April 12, 2021

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The Health 202: Democrats hope wins in Georgia would allow them to bolster health coverage

9 min read

The Georgia elections, if they go the way of Democrats, would expand the ranks of senators backing a public option.

Democrats Jon Ossoff and Raphael Warnock are seeking to unseat Republican Sens. Kelly Loeffler and David Perdue, and give their party 50 seats in the Senate, making Vice President-elect Kamala D. Harris the tie-breaking vote. Polls in Georgia close at 7 p.m., concluding a race that has seen record-breaking spending for a nonpresidential election.

“Georgia’s two Republican Senate candidates careened over the weekend toward a rocky end to their high-stakes dual runoff races, trying hard to avoid becoming collateral damage in a series of raging disputes that have embroiled the GOP,” our colleague Cleve R. Wootson Jr. reports.

Both Ossoff and Warnock have said they want to expand health insurance incrementally through broadening the Affordable Care Act and creating a government-backed public option plan for Americans, rather than overhauling the whole system with Medicare-for-all or something like it. 

This is the approach advocated by Biden, House Speaker Nancy Pelosi (D-Calif.) and moderate Democrats. Yet the Republicans spent the last two months pummeling Ossoff and Warnock over health care, labeling them as extremist and socialist and painting them as Medicare-for-all proponents.

“The Republican talking points are the things we heard in the general elections, [that the Democrats are] radical socialists who want a government-run health-care system,” said Ken Thorpe, professor of health policy at Emory University. “On almost every ad it’s either directly talked about or implied.”

Yet even incremental health coverage expansion won’t necessarily be possible in the Senate, even if Ossoff and Warnock win. 

With 50 seats and a tie-breaking vote from Harris, Senate Democrats would have to get every single one of their members in line — or nab the help of some Republicans to pass legislation. And unless there’s a budget reconciliation bill, which requires a simple majority to pass, they’d need 60 votes to get around any filibusters.

Any significant health-care legislation will likely originate in the Democrat-run House.

And now House Democrats have tweaked rules around paying for legislation, potentially making it easier for their members to pass bills if they can be reasonably seen as related to the coronavirus pandemic or climate change.

Normally, lawmakers must offset any increase in government spending with cuts or tax increases, under the “pay-as-you-go” rule. This requirement can make it incredibly difficult to achieve consensus on any legislation demanding significant cash.

But House Rules Committee Chairman Jim McGovern (D-Mass.) advanced two major exceptions, which the House approved yesterday. Legislation “to prevent, prepare for, or respond to economic or public health consequences” of the coronavirus pandemic or climate change will be exempted from the pay-as-you-go rules.

This could make it easier for the lower chamber to pass bills related to the coronavirus pandemic and send them over to the Senate, putting pressure on that body to approve them. 

The move will likely spur House Democrats to propose legislation expanding health coverage as a specific coronavirus response. Rep. Pramila Jayapal (D-Wash.) has already introduced legislation along these lines, proposing a bill to expand Medicare and Medicaid during the pandemic.

“This is a rules package that encourages us to tackle the most pressing issues facing our nation today,” McGovern said in a floor speech Monday. “It makes reforms to our budget rules so we can deal with these dual challenges through an all-hands-on-deck approach while maintaining fiscal responsibility.”

Ahh, oof and ouch

AHH: U.S. health officials are rejecting suggestions to defer the second dose of the coronavirus vaccine.

“In recent days, some public health experts have debated whether it is worth taking a scientific gamble by altering the two-dose regimens that proved highly effective in trials to maximize the number of people partially protected with at least one shot as the pandemic surges,” The Post’s Carolyn Y. Johnson reports. 

The United Kingdom has already announced it will prioritize giving as many people as possible an initial dose of an authorized vaccine, even if it means delaying the booster shot. Limited data suggests the first vaccine dose may offer partial protection, and some prominent public health officials argue it’s worth taking the risk to stem the spread of the virus.

But top government health officials dismiss the suggestion. Leading infectious-disease expert Anthony S. Fauci, Health and Human Services Secretary Alex Azar and Operation Warp Speed chief Moncef Slaoui have all recently roundly rejected proposals to alter the timeline of the two-dose vaccine regimen.

“There really are no data on what happens if you delay the second dose by three months or four months or two months,” Fauci, who directs the National Institute of Allergy and Infectious Diseases, said Monday. Fauci said that there was more interest in potentially administering two half-doses of the coronavirus vaccine, but that at this point the main obstacle was “efficiently getting doses we already have into people.”

So far, the United States has only administered a small fraction of the vaccine doses that have been distributed to states, according to a Washington Post tracker, which looks at vaccine priorities and administration state by state.

Vaccine administration rates vary across states. While Georgia has vaccinated 0.7 percent of its population, South Dakota has vaccinated 3 percent of its population. 

Most states have adopted Centers for Disease Control and Prevention guidelines and are prioritizing health-care workers and nursing home residents and staff, followed by front-line essential workers and individuals over the age of 75. But states can also set their own vaccine priorities and some are giving preference to vaccine trial volunteers who received the placebo or are focusing on vaccinating the elderly before first responders.

OOF: England is entering a new national lockdown amid a coronavirus outbreak driven by a new, more contagious virus variant.

“With most of the country already under extreme measures, it’s clear that we need to do more together to bring this new variant under control while our vaccines are rolled out,” Prime Minister Boris Johnson said Monday. “In England, we must, therefore, go into a national lockdown which is tough enough to contain this variant.”

British Prime Minister Boris Johnson ordered a new national lockdown in England on Jan. 4 to try to slow a surge in coronavirus cases. (Reuters)

New York confirmed its first case of the new U.K. strain on Monday. The case was identified in a 60-year-old man who had no recent travel history and comes after cases have also been identified in California, Florida and Colorado.

South Africa has also identified another new strain of the coronavirus that also appears to be more transmissible. Britain’s health minister Matt Hancock told BBC Radio 4’s “Today” program that this variant could be “even more of a problem than the UK new variant.” The South Africa variant has additional mutations to the virus’s spike protein, sparking concerns that existing vaccines may not be as effective against it. John Bell, a professor of medicine at the University of Oxford and a member of Britain’s vaccine task force, said it would be unlikely for the vaccines to be entirely ineffective but that it might be necessary to tweak existing vaccines.

OUCH: Young ER doctors who risked their lives in the pandemic are struggling to find jobs.

Young doctors, called residents, who specialize in emergency medicine are struggling to find full-time employment even while working on the front lines of the covid-19 response. The doctors, many of whom are saddled with debt from medical school, find themselves in a predicament that would have been unimaginable for them a year earlier, The Post’s Ben Guarino reports.

“The dearth of jobs is the result of a domino effect: Many people stayed away from hospital emergency rooms this past year, wary of contracting the virus. As patient numbers dropped, emergency departments brought in less money. As a result, cash-strapped employers stopped recruiting new doctors,” Ben writes.

Some residents have seen their contracts changed or even rescinded, as hospitals and medical practices struggle with budget shortfalls. A survey from the American College of Emergency Physicians found that 20 percent of emergency medicine practices laid off doctors this year. It’s a strange paradox in the midst of a pandemic when it seems like emergency medicine doctors should be in high demand.

“We’re putting our own lives at risk, our family’s lives at risk,” emergency medicine physician R.J. Sontag, the president of the Emergency Medicine Residents’ Association, told The Post. “We’re in, frankly, a financially precarious position with a ton of debt and limited income. And the fact of the matter is that employers just aren’t hiring.”

More in coronavirus

  • A Florida state representative is calling for Mar-a-Lago to be shut down after President Trump’s private club held a New Year’s Eve bash in which attendees did not wear masks in violation of a Palm Beach County mask order, The Post’s Lori Rozsa reports. Palm Beach County officials said they were reviewing the complaint from state Rep. Omari Hardy, a Democrat from nearby Lake Worth Beach.
  • A Wisconsin pharmacist tried to spoil 500 doses of a coronavirus vaccine because he believed they were unsafe, according to Ozaukee County District Attorney Adam Gerol, The Post’s Hannah Knowles reports. The employee of Aurora Health Care removed Moderna vaccine vials from refrigeration, seeking to sabotage the supplies, but charges are still up in the air as investigators seek to determine whether the removal of the doses hurt their viability. At least 57 people received doses that were taken out of refrigeration.
  • It’s been a year since the first rumblings of a coronavirus outbreak in China. On Jan. 4, 2020, the World Health Organization tweeted that it was investigating a cluster of pneumonia cases in Wuhan. The following day the U.S. agency said that China reported its first cases to the WHO on Dec. 31, 2019, and that at least 44 cases had been reported, The Post’s Siobhán O’Grady reports.
  • Because vaccine doses must be used within a certain time frame once they have been removed from refrigeration, some lucky individuals who are not in priority groups have been able to get early doses. This happened, for instance, at a Giant Foods store in Northeast Washington, D.C., where a pharmacist flagged down a law school student who happened to be shopping at the store after several first responders missed their appointments, The Post’s Lola Fadulu reports.  The decision was in line with guidance from the D.C. Department of Health, which instructs providers to use any vaccine doses that might otherwise go to waste.

Elsewhere in health care

A high-profile venture that promised to disrupt health care is disbanding.

“Haven, created two years ago by Amazon, JPMorgan Chase and Berkshire Hathaway to address soaring health-care costs and improve patient outcomes, announced in a terse statement on its website Monday that it will shutter,” The Post’s Jay Greene reports.

The venture sent shock waves through the medicine field when it was announced three years ago, with an ambitious promise that the combined forces of the three major companies could lead to massive cost-cutting across the health-care system. “The ballooning costs of health care act as a hungry tapeworm on the American economy,” Berkshire’s Warren Buffett said in a statement at the time. “Our group does not come to this problem with answers. But we also do not accept it as inevitable.” 

But the initiative is ending with little to show for its efforts, as health-care costs continued to grow in 2019, accounting for 17.7 percent of the nation’s gross domestic product. A spokesperson for Haven said that Amazon, Berkshire Hathaway and JPMorgan Chase would continue to leverage insights gained from the joint-venture. (Amazon CEO Jeff Bezos owns The Washington Post).

Children’s hospitals may be partially to blame to for the spread of antibiotic-resistant bacteria.

“A growing body of research shows that overuse and misuse of antibiotics in children’s hospitals — which health experts and patients say should know better — helps fuel these dangerous bacteria that attack adults and, increasingly, children. Doctors worry that the covid pandemic will only lead to more overprescribing,” Kaiser Health News’s Laura Ungar reports. 

“A study published in the journal Clinical Infectious Diseases in January found that 1 in 4 children given antibiotics in U.S. children’s hospitals are prescribed the drugs inappropriately — the wrong types, or for too long, or when they’re not necessary,” she continues. The study could even be an underestimate because it focused on 32 children’s hospitals that were already working to reduce antibiotic use. 

Researchers say that the overprescription of antibiotics is fueling drug resistant strains of dangerous bacteria like Enterobacteriaceae, Staphylococcus aureus and Clostridium difficile. 

Sugar rush

Paige Winfield Cunningham

2021-01-05 07:48:13

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