At a Glance…

  • House passes the Build Back Better reconciliation bill
  • Cures 2.0 legislative text is released
  • Biden Administration expands COVID-19 vaccine production
  • And more…

House Democrats pass the Build Back Better Agenda

The House passed the almost $2 trillion Build Back Better (BBB) reconciliation bill, 将其提交给参议院,预计在可能获得通过之前,参议院将对其进行重大修改. 众议院通过的法案将为联邦托儿援助的历史上最大规模的扩张铺平道路, seeking to fund free, universal prekindergarten for all American children ages 3 and 4. Targeting health care, 该措施将提供新的医疗保险福利,包括听力服务,并首次授权政府公司协商一些处方药的价格, aiming to lower the costs that seniors pay for lifesaving medicines such as insulin. Specific policies in the bill include:

  • Guaranteed four weeks of paid family and medical leave to all workers to welcome a new child, recover from a serious illness, or care for a seriously ill family member. The United States is the only industrialized nation without a national standard of paid leave.
  • Capping out of pocket spending on medications, 包括医疗保险的老年人每年自掏腰包支付处方药的金额上限2000美元, which would affect an estimate 1 million older Americans.
  • Capping the price of insulin at $35 a month for all Americans.
  • New Medicare benefits for hearing services for seniors. Audiologists and other hearing specialists would qualify for Medicare reimbursement, and the program also would cover the cost of hearing aids for seniors.
  • Expanded Affordable Care Act insurance subsidies for lower and middle class patients.
  • 一项新计划将允许有医疗补助缺口的个人购买私人ACA健康计划,而无需每月缴纳保费, which could expand health insurance to 4 million currently uninsured people.
  • 为家庭和社区服务提供的联邦医疗补助配套资金增加6个百分点, that help seniors and people with disabilities with daily self-care and independent living needs.
  • 允许联邦医疗保险与制药公司就少数缺乏仿制药或生物仿制药竞争对手的高成本药物进行价格谈判.

The measure is now with the Senate, where negotiations remain ongoing. 参议员乔·曼钦(民主党- wv)和基尔斯滕·西内玛(民主党- az)一直反对法案中的主要条款, and have withheld their needed votes as the bill continues to be negotiated. Additionally, Democrats are relying on a process called budget reconciliation, which prevents Senate Republicans from filibustering the bill, 但需要权衡的是,有严格而复杂的预算要求,这将要求参议院议员在投票之前做出裁决. The Congressional Budget Office (CBO) has scored the legislation as costing $376 billion over the next ten years, without taking into account significant savings from new IRS enforcement.

Upton-DeGette release Cures 2.0 bill text

Representatives Diana DeGette (D-CO) and Fred Upton (R-MI) introduced their bipartisan Cures 2.0 legislation, which is designed to reimagine how the US conducts biomedical innovation. 这项立法的关键条款之一是授权卫生高级研究计划局(ARPA-H), which is designed to invest in high-risk, high-reward biomedical innovations that would otherwise be unlikely to be funded. 皇冠365app首页 has been in communication with Congress, NIH, 白宫也强调了ARPA-H的重要性,它的设计重点是公平和高效地提供服务,以减少而不是扩大健康差距. The former director of DARPA, Arati Prabhakar, argued that ARPA-H is an opportunity to consider the root causes of poor US health outcomes, including obesity and the opioid crisis. 她指出,仅仅关注ARPA-H的科学会限制他们的工作只关注投入而不是结果.

It is unclear when Cures 2.0 will be marked up or voted on by Congress, but expectations are that it could happen in the next calendar year.

CMMI refocuses on making payment models more streamlined and equitable

The Center for Medicare and Medicaid Innovation (CMMI) released a “strategy refresh” designed to inform how models are evaluated and crafted over the next decade. 一个关键的新目标是,判断一个模式是否成功,不仅要看它是否为医疗保险节省了成本, but whether it improves health equity. CMMI表示,这项新战略的目标是通过高质量实现公平的结果, affordable, person-centered care.

Biden nominates Robert Califf for head of the FDA

President Joe Biden nominated former Food and Drug Administration head Robert Califf to return to the agency as its commissioner, choosing a familiar name to lead the regulator after a drawn-out search. Dr. Califf served as FDA Commissioner for less than a year at the end of the Obama Administration. Janet Woodcock, a longtime top agency official, has served as acting commissioner during the search process, and was at one point considered a leading contender for the position. 但在阿片类药物过量成为全国性流行病之际,她监督FDA主要药物审查办公室的角色招致了立法者的批评, as did the agency's controversial approval of Biogen's Alzheimer's drug Aduhelm under her watch. Dr. Califf may not have a smooth Senate consideration as Democratic Senators 由于他与制药公司的关系,乔·曼钦和理查德·布卢门撒尔已经站出来反对他的提名.


The Biden Administration plans a major expansion of COVID-19 vaccine production


The Biden administration, under pressure to increase the supply of coronavirus vaccines to poor nations, plans to spend billions of dollars to expand manufacturing capacity, 目标是从2022年下半年开始每年至少增加10亿剂. The investment is part of a new plan, announced Wednesday by White House officials, 政府必须与产业界合作,解决美国和海外目前的疫苗需求,并为未来的大流行做好准备. 在此之前,辉瑞最近决定购买足够的新型Covid-19药片,用于大约1000万疗程的治疗, and to spend $3 billion on rapid over-the-counter tests, which are needed to detect the virus early enough for the Pfizer drug to work. The vaccination rate in low- and middle-income countries can be as low as single digits.

Partisanship becomes an increasingly important predictor of COVID-19 vaccination status

The KFF COVID-19 Vaccine Monitor and other surveys have consistently shown 党派认同与个人对COVID-19大流行的看法和体验之间存在密切关系, on questions ranging from worries about getting infected, to self-reported behaviors like mask-wearing and social distancing, to views on vaccinations. 这一新的分析表明,尽管COVID-19疫苗接种率随着时间的推移有所增加,大多数党派团体都报告接种了疫苗, 在未接种疫苗的人群中,共和党人所占比例越来越高,而政治党派比年龄等人口因素更能预测一个人是否接种了疫苗, race, level of education, or insurance status. 这些结果表明,要进一步提高美国人对疫苗的吸收,任何努力都面临巨大挑战.S. adults, 这也可能影响儿童接受加强注射和COVID-19疫苗的资格扩大.

What I’m reading

Frustratingly, some 30 percent of U.S. health  care workers employed at hospitals remained unvaccinated as of Sept. 15, 根据传染病控制和流行病学专业人士协会发布的疾病控制和预防中心数据分析. 医疗机构必须遵循即将出台的CMS规则,在1月4日前强制接种COVID-19疫苗,否则将面临失去医疗保险和医疗补助资金的风险. The rule does not have a testing exemption. Beyond the financial necessity of the CMS rule, 卫生保健工作者需要在他们的社区中成为领导者,认识到通过安全措施结束这场大流行的重要性, free, and effective vaccine choices.

患者获得所需医疗保健的一个太常见的挑战是,是否能够亲身获得它. Maliha et al wrote in Health Affairs about how transportation barriers to health care have been neglected and understudied. 据报道,服务不足的人群在10%到50%的情况下,交通运输是一个障碍. 这篇文章很好地提醒我们,我们需要采取多学科和全患者方法来减少健康的社会决定因素, like transportation access. 卫生保健部门应该运用更多的精力和创新来缩小交通运输的差距.

随着各州机构开始接受联邦政府超过920亿美元的支持,我们有一个独特的机会来做出有意义的改变,重新定义医疗保健服务. Cohen et al argued in Health Affairs 来自《365皇冠登陆app》和《皇冠365app首页》的联邦资金的涌入,提供了一个独特的时机,将其影响范围扩大到传统卫生系统之外,以解决卫生的驱动因素, such as affordable housing, access to healthy food, reliable transportation, job training, and childcare.

As we all work to tear down the structural racism and the barriers it has created, we can look to the American Psychological Association, which released 为美国心理学会和心理学家在创造和实施种族主义体系中所扮演的角色道歉. The APA said that it “failed in its role leading the discipline of psychology, was complicit in contributing to systemic inequities, and hurt many through racism, racial discrimination, and denigration of people of color, thereby falling short on its mission to benefit society and improve lives. APA is profoundly sorry, accepts responsibility for, and owns the actions and inactions of APA itself, the discipline of psychology, and individual psychologists who stood as leaders for the organization and field.” This resolution can be a blueprint for how we all think of our organizations and roles, and the fierce urgency of doing better.

From misinformation on vaccines to climate change to even the integrity of our elections, our country is facing a true crisis of trust and truth in our institutions and amongst ourselves. As an organization focused on creating evidence-based solutions for our health care system, we understand the dire health threat that lies and disinformation can cause. The Aspen Institute’s Commission on Information Disorder released a report that sought to create a framework of action with 15 recommendations for how government, private industry, and civil society can help to increase transparency and understanding, build trust, and reduce harms.

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