Greetings from Portland
Friday Pulse Check
Good morning and greetings from Portland, Oregon where Ron and I have been spending most of the week at the ASCENT 2022 conference. It has been great to meet many of you and if this is your first edition of the Friday Pulse Check, welcome!
In the news:
The next phase of the human genome project
Scientists from across the United States are working with the National Institutes of Health to complete an entire mapping of the human brain that seeks to give us a better understanding of the complex organ. The new phase includes $2.4 billion in research funding from the NIH and will be looking at the brain’s different cell types and how they are related to one another. The project also seeks to find just how much memory the brain can hold. The scientists hail from institutions such as Duke University, the Broad Institute of MIT, Harvard, and others. Read more from STAT.
Private equity in the funeral industry
We’ve talked about private equity’s involvement in healthcare a number of times, both here on FLATLINING.net and on the FLATLINING Podcast. Kaiser Health News is reporting about how it is also making inroads into the funeral industry. What does that mean for the average person? While pricing data for funeral homes is not public, surveys have shown that when a publicly traded company or private equity buys a funeral home (or a slew of them), a price hike follows soon after. It doesn’t have to be that way, though. As we’ve mentioned on the podcast, it is possible that a new look at the industry could mean better and more affordable options. Read more in FORTUNE.
Humana interested in owning primary care
A few weeks ago, we discussed Amazon.com’s (AMZN 0.00) bid to buy OneMedical and get into the primary care game, though the Federal Trade Commission is looking into the deal. The Wall Street Journal reported this week that Humana (HUM 0.00) is in talks with primary care chain Cano Health (CANO 0.00) in a bid to purchase the company. Cano Health’s stock price rose forty percent following the WSJ story, adding nearly $5 billion to its value. Retail giant CVS (CVS 0.00) is also apparently interested. Cano Health has practices in California, Florida, Nevada, New Mexico, Texas, Illinois, New York, New Jersey, and Puerto Rico and serves mostly Medicare Advantage patients. Read more in the Wall Street Journal.
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Biden: The pandemic is over.
White House: Well, what he meant was…
President Biden’s 60 Minutes interview last Sunday has undoubtedly caused a number of headaches for White House communications officials this week. White House Press Secretary Karine Jean-Pierre went on friendly MSNBC to try and clean things up, leaving the communications chief for the National Security Council John Kirby to try and do damage control on FOX News. Even during the segment, Scott Pelley announced in his voiceover that the White House had already tried to clarify what the president was saying.
We discussed President Biden’s interview in length on the FLATLINING Podcast this week. We completely agree that the response to the virus that we saw in mid-2020 is over. Even here in progressive Portland, Oregon, mask-wearing is limited (though there has been much more mask-wearing than I have seen in a while) and no one has asked to see a vaccine card.
The president’s statements have political consequences. Republicans were quick to say they wouldn’t approve any more pandemic relief money because, in the president’s own words, the pandemic is over.
I have a feeling that the White House thought the 60 Minutes interview would be a good campaign boost for Democrats ahead of the midterms. After all, FiveThirtyEight is giving Democrats a 71% chance of keeping the Senate but only a 30% chance of keeping the House. Instead, it turned into a messaging kerfuffle that had to be cleared up ahead of the president’s speech at the United Nations in New York.
When the White House communications office has to clarify what seemed to be clear statements made by the president, it gives the appearance that the president and his staff (or advisors) aren’t on the same page. Now, I’m not going to lay the blame at anyone’s feet, but we are weeks away from a midterm election and voters must have a good understanding of the positions and proposals of the candidates before they get to the ballot box.
The Republicans released their new Commitment to America yesterday; a clear plan that they are showing to voters. “Vote for us, and here is what we’ll do.” A unified message like that is more palatable to undecided voters than a week of clarifications from a tv interview with the president.
Also on the podcast, we discussed some of the criminal trials for physicians involved in the opioid crisis. Many of them had already pleaded guilty to overprescribing the medication, but some have asked judges to change their plea to not-guilty because of a recent Supreme Court decision that raises the burden of proof for prosecutors.
The Ruan v. United States decision requires prosecutors to not only prove that doctors overprescribed the addictive pain medication but did so knowing it would harm the patient. It has been hit or miss for some physicians. One successfully changed his plea and will be going to trial, while another was denied a request to avoid prison and received a twenty-five-year sentence.
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War is obviously detrimental to physical health and physical ailments are contained to just soldiers in this conflict in Ukraine. I’ve shared many stories about the indiscriminate bombing of hospitals and medical clinics; these attacks are designed to directly impact the lives of Ukrainian civilians.
At the same time, much has been made about the mental health of Americans, in particular, American children in the wake of violence and rioting or school shootings. War, undoubtedly, has a greater impact on mental health.
As Kimberly Hook, Ph.D. and Jacki Hart, MD write in the Hill, Ukraine already had a mental health crisis that has been made worse by the Russian invasion. Prior to the start of the conflict, post-traumatic stress disorder was the second leading cause of disability and affected almost thirty percent of the population. They argue that combatting the mental health crisis in Ukraine, made worse by the war, must be a top priority when considering humanitarian aid. Read more in the Hill.
If the pandemic is over, what are we to make of vaccination requirements? It is a question we touched on briefly on the FLATLINING Podcast this week. Hospitals, for a long time, have required different vaccinations that are optional to the rest of the population; the influenza vaccine is a good example of this. Some hospitals appear to be taking different approaches. When the Food and Drug Administration approved the Novavax COVID-19 vaccine, which is protein-based and does not use mRNA technology, Froedtert Health in Milwaukee, Wisconsin updated its policy. It told its employees that previously had vaccine exemptions they needed to get a new exemption or get the Novavax jab if they wanted to remain employed at the hospital.
Froedtert Health told Becker’s Hosptial Review that less than one percent of its employees had a religious exemption to the vaccine. They also said that because Novavax doesn’t have the same connection to a fetal cell line that the Moderna, Pfizer, and Johnson and Johnson vaccines did, the religious and moral argument against the vaccines is moot. They said, “Since those staff are now eligible for a vaccination that does not conflict with their religious beliefs or medical situation, their exemption will expire” and that “Impacted staff were provided the opportunity to apply for an exemption after learning the previous exemption kept on file was no longer valid.”
St. Charles Health System out here in Bend, Oregon announced that unvaccinated employees with qualifying religious exemptions must wear N95 masks if they are rendering patient care. Those not rendering patient care must still wear a medical great mask.
Even as the president says “the pandemic is over,” the Centers for Medicare and Medicaid Services mandate remains in effect. That directive requires all healthcare facilities that render care to Medicare or Medicaid patients must have a vaccine requirement.
Will this ease away soon? No, probably not. Employers, particularly healthcare employers, are in their right to require vaccines for their employees. As the US toys with transferring to annual COVID-19 shots, similar to how the influenza vaccine is distributed, coronavirus vaccine mandates aren’t going anywhere in healthcare settings.
Have a good weekend,