The Red Splish Splash
The Friday Pulse Check
Good morning and happy Friday. Welcome to the Friday Pulse Check. As promised on the FLATLINING Podcast this week, I will get to the election in a moment. But first…
In the news…
The IRA may raise Rx drugs for Medicare members
As Republicans continue to critique the Inflation Reduction Act (which mind you does not reduce inflation), the Congressional Budget Office (CBO) has pointed to a new, potential flaw in the law. Even though it is good for some seniors that out-of-pocket expenses are capped at $2000 per year for Part D coverage, the CBO and other private firms are projecting that premiums will rise 6% per year. Why? As two columnists in the Hill pointed out, it’s because the government is reducing its amount of coverage for catastrophic costs; it is being reduced from 80% to 20%. This leaves the rest of the bill with the private sector. Read more in the Hill.
Do immigrants subsidize healthcare for citizens?
An interesting study was published in JAMA this week that I will present without comment. The authors studied 210,669 respondents to the 2017 Medical Expenditure Panel Survey and Current Population Survey and looked at data from the American Community Survey from 2014 and 2018. Immigrants accounted for 14.1% of the respondents; of those 3.7% were documented non-citizens, 3.6% were undocumented immigrants, and the remainder were immigrants who are now citizens. The results of the study showed that, per capita, third-party payors paid less for immigrants than they did for US-born citizens. Read more in JAMA.
DeSantis picks Broward Health CEO
Ron DeSantis was one of the few Republicans who had a good night on Tuesday. More on that in a bit. Mr. DeSantis, however, also raised hospital eyebrows this week when he picked Broward Health CEO Shane Strum to join his transition team. Mr. Strum was Mr. DeSantis’ chief of staff during his first term before being named CEO of the public health system. In a press release, Governor DeSantis said, “We look forward to building upon our many successes of the first term and identifying a top-notch team to continue the fight for Florida families, businesses and freedom.”
Other articles:
Jump ship or fight misinformation? Physicians debate staying on Twitter - Becker’s Hospital Review
California Voters Ban Flavored Tobacco, and a Cigarette Maker Is Suing - US News
South Dakota Voters Approved Medicaid Expansion, but Implementation May Not Be Easy - Kaiser Health News
Our “not an election” episode
This week on the FLATLINING Podcast, since Ron and I did not know the results of Tuesday’s election when we recorded it, we obviously couldn’t comment on them.
Instead, we decided to cover some more lighthearted issues like daylight savings time, Christmas music, and cybersecurity, if you can call cybersecurity lighthearted.
Without a doubt, cybersecurity is something every modern business needs to be wary of and healthcare is no exception. Healthcare needs to be especially vigilant because the weak point can be employees and not the system itself (*ahem* Michigan Health).
With that in mind, how do we “solve” the cybersecurity problem? Well, Senator Mark Warner (D-VA), chairman of the Senate Intelligence Committee thinks we need a stockpile of devices so they can be replaced in the event of a cyber-attack quickly. But what devices is he referring to? Medical equipment is usually not the target, it’s electronic records systems.
We discussed that and whether or not daylight savings time and Christmas music can have a negative impact on your physical or mental health. If you need a break from election coverage this episode is for you.
I put this stock image (of what I am calling “Christmas guitar guy”) as the cover to help sell the fact it is not election-related.
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The Red Splish Splash
Republicans wanted a red wave; they had predicted a red wave. They didn’t get that.
Some called it a red trickle, others called it a red splatter. Al Kresta called it a red “splish splash” on his radio show Wednesday and I’m going to co-op that. A splish splash describes just how bad the night was for most Republicans. It wasn’t a tidal wave, it wasn’t a rain shower, it was what a bird does when it lands in the bird bath. Splish splash.
At the time of publication, I still do not know who will win the House or the Senate, so my ability to predict healthcare outcomes is a little bit hindered. I can, however, do a post-mortem on policy.
Earlier this year, after President Biden’s State of the Union Address and Governor Kim Reynolds (R-IA) response, I said that Republicans needed to have a marketable healthcare policy going into the midterms if they wanted to win.
President Biden spoke at length in his State of the Union Address about wanting to cap the price of insulin, reforming and expanding the Affordable Care Act, and allowing Medicare to negotiate drug prices. To give credit where credit is due, he got two of those three things done. In Washington, that is not a bad batting average. Democrats ran on those successes in the midterms.
Governor Reynolds spoke at length about COVID-19 policy and as I predicted at the time, that became the healthcare torch for Republicans.
Now, because I write this newsletter and produce our podcast, I would like to think that this is what caused Tuesday night to go the way it did, but I’m intelligent enough to say that these two things were true, true, and unrelated.
The real reason Republicans lost was because of Donald Trump. In every single one of the contested races where he handpicked the nominee, with maybe Ohio’s senate race as an exception, he lost.
Take Michigan for example. Mr. Trump didn’t like the two people who could win, quality guru Perry Johnson and former Detroit police chief James Craig. So Tudor Dixon’s campaign sued to kick them off the ballot; granted, they left themselves open to that by failing to do their signatures correctly. The chair of the Michigan Republican Party blamed the entire state’s losses on Ms. Dixon yesterday. She shot back saying the Michigan Republican Party never wanted her. She’s right; they knew she was not the best candidate, but she was the nominee because Trump wanted her.
In Michigan’s Attorney General race, the Republican nominee was not only someone who didn’t believe in the results of the last election, he somehow got his hands on a tabulator machine after the election was over and “performed ‘tests’” on it in a hotel room or an Airbnb. But, he was Trump’s guy because he agreed with him about the 2020 election.
Had Trump not played kingmaker, I do believe that voters would have cared about healthcare more than they did in this election. Despite the fact that most exit polls showed Americans were unhappy with President Biden’s leadership (likely because of inflation or crime or abortion or healthcare costs) they chose to reject Trump instead of Biden.
Had this been a normal midterm, real issues would have decided the election, including healthcare. As I mentioned above, the CBO and private firms are expecting premiums for Medicare Part D drugs to go up and we talked at length a few weeks ago on the podcast about why premiums are going to continue to go up over the next few years. Those really affect people because it is money they see leaving their wallets.
As we begin to roll into the 2024 election cycle, keep an eye out for who is saying what about healthcare. Regardless of who controls Congress by January, healthcare will continue to play a role in national elections. Democrats will continue to argue that more drug prices should be capped and that the Affordable Care Act should be expanded or even allow for Medicare buy-ins. Republicans on the other hand, I have no idea what they’re going to argue at this point.
Perhaps as the party (hopefully) gets away from Trump they can focus on real things that affect people, not past elections or COVID-19 policy. Clearly, that is not a winning issue.
I’m sure Americans, except for our friends down in Georgia, will enjoy the next few months without political ads. I certainly will enjoy not seeing ad after ad on abortion and if I have to hear Dave Scillian on WDIV tell me about absentee ballots one more time…
Ukraine
Believe it or not, other things happened in the world this week. Russia continues to launch airstrikes against Ukraine, knocking out power for thousands of homes, businesses, and hospitals. Ukrainian President Volodymyr Zelenskiy said that around 40% of the country's energy infrastructure has been seriously damaged. Fortunately, so far, Deputy Health Minister Bohdan Borukhovskiy has told Reuters officials had not recorded any deaths as a result of power cuts. Read more from FOX News.
Final thought
In an uplifting final thought today, there may actually be some science behind “dad brain.” This is the unscientific concept that men become stronger after a child is born. According to a study published in Cerebral Cortex this September, “first-time fathers show longitudinal gray matter cortical volume reduction.” As science and research continue to show the effects that parenthood has on both men and women, governments and companies may have to play catch up when it comes to paid maternity or paternity leave. Read more in InsideHook.
Have a good, political ad free weekend.
Matthew