The Healing American Healthcare Podcast
The Healing American Healthcare Podcast

Episode 15 · 1 year ago

The Patients of American Healthcare


John Dalton & Ed Eichhorn look at recent vaccine advancements, healthcare eligibility statistics and how the US healthcare system should be going about treating its patients. They also touch on weight gain during the pandemic and recent news within the pharmaceutical community in the most recent issue of The Three Minute Read™

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"The Discovery" 

by The Lemming Shepards 

Exzel Music Publishing ( 

Licensed under Creative Commons: By Attribution 3.0 

Welcome to this preminute podcast. I'm John Dolan, editor of the twice a monthly newsletter of the healing American healthcare coalition. Joining once again is at Ikorn, the coalitions cofounder and Co author of healing American healthcare. They plan to provide quality care to all while saving one trily in a year. By John Ed. Next have you back? Actually today we'll be discussing the third march issue, because so much happened this month. But together Ed and I have nearly a century of health care experience and we're still trying to figure it out. It's really complicated. You can find our background and contact conformation at the end of the podcast. We launched the three minute read last March to summarize some of the critical issues affecting busy clinicians and physicians as we all struggle through the Pandana, the art of the summies. In this third March issue look at Covid Nineteen, weight game, the value of pharmaceutical oversight, the impact of the American Rescue Plan Act on the number of uninsured Americans and an argument that the patient should be at the center of every healthcare decision. So let's dig into the latest news. Our first article is entitled stay at Home Orders Linked to weight gain. It was written by Jeff Minner, a contributing writer at medpage. Today on Mars twenty two, the study led by Gregory Marcus and D at the University of California San Francisco found that Americans gained weight at a rate of about one point five pounds per month after being told to stay at a public places. We want this note to quote. It is important to recognize the unintended health consequences shelter in place can have on a population level. During the initial surge of covid nineteen cases in the US, forty five different state governments issued various shelter in place orders in March and April. Two Thousand and twenty those were intended to slow the transmission of the disease. In the studying that the UCSF did, two hundred and sixty nine participants from thirty seven different states and DC reported a weight measurements from their fitbit or Il smart scale. So basically, these are folks who already were looking to stay fit. Nonetheless, they all gained weight to varying degrees during these study period Dr Marcus said the weight game problem may persist even if the shelter in place restrictions have been lifted. Our take on it. But in our last issue, where we come the world of beesity foundations report and we saw the connection between the increased risk of severe covid nineteen KS with death and Higher Body Weight. There was a study that we cited that found that obese people or twice as...

...likely to be hospitalized with Covid nineteen at six times more likely to die after develop the disease. When asked for comments about the study, here's what Dr Marcus had to say, and I'll quote. Our study wasn't equipped to determine the specific reasons why individuals experienced weight gain during shelter in place, but it's reasonable to assume much of it was related to lack of physical activity plus possibly more constant accessibility to food while working from home. So snacking on the job was also a contributory factor. And now all of us who sent children off the college are all too familiar with the so called Freshman fifteen weight game. However, the COVID nineteen weight game is much more dangerous, as we've learned from several studies. The second article we summarized was FDA panel says risk of fires or pain drug out weighs the benefits, and it was published in step written by Damian Guard on March twenty five. Are All aware of the need for non addictive alternatives to Opiois for pain management. But recently a panel of expert advisors to the FDA voted nineteen to one to reject FIS's application to approve to news of APP which is a non addictive injectable pain killer given every two months, and they concluded that it's risks. I doubt way. It's manifests to news and AB is an investigational monoculonal and body. It's a new class of medicine called nerve growth factor. Inheritors. There are roughly thirty one willion Americans who suffer from Osteoarthritis, at eleven million of them with moderate to severe Osteo authoritist. So that's the population of prisor was tardening because for many of these thing with severe osteoarthritist they've exhausted all manner of pain relief and pain management protocols. So they have proposed a post approval plan. was they wanted to get the drug that approved, and then they had a plan that they would use to many gate risk for patients with moder to severe osteoarthritis. The drugs developed to the osteoarthritis pain does have a link to some rare but serious cases of joint damage. In one of their studies at a high dose it's roughly one out of every hundred patients had deterioration of Lone in the joints, and that's certainly something that is an undesirable outcome. The FDA is unlikely to overrule its expert panel. I think we can all agree that the search for a safe, effective and non addictive alternative to opiois remains as a lucive as the holy grail. Some day soon. Let's hope sooner rather than later we'll find one. But apparently to news of AB does not feel that bill. The third article is summarized was, quote Fauchy asters. Zenega needs to straighten that vaccine data, who was written by Sarah Overmole in political on March twenty three and dealt with the ASTERS AENNICA Oxford vaccine. Just hours after after Zeneca announced...

...that its vaccine was seventy nine percent effective the National Institute of Allergy and Infectious Diseases, data safety and monitoring board, ds MV, express concern that astkxeneca had included quote outdated and information, and I aid directed. Dr Anthony Fauchy oversees the data safety and Monitoring Board that assesses trial results and ratifies the board's decisions, but he's not directly involved in his assessment. Here's what he had to say. He said that the PSNB felt that the data released quote might in fact be misleading a bit and wanted them Aster Seneca to straighten it out. The company agreed to set things right soon and later confirmed seventy six percent effectiveness. So seventy nine percent was a slight overstatement or both. Of these instances reinforced the need for is independent governmental oversight of the pharmaceutical industry. Unfortunately, that Fox can't be trusted to guard its chicken coop and self regulate. Fires his application for Proogle, a drug that was then deemed too risky, and after Zeneca's faulty claim of seven nine percent effect in this sports vaccine. Those kinds of things shouldn't happen. Some drug companies, and notably mark and severances, is actually withdrew drugs from trials when they find unacceptable risks that exceed the benefits. Others just can't be trusted. Unfortunately, drug makers cannot be trusted to play patient safety above profits. Next article is one of Ed's that it's going to talk about and in concluding comments before we move into the insurance information. No, I think it's just very interesting that we have to deal with the weight gain during the pandemic and and it's something that we all need to think about in that the number of people in the United States that are severely obese has grown and for overall health beyond the pandemic as a nation, we need to lose a little bit of weight and that will help to make all of us a little bit healthier as we move along, and I think we'll probably see more information about that as the pandemic hopefully winds down in the fall. Yeah, that's correct. Even prior to the pandemic, the US was one of the most obast nations in the world. That World Oll BC foundation report had the US at thirty six point two percent of adults over eighteen who are obese in two thousand and sixteen. So That's pre pandemic. I can't imagine what the numbers must look like them. MMM. Well, let's talk about the next article. This one is entire build. Biden extends health insurance market place through the summer and it's by Chelsea Seruso, and it was written out for US News and World Report and published on the twenty three March. She reported that the Biden administration has extended open enrollment through August fifteen for...

...the thirty six states that expanded Medicare eligibility. Ten years to go, or eleven years ago, when the affordable care act was passed. Originally, this deadline was extended to February fifteen and then extended once again to May fifteen, and now it's been extended to August fifteen, and the reason for that is people need to have the time to think about taking advantage of the savings that may be available to them under the American Rescue Plan Act, which include things like subsidized health insurance premiums for people with incomes under one hundred and fifty percent of the federal poverty level, also limiting healthcare premiums to eight and a half percent of income for people earned incomes up to four hundred percent of the federal poverty level. Let's just know what those levels are. The federal poverty level for a single earner is nineteen thousand, one hundred and forty dollars per year, and for a family it's thirty nine thousand three hundred dollars a year, and four hundred percent of the federal poverty level is fifty one thousand forty dollars a year for a single earner and one hundred four thousand eight hundred dollars for a family income. The White House also estimates that premiums will decrease by an average of fifty per months and one in four enrollees will be able to upgrade their plans to get better out of pocket costs at comparable or lower premiums as a result of the plan. The next article that I will cover is also about the plan and it is entitled will the American Rescue Plan reduced the number of uninsured Americans, and it's by Sarah Collins and Gabriella Alafia. The Commonwealth Fund published the Article On the twenty two of March. They point out in their article that the American Rescue Plan Act is the most extensive health insurance improvement since the affordable care act was passed eleven years ago. They cited the statistics of the uninsured in our country. They said there are approximately thirty million uninsured Americans today and they broke this number down and it's followed based on data from two thousand and nineteen. Fourteen point nine million Americans are eligible for subsidized plans or may have an offer of employer coverage. Of these, eleven point two million are eligible for subsidized coverage and three point six million had incomes that were too high to qualify for subsidies. Six point four million are eligible for Medicaid or the Children's health insurance program but are not enrolled. Another four point eight million have incomes below the poverty level and live in Medicaid non expansion states.

And your three point one million undocumented immigrants, and they do not qualify for coverage as a part of the plan. The authors pointed out that surveys report that affordability is the most frequent cited reason that eligible uninsured people do not roll in market places for and many of those who are eligible for subsidies or medicaid or not aware of their eligibility or they face confusing rules to get their coverage. The plan also provides temporary subsidies for people who lost their jobs and their coverage this year, with zero premium plans if they have filed for unemployment by the end of September. Of Two thousand and twenty one. The plan addresses the affordability issue for many Americans. However, the subsidies support is temporary and only available for the next two years. For this reason, the Congressional Budget Office projects the increased financial support of the plan and will result in reducing the number of uninsured by only two point five million because of its temporary nature. The authors recommend policy changes that the Congress and the Biden Administration could implement that could increase coverage. They believe that making the subsidy plans permanent would go a long way towards increasing participation. They also suggest that we should allow people with incomes below the poverty level to register if they live in a non expansion states. They also believe that we should fully fund advertising and outreach and support to help the uninsured and roll. When the plan was originally written, it had navigators in the plan. The navigator's job is to help people who want to register for Insurance to find the plan they are either eligible for or the best plan for them. They also encouraged enrollment by just simplifying the plan choices that people have. They recommend offering a public plan and allow people with employer provided coverage to choose the public plan instead of the employer plan if they would prefer that. And Urban Institute study reported that these policy changes could expand coverage to all Americans, but there would be an annual cost of a hundred and twenty two to a hundred sixty one billion dollars to provide this universe of coverage. There are two things that we think the Biden Administration needs to do. First, it should make the public aware of the subsidies and other programs that can provide them with coverage under the plan. Universal Coverage, however, could be provided by the plan we proposed in our book, called the Korn Hutchinson all care plan, without increasing government expense. Thank you. Add The American Rescue Plan Act certainly contains the biggest expansion of the affordable care act since it was... acted back in two thousand and ten. It's kind of a stealth way of getting more coverage to more people. The timing is interesting because the two years run out immediately after the two thousand and twenty two elections, so the next year's elections should be very interesting. Once people will get a benefit. They don't like having a benefit taken away, so it's going to make for a very interesting for the whole year in two thousand and twenty two, you think? That's why we think it's important for people to begin to consider plans like the one we offered in our book right, because the federal deficit, although people are willing to extend it over and over again, it's gotten extremely large, based on both the recent tax cut of two thousand and nineteen and all of the expenses that are really necessary to defeat the pandemic. So we're hoping that plans like ours that actually could provide universal coverage without increase in federal spending, and actually you might decrease federal spending a little bit on the Garner more support in a time like this. Right, offering a public option that forces the for profit Chers to compete on a more level playing field is it's probably still a long shot, that that's one way to get the job done. Agree by art will we summarize as one of the resonated with me and was written by carry on and pleets in modern healthcare as a commentary on Markswin Tewod, which happens to be in their last weekly issue. Than that, moving to or twice want. The issue was the title healthcare leaders can't go wrong if we keep the patient at the center of every decision. Carry on plice is the incoming chair of the emericant college of Healthcare exectors. She's also a full time day job, is as president of Tisher prominenting in northern California, one of the largest health systems in the country. Her commentary is it a reflection on integrating and most of these are quotes directly from her commentary. Quote the fundamental value that is one of our professions most essential attributes. One of the reasons why I chose to spend most of my career in healthcare. Noting that quote. It has been critical in our ability to navigate the covid nineteen pandemic. She calls her quote reaffirming our own commitment to professionals. Every this bleat to quotes the meeting that's everydy with advice you received from her mentor. She was told by him if you make every decision with the patient at the center of that decision, you'll never make a bad decision. So health care leaders should quote, work intentionally every day on maintaining ethical standards every decision, communication, huddle and personal interaction and quote. Quote. In the same way, high reliability organizations gold safety uddles, start each meeting with the amission moment and talk about the good catches all. It's not easy to take the road in all cases. Each and every day. What she recommends is quote,...

...remaining centered on what is best for the patient and letting it guide our decisions and our relationships with our teams and communities. Is Our not star. We agree whole harder. Her sound advice really resonated with me. Fortune of this have served on several hospital boards, including one currently, where every meeting begins with the safety story and decisions are reaching the prison of what's the best for the patients that we serve and the community. Of rest surely stands in dramatic contrast to the response taken by the trump White House coronavirus response team. We actually did the article in the summary Prior to last Sunday. CNN documentary. Quote, Covid War, the pandemic. Doctors speak at Doctor Santage groups. that WHO's CNN. A chief medical expert conducted a wide ranging interview with the doctors who were reported the White House Coronavir virus responseing during trump administration. Some of the revelations were, at least to make shocking. DOCT Debra Burks, who we saw choked up one from talk about taking a droxy cord to beat the pandemic. She said that although the first hundred thousand deaths that America experienced were unavoidable, quote, the rest of them, in my mind, could have been mitigated or decreased substantially. Then she had a quote. The majority of people in the White House did not take this seriously. Dr Burchi aw the nation's coronavirus testing chief on the trump admitted quote. When we said there were millions of tests available, there weren't. There were components of the test available, but not the full deal. and quote. And then for a director the city see Dr Robert Redfield said that help. The Human Services Secretary, Alex as are personally tried to change scientific reports that the White House did hit mainly the seed. You see longstanding of well trusted mortality and morbidity report this issue weekly. Of course, former secretary as are denies Dr Redfields for seertion. So whatever, the ultimate truth is clear that the trump administration's failure to take the pandemics seriously resulted in well over a hundred thousand avoidable American deaths. I had and I have been tracking the ONLYC means fatality rates since last April, the first full month of the pandemic under the Wahl Declaration, as a March during first here's where Americas stand. If US had really matched the OECD's average fatality rate per a hundred thousand, one hundred nineteen point three, one hundred fifty seven thousand more of us would be alive today. That's the ONLYC, the average. If we have matched Germany's performance, two thousand and fifty thousand more of us would be alive today. If we had matched the five scandinating countries, including Sweden, who fumbled and bumbled at the start,...

...three hundred and thirty nine thousand more Americans would be alive today. At closer to home, if we had just really matched our neighbor to the north, Canada. Three hundred and fifty thousand more of US would be alive to day. Shame on the trump coronavirus response to thank you at any final comments. I think you made some very good points in that data. It's really important for us to keep this in mind and we grow complacent because we hear of a report of another thousand people today or another eight hundred people they who have passed away. But if we had done the things of mitigation that our CDC recommended, that other nations did, the results would be more palatable than they have been because of the lack of directions that Dr Sends You Group to report it on in the s CNN report that you reference. So I think we just need to keep our proverbial eye on the ball and keep moving forward in a way that protects more Americans and prevents more deaths as the vaccine rolls out and more and more people are in a position to resume their normal lives because they've gotten the vaccine that will protect them. So thanks for bringing that up. I think it was really important information. Thank you had we still have a survey out there that we love to have. You take the click on wwwal American healthcare dot Org and take that brief survey future podcast, but we need to share feedback with our listeners on the key issues. That include universal healthcare versus Medicare for all, the ICORN hunches and all pair plan prescriptions are pricessing and others. There are issues of particular interstant you would like to see US cover, feels free to contact us and if you'd like to be on our mailnness, just sex, FL healthcare to two, eight to eight to get started and until the next time, wash your hands, watch your distance and wear a mask. Thank you all, and on May. First make sure you go out there and get your vaccine.

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