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Friday, April 10, 2020

Health Care Reform Articles - April 10, 2020

The America We Need


How to make the nation more just, less fragile — and more free.
From some of its darkest hours, the United States has emerged stronger and more resilient.
Between May and July 1862, even as Confederate victories in Virginia raised doubts about the future of the Union, Congress and President Abraham Lincoln kept their eyes on the horizon, enacting three landmark laws that shaped the nation’s next chapter: The Homestead Act allowed western settlers to claim 160 acres of public land apiece; the Morrill Act provided land grants for states to fund universities; and the Pacific Railway Act underwrote the transcontinental railroad.
Nearly 75 years later, in the depths of the Great Depression, with jobs in short supply and many Americans reduced to waiting in bread lines, President Franklin Roosevelt proved similarly farsighted. He concluded the best way to revive and sustain prosperity was not merely to pump money into the economy but to rewrite the rules of the marketplace. “Liberty,” Roosevelt said at the Democratic Party’s convention in 1936, “requires opportunity to make a living — a living decent according to the standard of the time, a living which gives man not only enough to live by, but something to live for.” His administration, working with Congress, enshrined the right of workers to bargain collectively, imposed strict rules and regulators on the financial industry, and created Social Security to provide pensions for the elderly and disabled.

This article is part of a Times Opinion series exploring how the nation can emerge from this crisis stronger, fairer and more free. Read the editor’s introductory letter.

The coronavirus pandemic has laid bare once again the incomplete nature of the American project — the great distance between the realities of life and death in the United States and the values enunciated in its founding documents.
Over the past half century, the fabric of American democracy has been stretched thin. The nation has countenanced debilitating decay in its public institutions and a concentration of economic power not seen since the 1920s. While many Americans live without financial security or opportunity, a relative handful of families holds much of the nation’s wealth. Over the past decade, the wealth of the top 1 percent of households has surpassed the combined wealth of the bottom 80 percent.
The present crisis has revealed the United States as a nation in which professional basketball players could be rapidly tested for the coronavirus but health care workers were turned away; in which the affluent could retreat to the safety of second homes, relying on workers who can’t take paid sick leave to deliver food; in which children in lower-income households struggle to connect to the digital classrooms where their school lessons are now supposed to be delivered.
It is a nation in which local officials issuing stay-at-home orders must reckon with the cruel irony that hundreds of thousands of Americans do not have homes. Lacking private places, they must sleep in public spaces. Las Vegas painted rectangles on an asphalt parking lot to remind homeless residents to sleep six feet apart — an act that might as well have been a grim piece of performance art titled “The Least We Can Do.”
It is a nation in which enduring racial inequalities, in wealth and in health, are reflected in the pandemic’s death toll. In Michigan, where the coronavirus hit early and hard, African-Americans make up just 14 percent of the state’s population but 40 percent of the dead. Jason Hargrove, who kept driving a Detroit city bus as the virus spread, posted a Facebook video on March 21 complaining about a female passenger who coughed without covering her mouth. He said he had to keep working, to care for his family. In the video, he told his wife he’d take off his clothes in the front hall when he got home and get right in the shower, so that she stayed safe. Less than two weeks later, he was dead.
The federal government is providing temporary aid to less fortunate Americans, and few have objected to those emergency measures. But already some politicians are asserting that the extraordinary nature of the crisis does not warrant permanent changes in the social contract.
This misapprehends both the nature of crises in general and the particulars of the present emergency. The magnitude of a crisis is determined not just by the impact of the precipitating events but also by the fragility of the system it attacks. Our society was especially vulnerable to this pandemic because so many Americans lack the essential liberty to protect their own lives and the lives of their families.
This nation was ailing long before the coronavirus reached its shores.

A great divide separates affluent Americans, who fully enjoy the benefits of life in the wealthiest nation on earth, from the growing portion of the population whose lives lack stability or any real prospect of betterment.
The hedge-fund billionaire Kenneth Griffin paid $238 million last year for a New York apartment overlooking Central Park. He plans to stay there when he happens to be in town. Meanwhile, 10.9 million American families barely can afford an apartment. They spend more than half of their incomes on rent, and so they scrimp on food and health care. And on any given night, half a million Americans are homeless.
For those at the bottom, moreover, the chances of rising are in decline. By the time they reached 30, more than 90 percent of Americans born in 1940 were earning more than their parents had earned at the same age. But among those born in 1980, only half were earning more than their parents by the age of 30.
The erosion of the American dream is not a result of laziness or a talent drought. Rather, opportunity has slipped away. The economic ladder is harder to climb; real incomes have stagnated for decades even as the costs of housing, education and health care have increased. Many lower-income Americans are born into polluted, impoverished neighborhoods, with no decent jobs to be found.
“By 40, my parents owned a house, had a kid — me — and were both doing well in their careers,” said Melanie Martin-Leff, who works in marketing in Philadelphia. “I’m freelancing, renting, partnerless and childless.”
The inequalities of wealth have become inequalities of health. A middle-aged American in the top fifth of the income distribution can expect to live about 13 years longer than a person of the same age in the bottom fifth — an advantage that has more than doubled since 1980.
These changes have become harder to reverse because the distribution of political power also is increasingly unequal. Our system of democracy is under strain as those with wealth increasingly shape the course of policymaking, acting from self-interest and perhaps also because it has become harder to imagine life on the other side of the divide or to design policy in the common interest.
The wealthy are particularly successful in blocking changes they don’t like. The political scientists Martin Gilens of Princeton and Benjamin Page of Northwestern have calculated that between 1981 and 2002, policies supported by at least 80 percent of affluent voters passed into law about 45 percent of the time, while policies opposed by at least 80 percent of those voters passed into law just 18 percent of the time. Importantly, the views of poor and middle-class voters had little influence.

The fragility of our society and government is the product of deliberate decisions. The modern welfare state was constructed in three great waves:


These policies embodied a broad and muscular conception of liberty: that government should provide all Americans with the freedom that comes from a stable and prosperous life.
“We have come to a clear realization of the fact that true individual freedom cannot exist without economic security and independence,” Roosevelt told the nation in 1944.
The goal, of course, was never realized in full, but since the late 1960s, the federal government has largely abandoned the attempt. The defining trend in American public policy has been to diminish government’s role as a guarantor of personal liberty.
Advocates of a minimalist conception of government claim they too are defenders of liberty. But theirs is a narrow and negative definition of freedom: the freedom from civic duty, from mutual obligation, from taxation. This impoverished view of freedom has in practice protected wealth and privilege. It has perpetuated the nation’s defining racial inequalities and kept the poor trapped in poverty, and their children, and their children’s children.
One of the most important aspects of this retreat was the government’s role in constructing a new residential landscape of economically and racially segregated communities. The government built highways that carried white families to new suburban neighborhoods where minorities often were not allowed to live; it provided mortgage loans that minorities were not allowed to obtain; and even after explicit discrimination was declared illegal, single-family zoning laws continued to exclude low-income families, particularly minorities.
Policymakers tied funding for public services to the prosperity of the new communities, and the Supreme Court blessed the practice in a 1973 ruling, San Antonio Independent School District v. Rodriguez, that allowed differences in school funding based on differences in local property values. The effect was to substitute economic segregation for explicitly racial segregation.
The government similarly enabled growing divisions in the workplace. As the economy shifted from manufacturing to services, corporations — with the help of Congress and local lawmakers — successfully resisted the unionization of new jobs. And the government declined to replace organized labor as the protector of workers in burgeoning sectors like retail and health care.
Companies were not required to provide employees with basic benefits like paid leave, and they were given free rein to claim that many of their full-time workers were actually contractors. The purchasing power of the federal minimum wage has been falling since 1968.
A shift in corporate behavior also harmed workers. Many business leaders rallied around a narrow conception of corporate responsibility, arguing the sole obligation of a corporation was to maximize shareholder returns. Policymakers backed the shift, notably by writing that narrow definition into the laws of Delaware, where many large companies maintain official homes.
The results are clear enough: Executive pay has skyrocketed, and shareholders have enjoyed rising stock prices, at least until recently, while most workers are falling behind. If individual income had kept pace with overall economic growth since 1970, Americans in the bottom 90 percent of the income distribution would be making an extra $12,000 per year, on average. In effect, the extreme increase in inequality means every worker in the bottom 90 percent of the income distribution is sending an annual check for $12,000 to a worker in the top 10 percent.
The idealization of individual action in an open marketplace has had its mirror image in the denigration of collective action through government.
The United States does not guarantee the availability of affordable housing to its citizens, as do most developed nations. It does not guarantee reliable access to health care, as does virtually every other developed nation. The cost of a college education in the United States is among the highest in the developed world. And beyond the threadbare nature of the American safety net, the government has pulled back from investment in infrastructure, education and basic scientific research, the building blocks of future prosperity. It is not surprising many Americans have lost confidence in the government as a vehicle for achieving the things that we cannot achieve alone.
The nation’s hierarchies are starkly visible during periods of crisis. The coronavirus pandemic has necessitated extraordinary sacrifices, but the distribution is profoundly unequal.
The wealthy and famous and politically powerful have laid first claim to the available lifeboats: Senators Richard Burr of North Carolina and Kelly Loeffler of Georgia secured their own fortunes by selling off stock holdings as the virus spread in January and February, even as they reassured the nation that everything was going to be OK; the billionaire David Geffen posted on Instagram that he planned to ride out the crisis on his 454-foot yacht, Rising Sun, adding, “I’m hoping everybody is staying safe”; large corporations lobbied successfully against a proposal to provide paid sick leave to every American worker, pleading they couldn’t afford the cost.
Less affluent Americans will bear the brunt in health and wealth. Already they suffer disproportionately from the diseases of labor like black lung and mesothelioma; the diseases of poverty like obesity and diabetes; and the opioid epidemic that has raged in the communities where opportunity is in short supply. By one estimate, these patterns of poor health mean those at the bottom of the income spectrum are twice as likely to die from Covid-19. Many are losing their jobs; those still working generally cannot do so from the safety of the living room couch. They risk death to obtain the necessities of life.
Children, relatively safe from the coronavirus itself, are in particular danger from the economic fallout. Public schools are one of the great equalizing forces in American life; the shift to online learning means existing inequalities matter more. Millions of children lack reliable internet access. The principal of a high school in Phoenix found three students huddled under a blanket outside the building on a rainy day, using the school’s wireless network to complete their required schoolwork because they could not log in from their homes.
And research shows the impact of economic traumas in childhood are long-lasting. The children of parents who lose work, for example, end up earning less over their own lifetimes.
The crisis has also exposed the federal government’s lack of resources, competence and ambition. The government failed to contain the virus through a program of testing and targeted quarantines; it is struggling to provide states with the medical equipment necessary to help those who fall ill; and instead of moving more aggressively to contain the economic damage, the federal government has allowed companies to lay off millions of workers. The unemployment rate in the United States has most likely already reached the highest level since the Great Depression.
A major reason for the faltering response is a chimerical expectation that markets will perform the work of government. The White House has for the most part refused to mandate or coordinate production of critical medical supplies. Indeed, the federal government has bid against states for available supplies and encouraged states to bid against one another. It is an embrace of markets so extreme it might seem farcical if it wasn’t resulting in unnecessary deaths.
Corporate action and philanthropy certainly have their places, particularly in the short term, given President Trump’s feckless leadership and the tattered condition of the government he heads. But they are poor substitutes for effective stewardship by public institutions. What America needs is a just and activist government. The nature of democracy is that we are together responsible for saving ourselves.
Americans need to recover the optimism that has so often lighted the path forward.

The crucible of a crisis provides the opportunity to forge a better society, but the crisis itself does not do the work. Crises expose problems, but they do not supply alternatives, let alone political will. Change requires ideas and leadership. Nations often pass through the same kinds of crises repeatedly, either unable to imagine a different path or unwilling to walk it.
The worst crises often occur under weak leadership; that is a big part of how an initial problem spirals out of control. Americans had every reason to despair of President James Buchanan’s ability to lead the nation through a civil war, or of President Herbert Hoover’s ability to lead the nation out of the Great Depression. Now, as then, the country is burdened with weak leadership — and it has a chance to replace that leadership, as it did in 1860 and 1932.
There is also a need for new ideas, and the revival of older ideas, about what the government owes the nation’s citizens, what corporations owe employees and what we owe one another.
The multi-trillion-dollar scale of the government’s response to the crisis, for all its flaws and inadequacies, offers a powerful reminder that there is no replacement for an activist state. The political scientist Francis Fukuyama has observed that the nations best weathering the coronavirus pandemic are those like Singapore and Germany, where there is broad trust in government — and where the state merits that confidence. A critical part of America’s post-crisis rebuilding project is to restore the effectiveness of the government and to rebuild public confidence in it.
A major investment in public health would be a fitting place to start.
The larger project, however, is to increase the resilience of American society. Generations of federal policymakers have prioritized the pursuit of economic growth with scant regard for stability or distribution. This moment demands a restoration of the national commitment to a richer conception of freedom: economic security and equality of opportunity. That’s why Times Opinion is publishing this project across the next two months, to envision how to turn the America we have into the America we need.
The purpose of the federal government, Lincoln wrote to Congress on July 4, 1861, was “to elevate the condition of men, to lift artificial burdens from all shoulders, and to give everyone an unfettered start and a fair chance in the race of life.” The Homestead Act in particular was a concrete step in that direction: 10 percent of all the land in the United States was ultimately distributed in 160-acre chunks. But Lincoln’s conception of “everyone” did not include everyone: The Homestead Act rested on the expropriation of Native American lands.
Roosevelt shared Lincoln’s vision of government, but industry had replaced agriculture as the wellspring of prosperity, so he focused on ensuring a more equitable distribution of the nation’s manufacturing output — although African-Americans were treated as second-class citizens in many New Deal programs.
The United States today is in need of new measures to stake all Americans in the modern economy.
To give Americans a fair chance in the race of life, the government must begin from birth. The United States must reclaim the core truth of the Supreme Court’s seminal decision in Brown v. Board of Education: So long as Americans are segregated, their opportunities can never be equal. One of the most important steps the United States can take to ensure all children have the opportunity to thrive is to bulldoze enduring patterns of racial and economic segregation. Zoning laws that limit residential development in the very areas where good jobs are most abundant are one of the most important structural obstacles to a more integrated nation.
Over the course of this project, we will examine other ways to equalize opportunity early in life, and also to restore a healthier balance of power between employers and workers.
One of the clearest lessons of the pandemic is that many employers feel shockingly little obligation to protect the health and welfare of their workers, and workers have been left with little means to organize or resist. Amazon, one of the nation’s largest employers, fired a worker protesting safety conditions at the company’s warehouses on the Orwellian grounds that his protest was itself a safety hazard. A manager at a Uline call center instructed employees not to tell colleagues if they weren’t feeling well because it might cause “unnecessary panic.”
And the nation’s tattered social safety net is in desperate need of reinforcement. Americans need reliable access to health care. Americans need affordable options for child care and for the care of older members of their families, a growing crisis in an aging nation. No one, and especially not children, should ever go hungry. Everyone deserves a place to call home.
Just a little more than a decade ago, Americans lived through a very different kind of crisis — a financial collapse — that exposed similar fragilities in American society. The government’s response was inadequate. The recovery was still underway when the coronavirus arrived, and partly because recovery had come so slowly, America’s political leaders had failed to take advantage of the intervening years to prepare for the inevitability of fresh tests.
The nation cannot afford a repeat performance, particularly as other challenges to our society already loom, most of all the imperative to slow global warming.
The United States has a chance to emerge from this latest crisis as a stronger nation, more just, more free and more resilient. We must seize the opportunity.
https://www.nytimes.com/2020/04/09/opinion/coronavirus-inequality-america.html?action=click&module=Opinion&pgtype=Homepage

The U.S. Approach to Public Health: Neglect, Panic, Repeat

Time to give new life to an old idea: A strong public health system is the best guarantor of good health.
by Jeneen Interlandi - NYT - April 9, 2020

A once-in-a-century public health crisis is unfolding, and the richest country in the world is struggling to mount an effective response. Hospitals don’t have enough gowns or masks to protect doctors and nurses, nor enough intensive care beds to treat the surge of patients. Laboratories don’t have the equipment to diagnose cases quickly or in bulk, and state and local health departments across the country don’t have the manpower to track the disease’s spread. Perhaps worst of all, urgent messages about the importance of social distancing and the need for temporary shutdowns have been muddied by politics.
Nearly all of these problems might have been averted by a strong, national public health system, but in America, no such system exists.
It’s a state of affairs that belies the country’s long public health tradition. Before the turn of the previous century, when yellow fever, tuberculosis and other plagues ravaged the country’s largest cities at regular intervals, public health was generally accepted as a key component of the social contract. Even before scientists identified the microbes that cause such diseases, governments and individuals understood that a combination of leadership, planning and cooperation was needed to keep them at bay. Some of the nation’s oldest public health departments — in Boston, New York and Baltimore — were built on that premise.
By pushing infectious disease outbreaks to the margins, those health departments helped usher in what scientists refer to as the epidemiological transition: the remarkable leveling off of preventable deaths among children and working-age adults. That leveling off continued in the second half of the 20th century, as new federal laws ensured the protection of food, air and water from contamination, and national campaigns brought the scourges of nicotine addiction and sexually transmitted infections under control.
So great was the effect of these public health measures that by the time the century turned again, life expectancy in the United States had risen sharply, from less than 50 years to nearly 80. “Public health is the best bang for our collective buck,” Tom Frieden, a former director of the Centers for Disease Control and Prevention, told me. “It has consistently saved the most lives for the least amount of money.”
One would never guess as much today. Across the same century that saw so many public health victories, public health itself fell victim to larger forces.
“It was like a great forgetting took place,” Wendy Parmet, a public health law scholar at Northeastern University, told me. “As the memory of epidemics faded, individual rights became much more important than collective responsibility.” And as medicine grew more sophisticated, health began to be seen as purely a personal matter.
Health care spending grew by 52 percent in the past decade, while the budgets of local health departments shrank by as much as 24 percent, according to a 2019 report from the public health nonprofit Trust for America’s Health, and the C.D.C.’s budget remained flat. Today, public health claims just 3 cents of every health dollar spent in the country.
The results of that imbalance were apparent long before Covid-19 began its march across the globe. Local health departments eliminated more than 50,000 jobs — epidemiologists, laboratory technicians, public information specialists — between 2008 and 2017. That’s nearly 23 percent of their total work force.
Crucial programs — including ones that provide vaccinations, test for sexually transmitted infections and monitor local food and water supplies — have been trimmed or eliminated. As a result, several old public health foes have returned: Measles and syphilis are both resurgent, as is nicotine consumption among teenagers and the contamination of food and water with bacteria and lead.
Each of these crises has received its own flurry of outrage, but none of them have been enough to break what experts say is the nation’s default public health strategy: neglect, panic, repeat.
“We ignore the public health sector unless there’s a major catastrophe,” said Scott Becker, the head of the Association for Public Health Laboratories. “Then we throw a pile of money at the problem. Then we rescind that money as soon as the crisis abates.”
There is a better way.
Imagine a public health system in which all public health entities used the same cutting edge technology in their laboratories and on their computers. This would include equipment that enables rapid diagnostic tests to be developed and deployed quickly in a crisis; web portals where data on disease spread, hospital capacity and high-risk communities can be logged and shared across the country; and user-friendly apps that enable private citizens to facilitate the efforts of epidemiologists.
The technology to create such a system already exists — it only has to be adapted and implemented.
That, of course, requires investment. In 2019, a consortium of public health organizations lobbied the federal government for $1 billion to help the nation’s public health system modernize its data infrastructure. They were granted $50 million. In the wake of Covid-19, that sum has been increased to $500 million. But much more is needed. There is a $5.4 billion gap between current public health spending and the cost of modernizing public health infrastructure, according to the Trust for America’s Health report.
However much money is ultimately allotted for this work, it will have to be deployed equitably, in high-income and low-income communities alike. Health departments everywhere are struggling to contain the Covid-19 pandemic, but that struggle is particularly acute in marginalized communities, where health is already fragile, public health departments are sometimes nonexistent and mistrust of officials tends to run high.
Early data from several states indicates that Hispanics and African-Americans already account for a disproportionately high number of coronavirus-related deaths, a finding that is both unsurprising and unacceptable. A better system would direct federal aid to where it’s needed most — and would work to eradicate legacies of injustice and abuse that mar the history of public health victories.
Of course, none of these changes will help if the underlying system is not grounded in and guided by rigorous, apolitical science. Public health agencies were created precisely because the decisions required to stop a pandemic in its tracks, or protect the nation’s food supply, or keep measles at bay were considered too difficult and too important to be swayed by politics.
The vision for public health reform is not especially complicated or expensive. But it is bold — and it will require boldness from every corner of the country.
Politicians will have to incorporate public health into their priorities; they might start by making “Public Health for All” as urgent a rallying cry as any concerning health insurance. Universal access to health care is a human right, but it will not protect us from the next pandemic — or clean water crisis, for that matter.
Captains of industry will have to commit acts of genuine altruism, because not all of the innovations needed to build a modern public health system will be clearly lucrative. If you’re making a fortune out of cornering the market on ventilators, for example, designing a cheaper, easier-to-make version of your product might sound like bad business. Likewise, developing vaccines and antibiotics may seem like a risky investment compared with the prospect of another million-dollar cancer drug. But when the next pandemic threat arrives, millions of lives — not to mention the entire global economy — may depend on exactly these things.
Mind-sets will have to change, too. A society that prizes individual liberty above all else is bound to treat health as a private matter. But if Covid-19 has taught us anything, it’s that our health and safety depend on collective action. That’s what public health is all about.
https://www.nytimes.com/2020/04/09/opinion/coronavirus-public-health-system-us.html?action=click&module=Top%20Stories&pgtype=Homepage
Medicare for Each of Us in the Age of the Coronavirus
The U.S. public—and increasingly the business community—are becoming acutely aware of the rising costs and inadequacies of our current for-profit system, particularly as the current epidemic unfolds. There is no other choice but Medicare for All.

by Peter Arno and Philip Caper - Common Dreams - April 3, 2020

Over the past two weeks, the explosive growth of the coronavirus pandemic has forced nearly 10 million Americans to file for unemployment benefits. Along with their jobs, many have lost their health insurance, if they had any to begin with. Aside from possibly spelling disaster for these newly unemployed workers and their families, this situation puts both the public health and economic wellbeing of our country at great risk. A clearer rationale for universal, affordable, lifetime health coverage as exemplified under a Medicare For All framework would be hard to find.
In this article we outline the need for a universal health plan, its historical context, and the obstacles raised by the medical-industrial complex that must be overcome.
There is a large elephant in the room in the national discussion of Medicare for All: the transformation of the US health care system’s core mission from the prevention, diagnosis, and treatment of illness—and the promotion of healing—to an approach dominated by large, publicly traded corporate entities dedicated to growing profitability and share price, that is, the business of medicine.
The problem is not that these corporate entities are doing something they shouldn’t. They are simply doing too much of what they were created to do—generate wealth for their owners. Unlike any other wealthy country, we let them do it. The dilemma of the US health care system is due not to a failure of capitalism or corporatism per se, but a failure to implement a public policy that adequately constrains their excesses.
"How is it that we spend more on health care than any other nation, yet have arrived at such a sorry state of affairs?"
Since the late 1970s, US public policy regarding health care has trended toward an increasing dependence on for-pofit corporations and their accompanying reliance on the tools of the marketplace—such as competition, consolidation, marketing, and consumer choice—to expand access and assure quality in the provision of medical care.
This commercialized, commodified, and corporatized model is driving the US public’s demand for fundamental reform and has elevated the issue of health care to the top of the political agenda in the current presidential election campaign.
Costs have risen relentlessly, and the quality of and access to care for many Americans has deteriorated. The cultural changes accompanying these trends have affected every segment of the US health care system, including those that remain nominally not-for-profit. Excessive focus on health care as a business has had a destructive effect on both patients and caregivers, leading to increasing difficulties for many patients in accessing care and to anger, frustration, and burnout for many caregivers, especially those attempting to provide critical primary care.
As a result, the ranks of primary care providers have eroded, and that erosion continues. One of the major reasons for burnout in this group is the clash between its members’ professional ethics (put the patient first and “first do no harm”) and the profit-oriented demands of their corporate employers. Applying Band-Aids can’t cure the underlying causes of disease in medicine or public policy. Ignoring the underlying pathology in public policy, as in clinical medicine, is destined to fail.
Many of the symptoms of our dysfunctional health care system are not in dispute:
We must therefore ask: How is it that we spend more on health care than any other nation, yet have arrived at such a sorry state of affairs?
"The theology of the market and the strongly held—but mistaken—belief that the problems of US health care can be solved if only the market could be perfected have effectively obstructed the development of a rational, efficient, and humane national health care policy."The answer is that only in the United States has corporatism engulfed so much of medical care and come so close to dominating the doctor-patient relationship. Publicly traded, profit-driven entities—under constant pressure from Wall Street—control the financing and delivery of medical care in the US to an extent seen nowhere else in the world. For instance, seven investor-owned publicly traded health insurers now control almost a trillion dollars ($913 billion) of total national health care spending and cover half the US population. In 2019, their revenue increased by 31 percent, while their profits grew by 66 percent.
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The corporatization of medical care may be the single most distinguishing characteristic of the modern US health care system and the one that has had the most profound impact on it since the early 1980s. The theology of the market and the strongly held—but mistaken—belief that the problems of US health care can be solved if only the market could be perfected have effectively obstructed the development of a rational, efficient, and humane national health care policy.
There are three main reasons to pursue a public policy that embraces genuine health care reform:
  1. Saving lives: To simplify our complex and confusing health care system while providing universal affordable health care coverage;
  2. Affordability: To rein in the relentless rise in health care costs that are cannibalizing private and public budgets; and
  3. Improving quality: To eliminate profitability and share price as the dominant and all-consuming mission of the entities that provide health care services and products when that mission influences clinical decision making. Profitability should be the servant of any health care system’s mission, not its master as seems to be increasingly the case in the US.

What Is The Best Approach To Reform? 

It is not an exaggeration to say that no reform other than publicly financed, single-payer universal health care will solve the problems of our health care system. This is true whether we are talking about a public option, a Medicare option, Medicare buy-in, Medicare extra, or any other half-measure. The main reason is because of the savings that are inherent only in a truly universal single-payer plan. Specifically, the administrative and bureaucratic savings gained by eliminating private insurers are the largest potential source of savings in a universal single-payer framework, yet all the “option” reforms listed above leave largely intact the tangle of wasteful, inefficient, and costly private commercial health insurers. The second largest source of savings comes through reducing the cost of prescription drugs by using the negotiating leverage of the federal government to bring down prices, as is done in most other developed countries. The ability, will, and policy tools (such as global budgeting) to restrain these and other costs in a single-payer framework are the key to reining in the relentless rise in health care expenditures and providing universal coverage.
"The real struggle for a universal single-payer system in the US is not technical or economic but almost entirely political."The various “option” reform proposals will not simplify our confusing health care system nor will they lead to universal coverage. None have adequate means to restrain health care costs. So why go down this road? Is it too difficult for the US to guarantee everyone access to affordable care when every other developed country in the world has done so?
The stated reason put forth in favor of these mixed option approaches is that Americans want “choice.” But choice of what? We know with certainty from former insurance company executives such as Wendell Potter that the false “choice” meme polls well with the US public and was used to undermine the Clinton reform efforts more than 25 years ago. It is being widely used today to manipulate public opinion.
But choice in our current system is largely an illusion. In 2019, 67.8 million workers across the country separated from their job at some point during the year—either through layoffs, terminations, or switching jobs. This labor turnover data leaves little doubt that people with employer-sponsored insurance are losing their insurance constantly, as are their spouses and children. And even for those who stay at the same job, insurance coverage often changes. In 2019, more than half of all firms offering health benefits reported shopping for a new health plan and, among those, nearly 20 percent actually changed insurance carriers. Trading off choice of doctors or hospitals for choice of insurance companies is a bad bargain.
The other major objection to a universal single-payer program is cost. Yet, public financing for health care is not a matter of raising new money for health care but of reducing total health care outlays and distributing payments more equitably and efficiently. Nearly every credible study concludes that a single-payer universal framework, with all its increased benefits, would be less costly than the status quo, more effective in restraining future cost increases, and more popular with the public—as 50 years of experience with Medicare has demonstrated.
The status quo generates hundreds of billions of dollars in surplus and profits to private stakeholders, who need only spend a small portion (millions of dollars) to influence legislators, manipulate public opinion, distort the facts, and obfuscate the issues with multiple competing reform efforts.

Conclusion

The real struggle for a universal single-payer system in the US is not technical or economic but almost entirely political. Retaining the status quo (for example, the Affordable Care Act) is the least disruptive course for the existing medical-industrial complex, and therefore the politically easiest route. Unfortunately, the status quo is disruptive to the lives of most Americans and the least effective route in attacking the underlying pathology of the US health care system—corporatism run amok. Following that route will do little more than kick the can down the road, which will require repeatedly revisiting the deficiencies in our health care system outlined above until we get it right.
The US public and increasingly the business community are becoming acutely aware of the rising costs and inadequacies of our current system, particularly as the current epidemic unfolds. It is the growing social movement, which rejects the false and misleading narratives, that will lead us to a universal single-payer system—truly the most effective way to reform our health care system for the benefit of the American people.

Pharmaceutical Profits and Public Health Are Not Incompatible

We need the capital and creativity of the private sector to take on the coronavirus.

The rapid spread of the coronavirus has revived a decades-old debate over pharmaceutical policy, with both sides doubling down on long-held views. Advocates for broader drug access insist that pharmaceutical companies must not be allowed to reap large profits from Covid-19 vaccines and treatments. Free-market true believers — including officials in the Trump administration — argue that pharmaceutical businesses must be allowed to set prices beyond some patients’ reach.
This either-or choice was always a false framing. And as the Covid-19 crisis tragically illustrates, it’s a dangerous one too. Patient advocates need to acknowledge that pharmaceutical companies aren’t the enemy — the virus is. But it’s equally urgent for free-marketers to recognize that with government help, we can reward businesses for groundbreaking innovations without sacrificing poorer patients along the way.
The latest flare-up in this battle began even before the first recorded Covid-19 death in the United States. At a Feb. 26 hearing, Representative Jan Schakowsky, Democrat of Illinois, pressed Health and Human Services Secretary Alex Azar to pledge that any Covid-19 vaccine or treatment would “be affordable for anyone who needs it.” Mr. Azar refused, saying “we can’t control that price because we need the private sector to invest.”
Predictably, Mr. Azar’s statement set off fireworks on Capitol Hill. Congressional Democrats called on him to reverse his stance. Representative Schakowsky demanded that Mr. Azar “not allow any pharmaceutical manufacturer to set a price” for a Covid-19 vaccine that “would cause private insurers to raise premiums or further exacerbate the federal deficit.”
As the death toll from Covid-19 began to mount, the push to limit returns to pharmaceutical companies at the cutting edge of coronavirus research only intensified. Gilead Sciences, a California-based biotechnology company whose antiviral drug remdesivir has emerged as a potential Covid-19 treatment, soon became a target.
On March 23, the Food and Drug Administration granted Gilead’s request to designate remdesivir as an “orphan” drug. A drug qualifies as an orphan if it treats a disease affecting fewer than 200,000 people in the United States at the time of the application, even if the disease becomes more widespread. The number of Covid-19 diagnoses in the United States fell well below that threshold at the time Gilead applied and when the F.D.A. designated the drug an orphan.
An orphan designation would have kept generic remdesivir off the market until 2027 unless the F.D.A. determined that Gilead could not meet demand for the drug. But remdesivir is covered by Gilead patents that do not expire until at least 2035, so this benefit is largely duplicative of what Gilead already enjoys under patent law. More immediately, an orphan designation would have allowed Gilead to claim tax credits for 25 percent of clinical trial expenses — a benefit potentially in the range of $40 million.
Although $40 million is a drop in the bucket compared with Covid-19’s social costs, politicians balked. Senator Bernie Sanders called Gilead’s application for orphan status “truly outrageous” — a day before he voted for a stimulus package with more than $50 billion in grants and low-interest loans to airlines. The consumer-rights advocacy group Public Citizen and 50 other organizations denounced Gilead’s use of “a loophole in the law to profiteer off a deadly pandemic.” The backlash quickly led Gilead to withdraw its request.
Ours is not the only country where Covid-19 has unleashed efforts to stamp out pharmaceutical profits. Last month, the Geneva-based Doctors Without Borders broadly called for “no patents or profiteering on drugs, tests or vaccines” for Covid-19. That campaign followed efforts by Canada, Israel, Germany and 33 members of the European Parliament to limit or override patents for drugs directed at the virus.
These drives to scale back patent protection for Covid-19 vaccines and treatments are motivated by a noble objective: to ensure that lifesaving drugs will be broadly affordable. But the unintended consequences are worrisome. The smaller the rewards for coronavirus drugs, the less that pharmaceutical businesses are likely to invest in research and development. Not only will that extend the current crisis, but it also will deter drugmakers from pursuing research directed at potential future pandemic-causing virus strains.
This doesn’t mean that governments must make a choice between ensuring patient access and encouraging drug development. With creative policymaking and political will, we can — and ought to have — both.
Governments can offer strong incentives to drugmakers while ensuring affordability by committing to patent buyouts for effective treatments. In a buyout, the government purchases the patents on a new drug — typically at a price that matches or exceeds what the patent holder otherwise would have earned — and then allows makers of generics to produce and sell low-cost versions. If, for example, clinical trials establish the efficacy of remdesivir in treating Covid-19, then the federal government should buy the U.S. rights to the drug from Gilead and give generic manufacturers free rein to ramp up production.
How much should the government pay? If remdesivir saves 10,000 American lives, then its value to our society — using traditional tools of cost-benefit analysis — would be as much as $100 billion. For a fraction of that sum, H.H.S. could buy the drug rights from Gilead and still leave the company with an eye-popping profit. Unfortunately, the $2 trillion Covid-19 stimulus package passed last month included only $11 billion that H.H.S. can use for patent buyouts, and the department will most likely need to draw down some of those funds for other purposes, like procuring diagnostic tests and purchasing other medical equipment. Mr. Azar’s department needs more money for patent buyouts.
Another time-tested tool for rewarding innovation while ensuring widespread access to new technologies is a “challenge prize.” We have proposed a prize for an effective coronavirus vaccine of $500 per vaccinated person, with the federal government footing the full bill. That almost certainly would make a Covid-19 vaccine profitable — potentially one of the most profitable drugs in history.
Patent buyouts and challenge prizes would of course add to the federal deficit — something that Representative Schakowsky, for one, said she was unwilling to do if it meant drugmakers would profit. But with Covid-19 already shutting down the economy and stealing thousands of lives, cutting costs on drugs directed at the disease is the very definition of penny-wise and pound-foolish. Worse yet, if we refuse to offer generous rewards for vaccines and treatments this time, we will find fewer pharmaceutical companies willing to invest in vaccines and treatments that address threats likely to emerge or return, such as the Zika virus, Dengue fever and new types of influenza.
None of this is to suggest that the only way to spur innovation is to dangle large payouts in the faces of pharmaceutical businesses. Reputational incentives and altruistic inclinations will lead some companies to pursue Covid-19 cures. Scientists employed by government agencies and academic institutions will make major breakthroughs too.
But to contain Covid-19 now and sustain a pipeline of drugs directed at other infections with pandemic potential, we will almost certainly need to enlist the capital and creativity of the private sector. We don’t need to compromise patient access, but we will need to promise profits to businesses that develop effective vaccines and treatments. Among all the costs that we as a society will bear because of this virus and later ones, the payout to pharmaceutical companies will be a rounding error.
https://www.nytimes.com/2020/04/08/opinion/coronavirus-drug-company-profits.html


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