1 in 8 Americans lives in a community that lost a local public health leader, our @AP @KHNews investigation found

Lawmakers in 24 states are crafting legislation to strip public health powers

This is U.S. pandemic public health #UnderfundedUnderThreat

apnews.com/article/pandem…
181 state and local public health leaders had resigned, retired or been fired since April.

It's the largest exodus of public health leaders in American history, @annabarryjester @hannah_recht @MRSmithAP and I found in our latest #UnderfundedUnderThreat investigation. 181 state and local public health department leaders have re
Many of the public health officials left due to political blowback or pandemic pressure.

Some departed to take higher profile positions, or due to health concerns.

Others were fired for poor performance.

Dozens retired.
Some have become the target of far-right activists, conservative groups and anti-vaccination extremists who have coalesced around common goals: fighting mask orders, quarantines and contact tracing with protests, threats and personal attacks.

In their own words:

“I received an envelope at my home. Typed. My name and my home address. And I opened it up and inside it is an 8.5-by-11 piece of paper that has a Nazi soldier wearing a Nazi swastika..."

apnews.com/article/public…
The backlash has moved beyond the angry fringe.

Lawmakers in at least 24 states have crafted legislation to weaken public health powers, which could make it more difficult for communities to respond to other health emergencies in the future. Lawmakers in at least 24 states have crafted bills that woul
A Supreme Court opinion last month:

"It is time — past time — to make plain that, while the pandemic poses many grave challenges, there is no world in which the Constitution tolerates color-coded executive edicts that reopen liquor stores and bike shops but shutter churches..."
Tisha Coleman, a public health administrator in rural Linn County, KS, has been pleading for a mask mandate.

People in town called her a sheep.

Commissioners said no, twice.

1 in 24 residents tested positive for #COVID19 .

Her mother died Sunday after time on a ventilator.
“We don't have a long line of people outside of the door who want those jobs,” said Dr. Gianfranco Pezzino, health officer in Shawnee County, KS.

“It's a huge loss that will be felt probably for generations to come.”

@AP @KHNews #UnderfundedUnderThreat

apnews.com/article/pandem…

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More from @LaurenWeberHP

1 Jul
The U.S. has starved state and local public health departments of funding for decades, leaving the country ill-equipped for #COVID19, our @KHNews @AP investigation found.

This is America's public health system in a pandemic.

#UnderfundedUnderThreat

khn.org/news/us-public…
Workers are paid so little, some qualify for Medicaid. They track the coronavirus on paper records shared via fax.

Working seven-day weeks for months on end, they fear pay freezes, public backlash and even losing their jobs amid a wave of budget cuts.
While interviewing 150+ public health experts, analyzing records from 100s of health departments and surveying statehouses, @laura_ungar @MRSmithAP @hannah_recht @annabarryjester and I heard story after story of what this weakened line of defense means amid #COVID19.
Read 12 tweets
30 Jun
🚨🚨🚨 Last year, @barbfederostrov and I spent months investigating Jorge Perez's rural hospital empire, which accounted for HALF of the 2019 rural hospital bankruptcies.

@TheJusticeDept just charged him in a $1.4 BILLION fraudulent billing scheme.

khn.org/news/hospital-…
How companies run by Perez and his associates were able to drive so many rural hospitals into the ground so quickly is a story about the fragility of health care in rural America and the types of money-making ventures that have flourished in America's fraught medical system
Perez and his associates would swoop in on struggling rural hospitals and then, prosecutors say, use them as a pass-through for a lab-billing scheme.

He said he was out to save rural hospitals; instead they allegedly brought in $400 million. 8 rural hospitals closed.
Read 9 tweets
12 Jun
🚨🚨🚨 Amid the pandemic, at least 27 state and local public health leaders have resigned, retired or been fired across 13 states, due in part to a mix of backlash and stressful, nonstop working conditions.

W/ @annabarryjester @MRSmithAP @AP @KHNews

khn.org/news/public-he…
Dr. Amy Acton, top health leader in Ohio, dealt with armed protesters at her house. She resigned yesterday. In California’s Orange County, the home address of health officer Dr. Nichole Quick, and her boyfriend’s name, were revealed in a public meeting. She resigned Monday.
I talked to Emily Brown, a member of @NACCHOalerts 's board and a rural health leader in rural Colorado. The day after a Facebook post criticized her and other officials’ weight and called for “armed citizens,” she was fired.
Read 6 tweets
21 Mar
NEW from me: I talked to rural hospital CEOs around the country, and the picture is dire.

Right when Americans most need them, droves of rural hospitals are weeks from closing their doors as the coronavirus prep saps their cash.

@NPR @KHNews

npr.org/sections/healt…
Nearly half of America's rural hospitals operate in the red on a normal day, much less during a global pandemic. The waves of canceled surgeries, labs and physical therapy means they may not have enough cash to make payroll in the coming weeks.
As one rural hospital CEO @RandyToblerMD looks at his older, sicker, underinsured patient population, he said he is afraid his MO hospital could last only until May. “In the truly safety-net areas, we’re being called to high duty,” he said. ”And we’re running on fumes.”
Read 6 tweets
6 Feb
Did you know your insurer can tell you something is covered, and then after you have surgery say they’re not going to pay for it?

And yes, it’s legal.

Welcome to American health care in 2020.

My latest @KHNews for @USATODAY : usatoday.com/story/news/hea…
This practice, which has left patients with thousands of dollars of bills, is called “retrospective denial.”

Essentially, insurers will give prior authorizations, a type of preapproval growing in number, for surgeries, medicines or tests.
You, the patient, think you’re covered.

But little do you realize those prior authorizations are not a guarantee.
Read 9 tweets
11 Sep 19
We need to talk about @AmbJohnBolton and Ebola.

In case you forgot, we're currently amidst the second-largest Ebola outbreak of all time. Over 2,000 dead so far. No sign of it stopping anytime soon.

The National Security Council had a head of global health security in 2018...
Until Bolton's NSC eliminated that office THE DAY AFTER the current Ebola outbreak was announced.

That followed the departure of White House homeland security adviser Tom Bossert -- another champion of investment in global health security -- THE DAY AFTER Bolton joined the WH.
As former Ebola czar @RonaldKlain told me at the time:

huffpost.com/entry/tim-ziem…
Read 6 tweets

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