America’s Future Starts Now: The View of the State of the Art and the Problems of Health Care in the U.S.

The CNN Opinion series, America’s Future Starts Now, in which people share how they have been affected by the major issues facing the nation and experts offer their proposed solutions, is part of this. The views expressed in these commentaries are the authors’ own. Read more opinion at CNN.

Almost everyone in the nation has been affected by the disease in some way, with over one million deaths in the US from Covid-19 and around 100 million cases since the epidemic began.

The last two years have shown the problems with the American health care system for Chimére Smith. To advocate for her own health, “I became who I never wanted to be: a confrontational, complaining Black woman,” she writes.

The new life has left me unable to teach the students I care about the most. I laugh at the money playing peekaboo in my bank account after exhausting all my leave benefits. Crying is all I can do on some days.

The Canary in the Coal Mine: Why Healthcare Matters More than Profits and How Companies Can Evade Their Role in Providing Quality Care

Many health care entities are more interested in profits than in healing. Nurses comprise the biggest labor pool of any hospital, and are therefore viewed in corporate terms as a cost center rather than a profit generator. Hospitals can cut labor costs by eliminating nursing positions. No nurse can do the job of two nurses, so care will inevitably be less safe if it is managed within a capitalist framework.

Staffing ratios in the hospital need to be mandated to save nursing and patient care. Ratios were put in place in California in 2004 without putting any big hospital systems out of business. And the Center for Medicare and Medicaid recently imposed nurse staffing requirements in skilled nursing facilities, which are specialized nursing homes. Hospitals that are financially struggling could get help from the government.

As nurses fare, so fare patients, because nurses are the canary in the coal mine for patient health. Patients should have safe care prioritized over profits.

Theresa Brown, nurse and New York Times bestselling writer, is the author of “Healing: When a Nurse Becomes a Patient,” and “The Shift: One Nurse, Twelve Hours, Four Patients’ Lives.”

Ensuring access to health services is more important than ever because of the high cost of living in the US and the increased strain on American families.

With the recent focus on monopolies and corporate power, the hospital industry has come under scrutiny. Ninety percent of metropolitan statistical areas are considered highly concentrated for hospital care, according to KFF, with hospitals buying up physician practices and driving further consolidation.

Stark Law could be altered to allow doctors to refer patients to facilities that have a financial interest in the patient’s care, with robust evidence showing that market competition lowers costs. Corporate self-referral is not subject to the restrictions and corporate health systems frequently mandate internal referrals.

Brian J. Miller, MD, MBA, MPH is a nonresident fellow at the American Enterprise Institute and an assistant professor of medicine at the Johns Hopkins University School of Medicine. In 2015, he was a special advisor to the Federal Trade Commission.

Source: https://www.cnn.com/2022/10/18/opinions/health-care-solutions-expert-roundup/index.html

Building Trust with Public Health Officials in a Divided Country: Addressing the Pancreas in Public Health Care Solutions Expert-Rundup

Building trust in science is a year-round job, not something that can be done in an emergency. We suffer from a cycle of panic and public health guidance, followed by neglect which leads to the erosion of relationships public health officials build with communities. We need to hear the voices of our public health officials, and see their faces, often and in times of non-emergency to establish trust for when crises strike.

It couldn’t come at a worse time. In a time when disease is more common, the need for communities to heed public health officials’ guidance is more important than ever.

Americans are often struggling to decide between reality and fiction in a divided country, causing an epidemic of misinformation that can quickly spread.

The senior director of the NYC Health + Hospitals special pathogens program is also an infectious disease epidemiologist, who teaches at Boston University. She is also a fellow at the Belfer Center for Science and International Affairs. She tweets @syramadad.

Source: https://www.cnn.com/2022/10/18/opinions/health-care-solutions-expert-roundup/index.html

The Story of Medicaid: The Failure of the Biden Plan, Obamacare, and Health Care Solutions Expert Roundup in Washington, D.C., (2022/10/18)

It’s no secret that it can be hard to get things done in Washington. No matter how reform is done, health care is always an exception. The legislation to lower prescription drug prices passed the Congress in the face of fierce opposition from the GOP and Big pharma. Unfortunately, efforts to expand Medicare to include dental, hearing and vision benefits perished with the failure of Biden’s Build Back Better Plan, which lacked unanimous support among Senate Democrats and got none from Republicans.

Medicaid can be expanded for almost all adults with an income of up to 131% of the federal poverty line because of theAffordable Care Act. In both red and blue states, it was an unmitigated success. Medicaid expansion has radically reduced the number of uninsured Americans and boosted health outcomes, including fewer premature deaths, among older adults. It has contributed to a reduction in health differences for people of color according to research from the Kaiser Family Foundation.

This is particularly urgent for those 12 states that have yet to expand Medicaid. 383,000 adults could lose affordable coverage in these states with the end of the PHE, while Medicaid expansion will give financial security and access to health care to millions of mostly working adults and parents.

Max Richtman is president and CEO of the National Committee to Preserve Social Security and Medicare. He is former staff director of the US Senate Special Committee on Aging.

Source: https://www.cnn.com/2022/10/18/opinions/health-care-solutions-expert-roundup/index.html

The End of the Affordable Care Act: Discriminating Between Black and White Doctors in the U.S. Medical Education and the Covid-19 Public Health Emergency

One of the biggest issues facing the American health care system are the disparities that keep many from accessing quality care. Medical education plays a big role in eliminating those differences.

The end goal is this: There should be a diverse community of doctors that represents the populations they serve. Studies show that minority patients benefit from having minority doctors, yet the current makeup of the US physician workforce is not representative of population estimates. According to the Association of American Medical Colleges, only 5% of Black physicians are found in the US.

The next generation of doctors will be able to identify discrimination in the health care system and dismantle it, thanks to the help of racist guidelines or a calculator that adjusts for race.

The Inflation Reduction Act takes a vital step by extending the premium tax credits for those who buy their own coverage on the Affordable Care Act marketplace, enabling 13 million individuals to continue to afford their coverage, according to the Kaiser Family Foundation. The tax credits need to be made permanent.

Estimates from the Department of Health and Human Services show that an estimated 15 million Americans, including 5 million children, could lose Medicaid when the Covid-19 public health emergency ends.

As the Georgetown University Health Policy Institute points out, as of September 30, only 27 states and the District of Columbia have publicly shared their plan to prepare for the end of the PHE. State leaders should act now to ensure every Medicaid enrollee knows how to stay covered and should work to simplify renewal processes, such as using electronic data sources to verify eligibility.

The public health emergency will be over and Covid-19 vaccinations will be free for those with insurance, regardless of federal laws.

The Budget Crisis During the First Five Years: The End of the National Emergency and Public Health Emergency in May 2015, Adjoint Deputy Vice President Jen Kates

It is essential that policymakers look at policies to mitigate the high prices of drugs, such as prohibiting drugmakers from shifting costs to non-Medicare consumers, and establishing a federal reinsurance program for expensive drugs.

The national emergency and public health emergency authorities will be extended one last time in May, the White House said in a statement.

“This wind down would align with the Administration’s previous commitments to give at least 60 days’ notice prior to termination of the (public health emergency),” the statement said.

The statement added, “To be clear, continuation of these emergency declarations until May 11 does not impose any restriction at all on individual conduct with regard to COVID-19. They do not impose mask mandates or vaccine mandates. They don’t restrict school or business operations. They do not require the use of any medicines or tests in response to cases of COVID-19.”

A senior Democratic aide said that the White House weighed in because they wanted House Democrats to reject the legislation to end the public health emergency.

The bills are unnecessary because the administration intends to end emergencies anyway, the administration argues. The White House also noted the passage of the measures ahead of May 11 would have unintended consequences, such as disrupting the administration’s plans for ending certain policies that are authorized by the emergencies.

The public health emergency can be lifted on May 11, so the administration is trying to figure out which policies can stay in place.

The aide told CNN that it will be up to each member to decide what is in their district’s best interests. Declaring an end to the public health emergency will also end the border restriction known as Title 42, which will also likely set up a showdown on Capitol Hill.

Jen Kates is a senior vice president at the Kaiser Family Foundation. “That’s the main thing people will start to notice.”

Most Americans covered by Medicare, Medicaid and private insurance plans have been able to obtain Covid-19 tests and vaccines at no cost during the pandemic. Medicare patients have been able to get up to eight tests a month from retailers at no cost. Medicaid also picks up the cost of at-home tests, though coverage can vary by state.

The uninsured had been able to access no-cost testing, treatments and vaccines through a different pandemic relief program. The federal funding ran out in the spring of 2202, making it hard for people without coverage to get free services.

The commercial prices of the Covid-19 vaccine will probably be between $82 and $130 a dose, about three to four times what the federal government has paid, according to Kaiser.

The public health emergency has also meant additional funds for hospitals, which have been receiving a 20% increase in Medicare’s payment rate for treating Covid-19 patients.

Also, Medicare Advantage plans have been required to bill enrollees affected by the emergency and receiving care at out-of-network facilities the same as if they were at in-network facilities.

Several of the most important enhancements to public assistance programs are no longer tied to the public health emergency. Congress ended the connection in December as part of its funding package.

Beginning April 1, it will be possible for states to begin processing Medicaid redeterminations and disenrolling residents who no longer qualify. They have 14 months to review the eligibility of their beneficiaries.

Food stamp recipients received a boost during the public health emergency. Congress increased food stamp benefits to the maximum for family size.

The Biden administration doubled the boost in the spring of 2021, so households already receiving the maximum amount will get a monthly supplement of at least $95 a month.

Source: https://www.cnn.com/2023/01/30/politics/may-11-end-of-covid-and-public-health-emergencies/index.html

Medicare Telehealth in the Presence of a Public Health Emergency: More Telehealth Visits and Mobile Apps for Medicare enrolled in Medicare

More Medicare enrollees are able to get care via telehealth during the public health emergency. The service is not limited to those living in rural areas. They can conduct the telehealth visit at home, rather than having to travel to a health care facility. More services can be accessed via telehealth, and beneficiaries can use smartphones to get them.