Very excited to see the re-introduction today of the House Medicare-for-All bill by @RepJayapal and @RepDebDingell — with a majority of House Democrats signed on as co-sponsors.

Medicare for All remains the reform we need today, for multiple reasons:

washingtonpost.com/health/2021/03…
1. Medicare-for-All would rapidly achieve 100% population coverage, at a time when uninsurance rates are on the rise. Numerous studies have demonstrated that lack of health coverage is not only financially ruinous — it can be deadly. We need a reform that covers us *all*.
2. Equally important, this bill would eliminate all copays and deductibles. These payments cause kids with asthma to forgo their inhalers, and women with breast cancer to put off chemotherapy (really). A recent study found that they, too, are deadly. And they are unnecessary.
3. But to cover everyone, and expand coverage for everyone else, we also need savings. Medicare for All can deliver them. As the CBO recently found, reducing private insurers' wasteful bureaucracy via M4A would save $400 billion annually *alone*

healthaffairs.org/do/10.1377/hbl…
4. This bill, however, does more. By paying hospitals & other institutional providers lump sum global budgets (which could not be realized as profit), it would dramatically slash providers' administrative costs while reforming the provision of care away from profit-orientation.
5. And by separately financing healthcare capital expenditures, the bill would we have healthcare infrastructure (including reserve capacity in times of pandemics and other disasters) where communities *need it*, not merely where it is profitable.
Medicare for All cannot wait — and it's great to see this bill re-introduced in the floor.

Worth noting as well that @FrankPallone is also a co-sponsor on this bill — and has promised to hold hearings on the bill in the Energy and Commerce committee.

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More from @awgaffney

19 Mar
Some have posited that seroprevalence studies underestimate population immunity because antibody levels wane over time, and hence implied that this or that area may "already be at herd immunity."

New Wuhan study in the @TheLancet refutes that:
thelancet.com/journals/lance…
This population level seroprevalence study found that only ~7% of the population of Wuhan was seropositive in April, 2020. With repeat measurement up to 9 months later, 90%+ of these individuals were still seropositive.
US seroprevalence estimates from commercial labs summarized by the CDC below (albeit with more methodological issues) suggest that seroprevalence remains relatively low in most US states: in every state, it appears that a majority are still susceptible.

covid.cdc.gov/covid-data-tra… Image
Read 5 tweets
18 Mar
There’s one question that the new Lancet study on COVID reinfection, which is based on testing data from the entire nation of Denmark and that finds ~80% protection against infection (less among older folks) from prior infection, doesn’t answer ... thelancet.com/journals/lance…
Does prior infection also reduce severity of infection? They don’t present data on whether infections led to hospitalization. However, even had they, there were only 72 instances of reinfection (though data is from all of Denmark!), so may not have been very illuminating ...
However, knowing the answer to that question could shed some light on the question of whether SARS-CoV-2 is destined to become “just another” (i.e. low virulence) circulating coronavirus, or not. Of course, these data do not necessarily apply to immunity from vaccination ...
Read 5 tweets
28 Feb
This is a fascinating study in @bmj_latest

The trial enrolled people who had stopped, or were considering stopping, cholesterol-lowering "statin" medications because they felt they were causing muscle pain — an oft-discussed potential side effect.

bmj.com/content/372/bm…
The study randomized these individuals to a year of either placebo or statin every two months, in a double-blinded fashion.

In other words, you took a pill every day, but didn't know if it was placebo or statin, and every two months what you were taking could change.
The researchers found zero association between statin use and muscle pain — none. Participants reported similar amounts of muscle pain when they took statin or placebo. Another similar study showed something similar. Quite simply, it seems that statins may not cause muscle pain
Read 11 tweets
27 Feb
The most-contrary-to-human-nature COVID-19 distancing request (and one that, I sense, was far more widely ignored than others, like mask-wearing) was that people should not spend any time in the same room as loved ones or friends for over a year (unless you lived with them).
So much of our reopening debate has focused on commerce — things like bars & restaurants that while fun are not intrinsic to human nature itself — and almost none on the question of: “can I share a meal or spend some time indoors with a friend or family member”?
Governors emphasized that small-group indoor gatherings were the real problem as they re-opened socially unessential businesses despite growing data on the role of workplaces as sites of propagation.
Read 6 tweets
21 Feb
For-profit entities should not be involved in the delivery of healthcare.

Healthcare is simply too important to be left to profit-maximizing corporations that, far too often, put revenue generation above the prerogative of patient care.
Yet corporations increasingly own and operate our healthcare facilities — our hospitals, hospices, dialysis facilities, nursing homes, home health agencies, surgical facilities etc. are more and more owned and operated by investor-owned firms ...
... So how can we push for-profits out, given that so many patients now depend on these for-profit facilities ?
Read 4 tweets
18 Jan
You probably heard: "We don't know if COVID-19 vaccination protects against transmission."

It's an odd statement! Presumably what is meant is: "It almost certainly protects against transmission, but we don't know by exactly how much, and we do know it's less than 100%."
You might think, what's the difference? It's a big difference!

Would you say: "condoms don't protect against HIV"

If you actually meant: "condoms do protect against HIV, although they are not 100% effective."

Hopefully not! You'd confuse people.
We already know for sure COVID vaccination is not 100% effective against transmission because it's not 100% effective against symptomatic infection. Insofar as any of this debate is about 100% efficacy in preventing transmission it should end. There's zero uncertainty.
Read 8 tweets

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