“Medical professionals are typically licensed on a state-by-state basis, so a doctor licensed in one state can’t practice in another without receiving an additional license. The patchwork of licensing requirements across states is a major obstacle to the use of telemedicine because physicians are generally only permitted to provide telemedicine services to patients in states where they are licensed.
States are recognizing the cost of these onerous regulations in light of the current crisis. Over the past few weeks, governors and medical boards in every state except for Alaska, Arkansas, and Minnesota have temporarily suspended their licensing rules to allow out-of-state physicians to work in their state. Most of them have also waived restrictions on the use of telemedicine across state lines.”
“Some states are in greater need of physicians than others. On average, there are roughly 263 physicians per 100,000 people in the United States. But in Massachusetts, there are 449 physicians compared to just 191 in Mississippi. Moreover, the number of COVID-19 cases is expected to peak at different times in each state, so the peak demand for health care providers will vary. Allowing physicians to practice across state lines grants them flexibility to help where they are needed most.”
“Beyond the current crisis, telemedicine has the potential to connect patients with specialists across the country. Telemedicine may also reduce inefficiencies that result from schedule gaps, unexpected appointment cancellations, and the uneven geographic distribution of physicians.
A growing, aging population is expected to generate a national shortage of nearly 220,000 physicians by 2032. As with the current distribution of physicians, shortages will not be evenly distributed across states. Regional projections from the Department of Health and Human Services (HHS) indicate that the Southeast will have a shortage of approximately 13,860 primary care physicians as early as 2025, while the Northeast will have a surplus of around 810 physicians. Telemedicine offers a solution, but states will need to reform their licensing laws for the technology to reach its full potential.”
“America is suffering from a shortage of almost everything it needs to combat the spread of COVID-19. Hospital beds, ventilators, gloves, and gowns are all in short supply.
That’s particularly true of the N95 masks that help medical professionals avoid catching and spreading the virus as they tend to patients. The N95 designation refers to the ability of these masks to filter out 95 percent of airborne particles.
In early March, the U.S. Department of Health and Human Services (HHS) said that the country’s stockpile of N95 masks was enough to meet about 1 percent of the three billion masks we would need during a true pandemic.”
“government regulations are stifling the ability of manufacturers to set up new N95 mask production facilities—handicapping the private sector’s ability to respond to the current crisis.”
“The production of N95 masks is regulated by the CDC’s National Institute for Occupational Safety and Health (NIOSH). Prospective makers of N95 masks must submit detailed written applications to NOISH, and send finished products to its Personal Protective Technology Laboratory for testing. NIOSH staff must also personally inspect new manufacturing sites before they’re allowed to start pumping out masks.
Chisholm says regulators have told the Open PPE Project that getting agency approval could take anywhere from 45 to 90 days.”
“3M, one of the largest makers of N95 masks, says that it is producing 35 million respirators per month in the U.S. and that within 12 months it plans to double global production capacity to 2 billion masks a year. It also says it is exploring coalitions with other companies to expand mask production further.
Honeywell, another major mask manufacturer, claims it has more than doubled its mask production, according to The New York Times.
That’s a lot of masks, but nowhere near enough to meet the current demands of the country’s medical sector, let alone the demands of other essential workers and volunteers who are out in public right now, potentially dealing with sick people.”
“The single most important failure of the U.S. response to COVID-19, the disease caused by the novel coronavirus, has been the slow rollout of testing. This was an abject failure of bureaucracy. But it was also a failure of presidential leadership.
The countries that have had the most success in containing the outbreak, such as South Korea and Singapore, have done so through early, rapid, and widespread testing and contact tracing, followed by targeted quarantines. South Korea and the United States discovered initial cases of the coronavirus on the same day in January. Since then, some 290,000 people in South Korea have been tested and new daily cases have fallen from 909 to just 93. Despite a much larger population, the United States, tested just 60,000 people in the same period of time.”
“Much of the failure to make mass testing available lies with the Centers for Disease Control and Prevention (CDC) and the Food and Drug Administration (FDA). As a Wall Street Journal report makes clear, the CDC, which managed the development of the initial test kits, botched the job in just about every possible way: The CDC not only produced a faulty test that had to be retracted but adopted narrow testing criteria that meant many people with symptoms simply couldn’t be tested.
Perhaps most disastrously, as The Washington Post reports, federal health agencies initially declined to certify tests produced by private companies that were better suited for rapid mass testing anyway. This is despite the fact that experts, including the former head of the FDA, were publicly recommending that they do so as early as February 2.
The CDC was following its usual protocols, developing initial diagnostic tests on its own in order to maintain quality control, as it usually does. But that’s exactly the problem.”
“But this was also a failure of political leadership, most notably from President Donald Trump. For weeks, Trump and senior White House officials actively downplayed the threat of the virus.
As late as February 25, National Economic Council adviser Larry Kudlow was offering assurances that the coronavirus was “contained” and that it was “pretty close to airtight.” Trump treated the virus with similar breeziness, suggesting that the virus was “going to disappear” and that while it might get worse, “nobody really knows.””
“The problem here is obvious: Trump, who as the head of the executive branch oversees federal agencies such as the FDA, did not view the virus as a serious problem—and did not want others to view it that way either. That, in turn, translated into a downstream lack of urgency, which meant that critical aspects of the response were not prioritized. According to The Wall Street Journal, health officials who have examined the testing calamity have concluded that it was a result of both bureaucratic bumbling and a “broader failure of imagination,” in which Trump and other administration officials “appeared unable or unwilling to envision a crisis of the scale that has now emerged.”
The job of a president is to make decisions, set priorities, and convey clear information to both the public and the staff of the executive branch. This is especially important in a moment of crisis, when the executive is in charge of acting both quickly and with sound judgment. In this outbreak, Trump has failed on every count. Not only did he fail to see the threat even when it was apparent to experts, but he actively undermined preparedness by downplaying its significance far long after the problem was apparent, and by providing false and misleading information as the mitigation effort proceeded.”
“The federal health bureaucracy deserves much of the blame for America’s faltering response to the coronavirus outbreak. But the president has made the fiasco worse.
The bureaucracy reports up to an executive, who is tasked with setting priorities and ensuring performance—and for taking responsibility when there are failures. Instead, Trump has inaccurately blamed the Obama administration for failures that occurred on Trump’s watch. (Indeed, under Barack Obama, diagnostic tests for swine flu were designed and approved in less than two weeks.) Asked whether any of this is his fault, the president rejected the idea, saying, “I don’t take responsibility at all.” Trump’s refusal to admit failures makes it more likely that he will repeat them, and that more Americans will pay the price.”
“Over the years, the terms “free market” and “limited government,” like so many conservative principles, have devolved into little more than rhetorical tics, bits of sloganeering that bear no resemblance to actual conservative governance.
What conservatives seem to have decided is that regulations, restrictions, or limitations — anything that might upset or inconvenience the corporations generating greenhouse gases — are the bad kind of big government and a bad way of picking winners and losers. Government subsidies, tax credits, and grants — anything that might benefit big corporations — is the good kind of big government and a good way of picking winners and losers.”
“There are plenty of models that show we will need carbon capture (both industrial and natural) to supplement other efforts to reduce emissions. We probably can’t hit our mid-century targets without it.
But there is no model in the world showing emissions falling fast enough with nothing but carbon capture, with fossil fuels continuing their current headlong expansion.
The fossil fuels that remain behind after deep decarbonization, the ones that still need their emissions captured and buried, will be a small vestige of the current fossil fuel regime. That is what every credible model shows. That is the cold, hard truth at the heart of the climate dilemma: There is no avoiding the imperative to reduce fossil fuel combustion and the social and economic disruptions that come with it.
Current Republican efforts to feign climate policy conspicuously fail to grapple with that truth.”