While President Trump mulls whether to reopen the country again in May, and as Fox & Friends host Brian Kilmeade suggests that “only” 60,000 people will die from the coronavirus, there are some warning signs that the White House COVID-19 Task Force’s prediction of 100,000-240,000 deaths may be way too low.
That isn’t surprising, considering that Administration
officials said this projection depended on us doing everything right. Of
course, it appears that large sections of the country have done many things
wrong—whether it’s Florida Governor Ron DeSantis’ reluctance to close houses of
worship or the refusal of several state governors to issue stay at home orders.
That doesn’t include Trump’s own refusal to admit the seriousness of the
COVID-19 outbreak until mid-March and the continuing failure of the federal
government to ensure an adequate supply of test kits, PPE and ventilators.
So here’s what all of this may be leading up to: a minimum
of 600,000 COVID-related deaths in the U.S. over the next two years.
Live from the tradeshow floor of HIMSS, it’s Health in 2 Point 00! And no, I’m not fading away from coronavirus on this episode—but how many people could I have singlehandedly infected had the conference gone forward? On Episode 111, Jess and I have some fun with virtual backgrounds and talk about all of the things we’re missing at HIMSS right now. From what Trump would’ve said had he gotten the opportunity to speak, to what conversation would’ve gone on about the new ONC rules, to the big funding announcement we missed, here’s everything that succumbed to #HIMSSpocalypse2020. —Matthew Holt
Today on Health in 2 Point 00, Jess is singing as we are finally back with a two-part episode to cover the deals over the past couple weeks! On part A of Episode 110, Jess and I begin with Trump as he is set to speak at HIMSS next week. K Health raises $48 million in its Series C round to focus development on AI-powered primary care. Accolade files for a $100 million IPO and the telehealth language service platform Cloudbreak Health raises $10 million. Finally, Q Bio raises $40 million in Series B funding aiming to open additional centers and enhance the digital health platform. -Matthew Holt
Today on Health in 2 Point 00, Jess and I are getting in the spirit of things with this week’s Democratic debate. In Episode 87, Jess asks me about Omada Health’s $73 million raise, bringing its total to $200 million, and about what happened with nursing home telehealth startup Call9 shutting down. We turn to politics with Trump telling HHS to have hospitals publish their price list—and it’s unclear that this is even going to make a difference—and to health care coverage in the Democratic debate. —Matthew Holt
Today the notion that health is a preferred state of being, rather than a set of disconnected functions or services, is increasingly being embraced. A recent JAMA article promoted a health measurement system called the “flourishing index” focused on 6 key domains: happiness and life satisfaction, physical and mental health, meaning and purpose, character and virtue, close social relationships, and financial and material security.
Gro Brundtland, former director-general of the World Health Organization, wrote
in the World Health Report 2000 that
“The objective of good health is twofold – goodness and fairness;
goodness being the best attainable average level; and fairness, the smallest
feasible differences among individuals and groups.”
the age of Trump, with forced separation of immigrant mothers and children,
criminalization of abortion, and purposeful obstruction of enhanced access to
health care for vulnerable populations, it becomes impossible to ignore a
significant modern-day truism. Health is profoundly political.
Health is a collection of resources unequally distributed in society. Health’s “social determinants” such as housing, income, and employment, are critical to the accomplishment of individual, family, and community well being and are themselves politically determined.
A Trump administration regulation issued just hours before the partial federal shutdown offers quiet hope for civility in government.
What happened, on its face, was simple: an update of the rules governing a particular Medicare program. In today’s dyspeptic political climate, however, what didn’t happen along the way was truly remarkable – and may even offer some lessons for surviving the roller-coaster year ahead.
A regulatory process directly connected to Obamacare and billions in federal spending played out with ideological rhetoric completely absent. And while there were fervid objections to the draft rule from those affected, the final version reflected something that used to be commonplace: compromise.
Think of it as Survivor being replaced by Mr. Smith Goes to Washington. Or, perhaps, a small opening in the wall of partisan conflict.
More on that in a moment. First, let’s briefly examine the specifics.
Often, a Congressional gridlock is essentially good. This is because the executive arm of government is forced to consider a bipartisan approach to issues if it’s to secure the approval of both Democrats and Republicans in Congress.
The outcome of the midterm elections indicates that the Republicans have managed to retain their control of the Senate, while Democrats have secured control of the House of Representatives.
Health a Central Issue During the Midterms
According to a survey by Health Research Incorporated, the three top issues of concern during the midterm elections were health, followed by Social Security and Medicare, with 59% of the respondents irrespective of age, race or geography citing health as the most significant.
Among Trump’s electoral promises was a complete repeal and replacement of Obamacare under the Affordable Care Act (ACA) with a policy that was apparently less expensive and more effective. On his first day of office, Trump signed an executive order instructing federal agencies “to take all reasonable measures that minimize the economic burden of the law, including actions to waive, defer, grant exemptions from, or delay the implementation of any provision or requirement of the Act.”
According to the Democrats, their success across the country in the midterm elections has largely been due to the party running on healthcare. Indeed, surveys such as the one conducted by Health Research Incorporated indicated that health was the number one concern for voters during the midterms. In the three states where Medicaid expansion was on the ballot, voters were in favor of it. We’ve been wondering about that, so we took a look at how Iowa voted.
It’s one thing for voters to support healthcare on its own. It’s another for an issue to outweigh all others. Did healthcare really beat every other concern a voter thinks about when picking a candidate during the midterms?
Congressional and Statewide Races
Democrats took 3 of the Iowa’s 4 seats, unseating 2 Republican incumbents. They had a sizeable majority of the votes cast, so things looked good for the Democrats. If the theory holds up, the focus the Democrats kept on healthcare throughout the race would pay off. And it would seem it worked, right?
There’s a big problem here. If Democrats had made gains in Iowa because of healthcare issues, we should expect them to have a pretty resounding victory in the gubernatorial race and in the statehouse.
In this start your weekend off right edition, Jessica DaMassa asks me about Andy Slavitt’s new Town Hall venture fund announced at HLTH, the ATHN buyout, Novartis paying Michael Cohen, Trump’s drug price speech & Lyra Health’s $45m raise….all in 2 minutes–Matthew Holt
Today Donald Trump pulled a big surprise. He changed the much criticized appointment for his new VA head from over-effusive physician Rear Adm. Ronny Jackson to well known lefty health blogger Matthew Holt. When asked why he wanted Holt to run the VA Trump said, “Look, I’m pretty smart and I’ve appointed now only the best people like John Bolton and Mike Pompeo to run our foreign policy. If I appoint someone else I like, how can I fire him quickly? That Holt guy seems to hate me, and he’s never stayed in one of my hotels, so he’s perfect for the VA–I hear that the accommodation is a bit rough, not exactly a ten.”
When THCB asked Holt why he agreed to take the job running the VA, he suggested that it had a lot to do with his English roots. “As most of my followers know I grew up in England and like the concept of everyone suffering together in a government funded and provided socialized National Health System. The VA and its fellow traveler the DOD is the only health system like that in America and it’s a brilliant place to start”. When asked about his likely future polices for the VA, Holt suggested that massive expansion was the key initiative. In a written statement, his VA spokesman noted “Given the utter lunacy of the Trump Administration and the crazy warmongers now running the show, the chances of total war versus North Korea and Iran are very high. So essentially everyone in the country will soon be called up to the military, which means that soon eventually everyone will be a Veteran. And if Trump loses in 2020, by 2021 we’ll be at war with the Russians so either way my theory pays off.”
Holt was on the Charlie Rose show last week when he told Rose about his philosophy for the future. “When everyone in the country is part of the VA, we can shut down that ineffective and expensive private health system, and instead everyone can get their care the way I think is best. And if they don’t like it Rasu Shrestha will send them their records using the Lighthouse Blue Button Carrier Pigeon system, and we’ll give them a row boat to head to Nepal or somewhere.
When TCHB reached him for comment, Cato health spokesman Michael Cannon said, “if you are going to expand this universal health care stuff, you might as well give it a real go. Lucky for me, I have bone spurs…”