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Healthcare Policy Issue

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Life beyond the COVID-19 pandemic is taking shape. Businesses are adapting to virtual meetings and working from home. Kids are adapting to life away from their schools and friends. All are contemplating how sporting events, malls and restaurants will operate as the summer approaches. And everyone is hoping a vaccine or treatment can be developed to avert a second surge of coronavirus.

Looking ahead, the realities are these:

  • As of May 13, 2020, the global COVID-19 vaccine research and development landscape includes 113 vaccine candidates. Of those candidates, 78 are confirmed as active, of which 73 are currently at exploratory or preclinical stages and 5 are in late-stage development. According to a recent Nature article, the candidates in late-stage development are mRNA-1273 from Moderna, Ad5-nCoV from CanSino Biologicals, INO-4800 from Inovio, and LV-SMENP-DC and pathogen-specific aAPC from Shenzhen Geno-Immune Medical Institute. In all likelihood, a vaccine will not be ready until early next year. Until then, social distancing will be the norm.
  • Gilead’s Remdesivir, which received emergency approval by the FDA, is the only drug currently approved for treating COVID-19 infections.
  • In the first eight weeks the U.S. shut down, 33 million jobs were lost, $5.8 trillion was added to the federal deficit and consumer confidence was driven to its lowest level since 2014. Note: a fourth relief package rumored to be $2 trillion to 3 trillion is in the works, which would add to the nation’s debt.
  • Roughly 90 percent of the $2.684 trillion in federal relief grants and loans to businesses and households has been disbursed. The availability of funds for small businesses (through the Payroll Protection Program) and households has been short of demand.
  • Economic recovery will be slow and bumpy. The stock market, an important source of capital for healthcare companies and retirement funds for households, is volatile and down from record highs three months ago. The Dow dropped from a high of 29,348 on Feb. 19 to a March 16 low of 19,898 (down 32 percent) and closed at 23,833 last week ( down 18.8 percent). The S&P 500 dropped from its high of 3393 on Feb. 19 to a low of 2191 (down 35 percent) on March 23 closing at 2939 last week (down 13.4 percent). 
  • The projected death toll from the COVID-19 in the U.S. is now expected to top 147,000.

That’s the backdrop for our elections in just a few months. Voters will not only cast their ballot for President, but also 35 Senate seats, 435 House seats, 13 governors and legislators in 86 of the 99 state legislative bodies. As a result of coronavirus and its disruption of our national normalcy, the future of the U.S. healthcare system is certain to be on voters’ minds.

As Election Day approaches, media coverage and voter attention will widen from vaccines, drugs, social distancing and relief funds to flaws exposed in our response to the pandemic and our lack of preparedness. Topics of discussion will include the U.S.’s disproportionately low spending for preventive health and high spending for specialty care, the lack of integration between public health programs and local delivery systems, and the slow progression of clinical research for needed vaccines and drugs and patent protections that limit competition. Other issues that will be highlighted? The disadvantages that face the old, poor and persons of color in accessing care when needed; the willingness of suppliers to price gauge in a time of soaring demand; the impact of social isolation, layoffs and anxiety on our collective emotional health and wellbeing; and the distinctions between “not for profit” and “investor-owned” healthcare and many more.

I believe the politics of healthcare in the U.S. will be center stage as we pivot past coronavirus. The solutions to the system’s flaws and defining its future are not the exclusive domicile of either party nor any sector that considers itself the occupant of the moral high ground. Lest we forget:

  • The majority of Americans care about the healthcare system. It matters.
  • Many people don’t know how the healthcare system works or how much it costs. They only know what they personally experience in their households and families.
  • The majority are open to changes that make their lives better.
  • And the majority are worried about the coronavirus. They’re afraid.

That’s it. The coronavirus heavily impacted our economy and may alter our politics for years to come. Board oversight of the organizations and companies in our industry must recognize that the future of the system is unlikely a return to its past.

Editor’s Note: This content was originally published in The Keckley Report on May 4, 2020. It has since been edited and updated with new information. You can find the original post here.


Paul H. Keckley, PhD, is managing editor, The Keckley Report (pkeckley@paulkeckley.com).