“Doctors, nurses and caregivers at smaller and poorer hospitals and medical facilities across the country are still struggling to obtain the protective gear, personnel and resources they need to fight the coronavirus despite President Donald Trump’s repeated assertions that the problems are solved.
Health care workers at all types of facilities scrambled for scarce masks, gloves and other life-protecting gear at the beginning of the pandemic. The White House was letting states wage bidding wars against one another, rather than establish a central national manufacturing, supply and distribution chain.
But now, health care workers say a clear disparity has emerged and persisted. Larger and richer hospitals and practices outbid their smaller peers, sometimes for protective gear, sometimes to fill in staffing gaps. And some of those having the hardest time are precisely where the virus is spreading.”
“For the second time this summer, voters in a solidly Republican state have decided now is the moment to expand Medicaid coverage through the Affordable Care Act.
Missouri voters passed a ballot initiative to expand Medicaid during Tuesday’s primary elections; 53 percent of voters supported the measure and 47 percent opposed it. That vote comes about a month after Oklahoma voters also decided to expand Medicaid via ballot referendum by less than 1 percentage point.
Once the expansion takes effect in those two states next year, an estimated 340,000 people who currently have no affordable health insurance option will become eligible for Medicaid. That still leaves nearly 2 million people in 12 states nationwide who are stuck in the Medicaid expansion gap — ineligible for coverage because their state refuses to expand the program but with an income too low to qualify for tax credits to buy private insurance — but it is yet another step toward the universal Medicaid expansion Obamacare authors envisioned. In the last few years, voters in Idaho, Maine, Nebraska, and Utah have also approved Medicaid expansion via ballot initiative.”
“Poll after poll, most recently a Gallup poll from July 13, has found American men are more likely to not wear masks compared to women. Specifically, the survey found that 34 percent of men compared to 54 percent of women responded they “always” wore a mask when outside their home and that 20 percent of men said they “never” wore a mask outside their home (compared to just 8 percent of women).”
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“Glick and Reny echoed a sentiment that health experts I spoke to in July said: To get people to change behavior, masks have to become a socially accepted norm. Once people start accepting masks as normal behavior, like they do wearing seat belts and not smoking indoors, the number of people going against the norm decreases.
Getting to that tipping point is a lot easier said than done.”
“More than one-in-five Texans who are tested for coronavirus are positive, the worst statewide rate in the country. But the number of people getting tests has plummeted in the last two weeks, which could understate how widespread the virus really is as schools reopen and hospitalizations and deaths remain near record highs.”
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“Public health experts say a number of factors may have depressed demand for tests, including long wait times and changing rules for who is eligible and the effects of Tropical Storm Hanna, which battered the southern part of the state late last month and disrupted services near the border with Mexico.
But the biggest reason may be an apparent false sense of security. The drop off in testing coincides with a decline in infections after Abbott ordered people to wear masks, reimposed seating limits in restaurants and closed down bars again. That worries disease trackers who suspect any positive news will breed complacency and make people willing to ignore the possibility they could be infected without showing symptoms. Without widespread testing, new Covid spikes could pop up and go unnoticed.”
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“Texas’s drop in testing is part of a larger nationwide trend that’s seen the average number of coronavirus tests fall from more than 800,000 a day in late July to roughly 700,000 over the last week.”
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“But the testing problems aren’t all linked to Texans’ behavior. There also are questions about flaws in the state’s data collection that may have distorted who was sick and where. Texas at the end of July had 1 million completed tests whose results had not been assigned to a particular county. Officials are now sorting through the backlog, which could have had the effect of making the tested population appear smaller than it really was.”
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“Abbot said testing numbers should rebound in the coming days. There will be a surge in Houston, the governor said, where he aims to test an additional 50,000 people over a 10-day stretch.”
“A report from the National League of Cities in May revealed that the states weren’t very good at getting the money to local governments. Also, a new dataset collected by the Department of the Treasury Office of Inspector General that looks at how much the state and local governments have spent of their coronavirus relief bill funds as of June 30 shows that they have spent much less than you might think.
Some states have spent virtually none of the money allocated by Uncle Sam.
South Carolina, for example, has yet to use its $2 billion in relief. Michigan, which is asking for a bailout, spent only 3 percent of the more than $3 billion it received. New Jersey is also asking for a bailout, yet it has distributed a measly 2.1 percent of its federal funds so far.
The states demanding bailouts may likely argue that what they really need is more flexibility in order to be able to use federal funds to address their revenue shortfalls. As matters stand right now, states must use the bailout money on coronavirus-related expenditures. So, when those actual expenditures are lower than the allocated funds, they can’t spend them.
The flexibility argument doesn’t hold water, in my opinion. It’s one thing for state and local governments to ask the federal government for help to cover expenditures they couldn’t foresee, such as those related to the pandemic. But they shouldn’t be asking federal taxpayers to pay for their routine expenditures, especially when these governments have failed to plan appropriately for revenue shortfalls that inevitably occur, as they’re bound to encounter emergencies. Governments should prepare for them. They should cut spending and, if that’s not enough, they should turn to their own citizens for the funds needed to cover non-coronavirus expenditures. Those funds could be obtained through higher taxes or spending cuts elsewhere. Their routine spending should come from their taxes.
State and local governments are always eager to have the federal government solve their financial problems for them. But they will continue to have financial difficulties as long as Uncle Sam continues to cave. The first step toward having healthier and more responsible state and local governments would be no bailout.”
“Over the past two decades, US health care has come to rely heavily on international suppliers, especially in China, for thousands of essential products, from surgical gowns to syringes. In fact, as of 2019, the US was the largest importer of medical goods — including of personal protective products — in the world.
Over the past few months as the pandemic raged, most US hospitals and health systems have responded by turning to domestic suppliers. They are more reliable given the difficulties with transportation and trade, which have become worse since the pandemic began.
This trend is likely to continue, as hospitals and health care systems try to ensure that they have a steady supply of essential products.
But this new domestic strategy has a particular disadvantage: In general, it is much more expensive. And this puts hospitals — and, potentially, their patients — in greater financial jeopardy.”
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“In February, to ensure that the country had adequate domestic supply, the Chinese government took over the production and distribution of medical products. China was not the only country to do this, but because it is a leading global supplier of so many health care products — personal protective equipment (PPE) such as N95 masks, medical devices, antibiotics, and pharmaceutical ingredients, to name a few — the decision had major consequences. In 2019 alone, China supplied a quarter of the entire globe’s face masks.”
“One could make a libertarian case for government mask mandates during a pandemic, on the grounds that no one has an inherent right to cough deadly pathogens on another person. But that theoretical case has to be weighed against the reality of policing in America, where cops frequently resort to petty and overaggressive enforcement.”
“when people like Trump don’t wear masks and make wearing masks a political issue, their supporters are less likely to wear them. When the president says people wear masks as a way of showing their disapproval of him, “that’s a pretty clear signal, not just that he’s not modeling responsible behavior, but that he views it as a sign of disloyalty,” Wiley said. “That does definitely further politicize the decision to wear a mask or not.”
The effects of this politicization can be seen in recent polling on mask use. In a Pew poll conducted June 4 to 10, 76 percent of Democrats and Democratic-leaning voters said they wear a mask in stores all or most of the time. Just 53 percent of Republicans and Republican-leaning voters said the same.”