID-19. Many relatives avoided gatherings to minimize the risk of infection. Some who attended social gatherings over the holiday are now in quarantine or worse – infected – because someone turned up asymptomatic but infected or now suspect they might be. Expect another surge in infections beginning this week. It hit close to home for us: My son and his family were unable to join us because a co-worker turned up at work despite feeling unwell, then couldn’t get tested in time because the waits were too long at testing sites. Out of consideration for us, my son and his family stayed home and wore masks. By the time the co-worker was tested – with negative results – the holiday weekend was over. By then, we all tested positive – for resentment at the co-worker’s thoughtlessness.

The holidays have only just begun. COVID-19 is rearing its ugly head again. You probably know someone who has tested positive or is in quarantine. Thankfully, Gov. Brian Kemp has been a steady hand at the helm as Georgia – which you may recall was first in the nation to reopen – works to balance economic and health considerations. COVID-19 is rearing its ugly head again. It behooves us all to exercise personal responsibility and heed the governor’s mantra: “Wear a mask, wash your hands, watch your distance, and get a flu shot. Together we can keep our state safe and healthy.”

From shot in the dark to shot(s) in the arm: Moderna has applied to the Food and Drug Administration for Emergency Use Authorization for its COVID-19 vaccine, joining Pfizer. Approval for both vaccines is expected by mid-to-late December. By the end of December, Moderna expects to ship enough doses for 7.5 million people to be vaccinated with two doses, while Pfizer plans enough for 12.5 million people. The two doses have to be given several weeks apart. A panel from the Centers for Disease Control and Prevention is set to vote Tuesday on how to prioritize who gets the vaccine, the Associated Press reports. Source: News reports

Accountability on eligibility: An op-ed by Brian Blase in the New York Post highlights the need to verify eligibility of both applicants and recipients of Medicaid. Improper Medicaid payments now exceed $100 billion a year, Blase writes, which amounts to more than one in four dollars that don’t meet program rules. The Centers for Medicare and Medicaid Services (CMS) examined states each year from 2017-2019 for its 2020 report and found an improper payment rate of 21.4%, totaling $86.5 billion. Blase notes this was before COVID-19. Additionally, he points out, the actual amount is much higher: Eligibility audits were not conducted in 2017. (If you only count the two years where an eligibility audit was performed, the improper payment rate is actually 27% and improper federal spending totals more than $100 billion.) Why is improper spending so high? He notes one reason: “Because Washington pays nearly two-thirds of the total Medicaid tab, states do not spend with an eye toward value. Program integrity efforts, like ensuring only eligible people enroll, almost always get short shrift.” Why should you care? “This staggering failure doesn’t just reduce health-care access for the truly eligible, it also harms taxpayers who fund it,” Blase points out.

You may recall Blase participated in a healthcare panel discussion at the 2020 Georgia Legislative Policy Forum, which took place via Zoom in July and August.

Land of the blind? It pays to be informed. The Wall Street Journal Editorial Board points out: “Some two-thirds of Americans who support Medicare for All (single payer) wrongly thought they’d be able to keep their current health insurance, Kaiser reported in October. … These polls suggest that what Americans really want isn’t single payer. They want protection from the risk that they or someone they love needs help paying for cancer immunotherapy or surgery. There is a political opening for policy that covers costs for the sick without compromising medical innovation or prompt access to care, and favors choice and competition over mandates and political control.” The editorial board cites alternatives for Americans from “a recent policy blueprint produced and supported by center-right policy minds like Mr. Goodman, Grace-Marie Turner, Brian Blase and Doug Badger.” The Foundation is a signatory to the policy blueprint.

Rural hospital closures: A report in Becker’s Hospital Review notes 33 states have seen at least one rural hospital shut down since 2010. It cites the Cecil G. Sheps Center for Health Services Research, which lists 21 rural hospitals in Texas that have closed since 2010 – the most of any state. Tennessee has the second-most closures, with 14 rural hospitals shutting down in the past decade. Tied for third place is Oklahoma and Georgia, with eight closures each. Georgia hospitals that closed:
Hart County Hospital (Hartwell)
Charlton Memorial Hospital (Folkston)
Calhoun Memorial Hospital (Arlington)
Stewart-Webster Hospital (Richland)
Lower Oconee Community Hospital (Glenwood)
North Georgia Medical Center (Ellijay)
Southwest Georgia Regional Medical Center (Cuthbert)
Northridge Medical Center (Commerce) 

Rethinking American capitalism? A McKinsey report suggests that while “Capitalism has contributed to significant gains in economic growth and prosperity throughout its history … capitalism in its current form – and American capitalism in particular – may face its most serious test.” It cites “growing public discontent about rising inequality, heightened competition from economies with different models, and existential threats including from climate change. … Now, the health and economic effects of the COVID-19 pandemic are exacerbating these inequalities between people and between places, with many low-income individuals either in high-contact essential jobs with greater health risks, or facing temporary or permanent unemployment.” Lest we forget, it’s in no small part thanks to Gov. Brian Kemp’s insistence keeping Georgia’s economy open that, amid the ongoing pandemic, this state has the lowest unemployment rate in the nation! Furthermore, in this season of giving, it’s worth remembering American capitalism has helped create a nation of generous givers: Americans gave $449.64 billion in 2019, up 5.1% increase from 2018. The largest source was individuals at $309.66 billion, or 69% of total giving. In four of the last five years, charitable giving by individuals has grown. Corporations, meanwhile, gave $21.09 billion, a 13.4% increase from 2018.

Notable Quote

“I take medication daily and have for many years. I also try to exercise a lot, because there’s some evidence that exercise lessens the symptoms of anxiety, and I try to use the strategies that I’ve learned in cognitive behavioral therapy to cope with my illness. But it’s a chronic illness and it hasn’t, like, gone into remission or anything for me. It’s something I live with, something that I’ve integrated into my life. And we all have to integrate stuff into our lives, whether it’s mental illness or physical disability or whatever. There is hope. There is treatment. You are not alone, and while I know the struggle feels at times completely hopeless and futile, there is a far shore for the vast majority of people, and I wish you the best.” –  John Green


Checking Up On Health is compiled by Benita M. Dodd, vice president of the Georgia Public Policy Foundation.

 

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