Former Biden Advisers Call for New Covid Strategy

“To state the obvious,” President Joe Biden said Thursday in a speech from the U.S. Capitol, “one year ago today, in this sacred place, democracy was attacked — simply attacked. The will of the people was under assault. The Constitution — our Constitution — faced the gravest of threats. … For the first time in our history, a president had not just lost an election, he tried to prevent the peaceful transfer of power as a violent mob breached the Capitol. But they failed. They failed. And on this day of remembrance, we must make sure that such an attack never, never happens again.”

To ensure that it doesn’t happen again, let’s remember that a healthy and vibrant democracy requires an informed citizenry. We at The Fiscal Times try to help achieve that goal in some small way by providing non-partisan information, under the belief that facts matter.

“At this moment,” Biden said today, “we must decide: What kind of nation are we going to be? Are we going to be a nation that accepts political violence as a norm? Are we going to be a nation where we allow partisan election officials to overturn the legally expressed will of the people? Are we going to be a nation that lives not by the light of the truth but in the shadow of lies? We cannot allow ourselves to be that kind of nation. The way forward is to recognize the truth and to live by it.”

On that dark day one year ago, we expressed the hope, naïve as it may have been, that the horrific events at the Capitol might force a reckoning — that they might demonstrate to those who embraced former President Trump’s Big Lie the perils of their propaganda. Sadly, that hasn’t happened. But the rest of us might want to remember the terrible shock of that day and commit again to taking whatever steps we can, large or small, to fighting misinformation and disinformation and protecting our democracy.

Now back to our regular programming.

Former Biden Advisers Call for New National Covid Strategy

Six public health experts who served on President Biden’s Transition Covid-19 Advisory Board are calling for the president to adopt a new strategy to deal with the pandemic.

In three opinion pieces published Thursday in the Journal of the American Medical Association, the former Biden advisers argue that “COVID-19 is here to stay” and that the administration should adjust its approach accordingly to avoid “a perpetual state of emergency.”

“Policy makers need to specify the goals and strategies for the ‘new normal’ of life with COVID-19 and communicate them clearly to the public,” three of the advisers — Drs. Ezekiel Emanuel, Michael Osterholm and Celine Gounder — write in one of the articles. They argue that, rather than aiming to eradicate Covid, the administration should treat the virus that causes the disease as one of a number of circulating respiratory viruses and try to help the American public adjust to the endemic threat posed by all of them.

“It is imperative for public health, economic, and social functioning that US leaders establish and communicate specific goals for COVID-19 management, benchmarks for the imposition or relaxation of public health restrictions, investments and reforms needed to prepare for future SARS-CoV-2 variants and other novel viruses, and clear strategies to accomplish all of this,” they write.

The authors argue that the nation’s public health infrastructure needs dramatic improvements, including better data collection, a stronger public health workforce and increased flexibility for medical professionals to practice across state lines. They also call for broader use of vaccine mandates and accelerated efforts to create a universal coronavirus vaccine along with a stronger emphasis on antiviral medicines.

And, they say, “testing, surveillance, masking, and ventilation all need significant improvement.”

Among their recommendations in those areas: Low-cost testing should be made available to everyone in the country; high-quality masks such as N95s should be encouraged, and provided for free or little cost, instead of cloth or surgical masks; and the country should establish an electronic vaccine certificate platform. “Relying on forgeable paper cards is unacceptable in the 21st century,” they write.

Why it matters: “The authors are all big names in American medicine,” The New York Times notes, adding that “several, including Dr. Luciana Borio, a former acting chief scientist at the Food and Drug Administration and Dr. David Michaels, a former head of the Occupational Safety and Health Administration, have held high-ranking government positions. The driving force behind the articles is Dr. Ezekiel Emanuel, an oncologist, medical ethicist and University of Pennsylvania professor who advised former President Barack Obama.”

The Times’s Sheryl Gay Stolberg reports that many of the steps the authors recommend are already part of Biden’s plans, but the former administration advisers are also frustrated by aspects of the administration’s coronavirus response and feel that Biden officials haven’t always heard their ideas. “The most surprising thing about the articles is that they were written at all,” Stolberg writes, “and that the authors are airing their criticisms so publicly.”

Surprise Medical Billing Protections Take Effect, but Some Providers Want Changes

As of January 1, Americans have some federal protections against surprise medical bills — the often-substantial charges patients are stuck with when they unknowingly receive care from out-of-network health care providers. Such bills have been quite common, occurring in about 20% of all emergency room visits, but special interest groups managed to delay the imposition of legal restrictions for years.

Signed into law by then-President Donald Trump at the end of 2020 as part of the $2.3 trillion omnibus spending bill for 2021, the No Surprises Act requires health care providers to negotiate out-of-network fees with insurance companies rather than billing patients directly. The new rules apply to doctors, hospitals and air ambulances, but not to the more common automotive ambulances.

The law also provides a mechanism for determining prices for services if negotiations between providers and insurers are unsuccessful, with billing conflicts to be resolved through an arbitration process that uses median in-network rates as a basis for determining appropriate charges.

Some medical providers, however, are questioning the way the new rules are being implemented. While insurers seem happy with the arrangement, some hospitals and physicians want arbitrators to consider other factors in addition to median in-network rates when determining final payments.

A group of more than two dozen Republican senators sent a letter last week asking the Biden administration to adjust its implementation of the new rules to require arbitrators to also consider factors such as provider training and market share, patient condition and prior contracting history when determining final rates — a more complex analysis that they say reflects the intent of Congress.

The White House is not expected to alter its interpretation of the new rules in response to the GOP letter, but the courts may provide clarity as lawsuits over the arbitration process are resolved over the next few years.