"In early September, amid the delta variant surge, Biden reiterated the promise that “every American, no matter their income, can access free and convenient tests.”
Now, nearly a full year into Biden’s term, as the virus has mutated its way through the Greek alphabet to the omicron variant, testing is in short supply in many places, leaving frustrated Americans waiting in long lines for tests — if they can get them at all.
That is feeding into a wave of concern, despondency and in some places near-frenzy at the likely approach of yet another spike in a pandemic the country has battled for nearly two years. This late-December disarray — crowded testing sites, empty drugstore shelves — is raising fresh questions about how Biden and his team have executed on his pledge to defeat the pandemic.
'One can make a strong argument that we are at war, but for the White House to recommit to a wartime position, that’s really hard to do,'Kocher said. 'It’s going to end in people saying, ‘Why didn’t you win the war the first time?’ It’s hard to go back. But biology is hard.”
FROM:
The Washington Post
Inside the administration’s failure to avert a covid testing shortfall
December 23, 2021
***
“I came up with a vaccine,” Trump boasted in an interview released Wednesday to right-wing media personality Candace Owens. Despite Owens’s disagreement, Trump insisted that “if you take the vaccine, you’re protected” and “people aren’t dying when they take the vaccine.”
Trump has also been publicly encouraging people to get booster shots. He’s practically sounded like Anthony S. Fauci.
“Retcon” is short for “retroactive continuity,” in which existing stories are retroactively rewritten to accord with a new and contradictory story someone wants to tell. In an early famous case, Arthur Conan Doyle killed off Sherlock Holmes, then after fans demanded more stories, decided that Holmes had only faked his death. Retcons are particularly common in soap operas (Last season was all a dream!) and comics (That other stuff happened in a parallel universe!)."
The Washington Post
Opinion: How Republicans will retcon the past to try to reelect Trump
"Trump’s “Warp Speed” vaccine push is one of the most underrated achievements of his presidency, and it understandably galls Trump to be blamed for covid-19 deaths when, in fact, he could more justifiably be credited for saving millions of lives…
To his credit, Trump seems undeterred. He considers the vaccines his babies, he believes in their efficacy, and he wants more Americans to embrace them. As Biden pointed out, for once he and Trump are on the same page."
***
"Biology is hard" on ordinary people when the health care they can get is managed not for their outcomes but for the profits of a health care system designed to benefit a few wealthy investors:
"Abstract
The current economic crisis in Europe has challenged the basis of the economic model that currently prevails in much of the industrialised world. It has revealed a system that is managed not for the benefit of the people but rather for the corporations and the small elite who lead them, and which is clearly unsustainable in its present form. Yet, there is a hidden consequence of this system: an unfolding crisis in health care, driven by the greed of corporations whose profit-seeking model is also failing. Proponents of commodifying healthcare simultaneously argue that the cost of providing care for ageing populations is unaffordable while working to create demand for their health care products among those who are essentially healthy. Will healthcare be the next profit-fuelled investor bubble? In this paper, we call on health professionals to heed the warnings from the economic crisis and, rather than stand by while a crisis unfolds, act now to redirect increasingly market-oriented health systems to serve the common good."
Conclusions
European citizens today are like those who looked around them in Eastern Europe in 1989 and realised that the systems they inhabited were being run not for them but for a small elite. These systems were becoming increasingly dysfunctional and were failing to deliver on what they had promised. They had to change and they did. Today, it is equally clear that our systems have to change, but so far they have not.
One of the first things that new public health trainees are taught is the importance of looking upstream, to the fundamental determinants of health. To make a difference to population health it is necessary to tackle the causes of the causes.30 The policies of austerity being pursued in Europe today are already impacting adversely on health, with rising suicides and denial of necessary care.6 Yet, as is now increasingly clear, they are not even doing what they were designed to achieve in the economy, instead they are choking recovery. As this paper has shown, many of those who promoted the deregulation of financial markets are now turning to the social sector as the next big opportunity to turn a profit. Yet their actions will not help those who need care and will medicalise the problems, real and imagined, of those who do not need it. Inevitably, scarce resources that could be used to alleviate genuine suffering will be wasted."
More at the Journal of Public Health Research
The Crisis of Capitalism and the Marketisation of Health Care: the Implications for Public Health Professionals
"Introduced during the Trump administration, “direct contracting” is a Medicare payment model that allows private medical practices and insurance companies to arrange set payments from Medicare for the year, rather than bill the administration for services. But critics warn that the system, which has continued under the Biden administration, is being exploited by venture capitalists. Merrill Goozner is a reporter who has spent decades covering the slow-moving crisis of American health care, and he joins Ryan Grim to discuss the present and possible future of Medicare.
[Musical introduction.]
Ryan Grim: You may not have heard much about it, but in the Medicare system, there’s now something called direct contracting. It was started under Trump, and it has continued under Biden, and it allows private physician practices, hospitals, or insurance companies to contract directly with Medicare and get a set amount of money over the year. That contrasts with traditional Medicare, in which healthcare providers bill Medicare directly for services.
The stated point of direct contracting is to experiment with new models that would save money and improve care, but its critics warn that it’s a runaway scam that is being exploited by venture capital and private equity firms, and that it’ll lead to worse care in the long run, based on private equity’s poor record of delivering care in other settings.
The project in question was designed by Adam Boehler, who was previously a dorm mate of Jared Kushner’s, and also the founder of Landmark Health, a VC-backed healthcare company. He was brought in to run the Centers for Medicare and Medicaid Innovation (CMMI) under Trump, and as he was designing this new model, career staff became concerned about conflicts of interest.
When a calender alert went out to staff in May 2019 reading “discussion with Landmark on the direct contracting model,” career staff were appalled. I obtained a group text in which they commiserated with one another and expressed their disgust over the corporate influence. This is a family podcast, so I’ll edit the messages, but a sampling: “This stuff is so effing gross,” wrote one. “Ugh. What the eff,” replied another. A third sent a link to the Office of the Inspector General, suggesting somebody report it.
These were not off-the-wall concerns. The Office of the General Counsel for the Health and Human Services Department warned, in comments on a draft of the proposal that I obtained, that it appeared as if the new project was being set up to benefit specific companies: “We are concerned based on the regular references to organizations like Chen Med, Oak Street Health, and Verily in the comments and otherwise, that this model has been designed with specific private sector entities in mind. If accurate, this could create ethics concerns, as the creation of this model would give those entities a leg up in the market.”
And the model has indeed been extremely attractive to VC- and private equity-backed firms. It’s now being overseen by Liz Fowler, who serves as director of CMMI. She was previously the top healthcare aide to Max Baucus during the Obamacare fight, and if you remember, Baucus was the chair of the Senate Finance Committee, which wrote the meat of the bill. CMMI itself came out of the Affordable Care Act. Previously, Fowler had worked in the insurance industry, and between her time with Baucus and now, she was an executive at Johnson and Johnson.
This week, I published a story about the roots of the direct contracting program. Not long afterward, Fowler appeared at a conference by video in Washington and responded to the story. She appeared to be reading from a prepared statement.
Liz Fowler: I have [perceived or received] the concerns that have been raised, some legitimate and some overblown. But as a responsible steward of Medicare, we appreciate the input and we are continuously looking for improvement opportunities, including how the model can help achieve our goals for advancing health equity. So, I know that wasn’t part of the question, but since I had the opportunity and since this issue has been in the press, I wanted to take the chance to weigh in and give you my perspective.
RG: Now, claiming that your for-profit model is actually in the business of generating equity — and they don’t mean equity as in the stock market — is a rather old corporate trick. But what makes this story so interesting is that the principle behind this new Medicare effort is actually quite a good one."
MORE AT:
The Intercept
Deconstructed: A New Way to Think About Medicare
Ryan Grim
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