Recent months have cast a glaring spotlight on the most insidious fault line in our culture: racial inequity. country
It pervades every corner of society. But healthcare leaders are uniquely positioned to address this intractable problem in two important ways.
First, with health disparities. We are privileged to work in service to the most basic human desire: wellness over sickness; life over death. Any inequity is horrifying; but inequity in physical and mental health is tragic.
Second, as enterprise leaders, we have the power to drive meaningful and sustainable change. In many communities, we are the largest employers and carry enormous economic weight.
Health disparities are an appalling consequence of racial inequity. Providers must do a better job of reaching at-risk populations, developing effective intervention strategies, and making it easier to engage with our systems. We must collaborate with community partners on elder care, education, housing, food security and economic opportunity.
But we can’t close the disparities gap without fundamental change—not just change on the margins. It requires policy and public investment. We must break free of the trap of fee-for-service that disincentivizes access, early intervention, affordability and patient outcomes. The fact that hospital revenue is plummeting during COVID-19 illuminates the dysfunction of the economic paradigms around healthcare.
Reform is easier said than done. Healthcare is the hottest of hot-button issues and enflamed by special interests vested in the status quo. There is no uniform delivery model or data gathering across the country. COVID-19 revealed the flaws of this fractured health system. Past efforts at reform tried to accommodate everyone’s perspective, watering down the solutions. We need political willpower. We must dismiss the rhetoric and disinformation stifling an honest national discussion about how we spend 18% of our gross domestic product on healthcare, using an unsustainable model.
Political fortitude will only happen at the insistence of an informed and engaged public. We need a nonpartisan national commission to holistically reimagine healthcare. The commission should be made up of leaders from healthcare, business, social services and the federal government with one goal—creating national policies to improve health outcomes.
The commission should develop and coordinate initiatives designed to address the social determinants of health to target infant mortality, mental health, healthy aging, substance abuse and other chronic issues. It should emphasize the importance of public health, articulate a national target for healthcare expenditures, and outline the path to achieve that goal.
Closing the racial divide means we must also look inward. As leaders of large institutions, we have the ability to economically empower millions of people when we fully embrace diversity and inclusion at every level, including the C-suite, medical staffs and boards. We must do better to reflect the communities we serve. It requires creating a culture to drive this change and being fully committed instead of simply compliant.
Real change comes through systems that ensure pathways of upward mobility, including training, education, mentorship, and a road map to better and higher-paying positions.
Real change can only happen when we ensure that minority suppliers are considered—and all suppliers are committed to diversity and equity within their own operations.
Real change can only happen when we expand spending among all minority vendors, not just in construction and janitorial services, but in financial, banking, consulting and legal services.
Real change can only happen when we support community partners who are also working to bridge the equity divide. Our work must be deliberate, always asking how every investment of our time and money is helping to heal the community.
Healthcare can’t solve everything alone. But these inequities demand our attention. And if we can make progress, we will have helped reconcile our nation’s long and painful history of racial injustice. We know what ails us. We must find a way to act.
While the bill allows employers to continue offering high-quality, gold-level coverage or higher to their employees, employers could enroll their employees in Medicare for America and just pay the government what they would have remitted to an insurance company. universal
Or, employees could choose Medicare for America over coverage being offered by their employer, no questions asked. Their employer would continue contributing to the worker’s health coverage.
We have put a man on the moon, so surely we can figure out how employers can pay the government or an insurance company. Congressional employees have multiple options for insurance carriers and are proof that employers can do both.
During the pandemic, healthcare providers and workers have been unsung heroes providing care for Americans, and our healthcare system should recognize their worth and value. For many providers and workers, student loan debt imposes financial difficulties and barriers to their career goals, and since many healthcare workers are approaching much-deserved retirement, we need to expand the workforce.
To address these realities, Medicare for America creates a new student loan forgiveness program for healthcare workers like direct-care workers, mental health counselors, licensed marriage and family therapists, physician assistants, pharmacists, dentists, dental hygienists, doctors and nurses. The program will forgive 10% of student loan debt for each year the provider or institution the provider works for accepts the Medicare for America plan.
We must also address reimbursement rates, and Medicare for America’s rates will be based on current Medicare and Medicaid rates, while proactively increasing rates for primary care as well as mental and behavioral health and cognitive services. Furthermore, Medicare for America establishes an all-payer rate-setting system to end the wide variation in prices. Private insurers would be allowed to offer plans in compliance with the Medicare for America Act rules.
Democrats believe every single person in this country should have quality, affordable health coverage. We just have a few different ideas on how to get there. The same cannot be said about the Republicans, who are actively seeking to take away healthcare from millions by uprooting the Affordable Care Act, with nary an idea for a replacement. If we could do it all over again, we would not choose our current system, but we must work with the hand we have been dealt. That is why Medicare for America takes the existing and very imperfect framework and makes the progressive and necessary changes to achieve our desired end goal–universal, high-quality coverage.
We’ve seen a similar trend with the pharmaceutical industry, with drug manufacturing slowly moving out of the U.S. As of August 2019, only 28% of the manufacturing facilities making active pharmaceutical ingredients, or APIs, to supply the U.S. were in America. time
The remaining 72% were overseas, and 13% were in China, which has doubled its number of registered facilities making APIs between 2010 and 2019.
U.S. manufacturers are struggling to compete, and we’ve allowed it to happen. Instead of building our own supply chain of American-made PPE and pharmaceuticals, we turned a blind eye to the problem and accepted China’s dominance.
Not only did our reliance on China fail us during this pandemic, it has broader implications for our safety and economic success.
In July, Federal Emergency Management Agency Administrator Pete Gaynor called our reliance on overseas suppliers “a national security issue,” and testified to Congress that, “PPE and lifesaving equipment is just as important as building an aircraft carrier. We need to have that capacity here in the United States. We cannot rely on peer competitors to manage our destiny.”
He’s right. We can’t forget that relying on China for critical supplies means putting our health and security in the hands of a nation that wants to be the dominant world power. Their success depends on our failure. And since the Communist Party controls every company in China, every time we buy their supplies we are supporting a regime that is stealing our technology and intellectual property, building up their military to compete with us, abusing human rights, stripping Hong Kong residents of their freedoms and threatening Taiwan.
We have to stand up and say that we, as Americans and freedom-loving people, are better than this.
President Donald Trump did the right thing by enacting the Defense Production Act to compel U.S. companies to begin manufacturing PPE. But we have a long way to go.
We need to build up domestic manufacturing. As Florida’s governor, I focused on keeping taxes low for manufacturers and eliminated the sales tax on capital equipment. In the Senate, I’m working to pass a bill that will help build the national stockpile of goods from American-based producers and remove China from the U.S. supply chain.
All of us, whether in the healthcare industry or not, need to recognize the threat of China and start taking real steps to stop relying on our adversaries and focus on supplies and products “Made in America.”
The future of our nation and the health and safety of our people depend on our action.
Patients should control their records. It’s easy to change a credit card or phone number, but biometric indicators and identifying traits are permanent. intersection
To safeguard against identity theft, discrimination and preserve individual privacy, patient records must be secure. Security measures should not come at the detriment of usability. If a patient and their doctor have difficulty accessing electronic health records, the patient’s care will suffer.
This March, the Office of the National Coordinator for Health Information Technology released the final rule required by the Cures Act. This rule eliminates information-blocking and calls for developing standardized application programming interfaces that allow patients to seamlessly access their electronic health information. These APIs are required to adhere to the same security protocols that banking apps utilize.
In many ways, COVID-19 has exemplified why EHR interoperability and the modernization of our public health data infrastructure are essential. The flow of data between clinical care and public health systems often relies on dated technology, such as paper submissions and faxes, and individuals are stuck in the middle navigating paper, emails, phone calls and patient portals. Our antiquated processes slow the tracking of the invisible enemy we know face, COVID-19.
Digitizing information introduces unique vulnerabilities. Information may be stored in perpetuity and transferred virtually anywhere. As a result, nefarious actors work to uncover this information and use it against patients, doctors or healthcare organizations. In recent years, the market for stolen personal information has grown. This demand is exacerbated by COVID-19 and the lack of preparation for the flood of COVID-19-related cyberattacks.
While we cannot legislate away cybercriminals, we can reduce their ability to steal personal information by passing a federal privacy law and offering incentives for stronger cybersecurity. HIPAA governs healthcare information and must be applied in conjunction with a single national privacy standard.
Technological advances transcend sector-specific prescriptions to provide greater benefits for patients and providers. Now is the time to debate and enact privacy and security standards.
Negotiations for a federal privacy law are ongoing. Just like everything else, COVID-19 has slowed down these discussions. Congress must get back to the negotiating table to do the job for which we were elected. If healthcare professionals can go to work each day under difficult circumstances, Congress can come together to write the laws that protect them and their patients.
Under our legislation, the federal government would pay all costs of treatment for the uninsured, and cover all out-of-pocket charges—such as copayments and deductibles—for those who already have public or private health insurance. combat
By empowering Medicare to use its existing payment infrastructure to make healthcare free at the point of service, this could be done quickly, without saddling states or patients with more paperwork and bureaucracy.
Our bill covers prescription drugs as well. This summer, Gilead Sciences announced it would be charging hospitals around $3,000 for the coronavirus treatment remdesivir, even though it costs $10 to produce and was developed with $70 million in taxpayer-funded research.
Enough is enough. It’s time to make coronavirus-related treatments free of charge for everyone in America.
Under our legislation, the federal government would pay the same price the Veterans Affairs Department charges for prescriptions on behalf of the uninsured. That means no costs for patients, major savings for taxpayers, and an end to pharmaceutical corporations ripping off the American people in the middle of a crisis.
Providing healthcare for free to everyone who needs it during a public health emergency is not a radical idea. If every major country on the planet can guarantee healthcare to all, please do not tell me the U.S. cannot do the same.
If, in the midst of this unprecedented crisis, Congress is willing to pass a $740 billion military budget that is larger than that of the next 11 countries combined, we can surely afford to spend a fraction of that to care for our people.
We can no longer ignore the deep injustice that we faced long before this pandemic: We are the only major country in which healthcare is treated as an employee benefit, one that can disappear at any time if you lose your job.
No one who is diagnosed with cancer should have to beg for money from strangers on GoFundMe. No one with diabetes should die because they cannot afford their insulin. No one with coronavirus symptoms should be afraid to go to a doctor because of the cost, and risk infecting their family, friends and neighbors.
Let us use the immense challenge we face as an opportunity to build a just society, where healthcare is finally guaranteed to all as a human right.