2/ in this article, Joseph Kannarkat and I break down all the tools that the Biden administration and @SecBecerra have to address competition beyond antitrust reviews
3/ first of all, if the Biden administration chooses to elevate health care competition as a priority, it may garner rare bipartisan support.
This is an issue that has support from left (@ZekeEmanuel) and right (@Avik) thought leaders and legislators.
4/ removing perverse incentives to consolidate in payment policies can arrest or reverse hospital-physician consolidation.
The appeals court upheld @CMSGov ability to enact site-neutral payments.
they need to be expanded beyond office visits to other services, like ultrasounds
5/ fight against state-level anticompetitive ploys
"Certificate of Need" is often abused to grant local monopolies that then drive up prices
CMS has set the precedent of saying "if there's a CON, we will provide additional flexibilities on network adequacy"- they can go further
6/ Enforce against holding data hostage.
I joined 5 other former national coordinators for Health IT in an unprecedented letter that supported using CMS Conditions of Participation as a tool for ensuring data sharing of hospital events.
We have a final rule, but no enforcement
7/ the FTC and DOJ should review physician non-competes.
They shouldn't be used to stifle competition if physicians find that hospital (or private equity) employment was not all they hoped it would be
8/ @JoeBiden was the first presidential candidate of a major party to explicitly call out the need to tackle market concentration in healthcare
But they can go beyond antitrust authority to ensure better care and lower costs for all.
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2/ Why do I think it's "The Question" of this moment for field epi to try to answer?
I'm going to be joining @Bob_Wachter@cmyeaton@inthebubblepod tomorrow in our continuing "Safe or Not Safe" series, and Variant vs Vaccine will make all the difference
1/ COVID Deaths are lower than horrible peaks, but seem to have plateau'd- as cases rise in several states are we due for another surge in deaths?
I don't think so.
(vaccines work)
2/ It's important to remember just how much deaths lag infections. Many of the deaths being reported today will have first become infected a month ago, or even longer
The death data does not yet reflect the big surge in vaccine administration that happened in the past few weeks
3/ The recent surge in vaccinations has been impressive, and the group with the highest vaccination rates (appropriately) are the 65+
As @aslavitt46 reported, 73% of elderly vaccinated now (and 36% of adults) 👏👏👏
1/ this is the most detailed description of the lab-leak hypothesis I have seen (and I don't buy it)
It posits a "chopped-and-channeled version of RaTG13 or the miners’ virus that included elements that would make it thrive and even rampage in people?" nymag.com/intelligencer/…
2/ to be clear, I've seen first-hand-in a 7 month-old baby-the scourge of a lab-produced bioweapon that was exfilitrated (anthrax 2001).
I agree w @mlipsitch position that the risks of creating Gain of Function pathogens w increased infectivity/deadliness outweigh the benefits
3/ beyond artful prose and connect-the-dots suggestions, here's the idea:
That a bat virus sample (RaTG13) was manipulated in Wuhan lab to be more infectious through the lego-block addition of key genetic mediators of human infection
3/ Here's some more data- why did life expectancy plummet in 1917-1918 (by 10 years!) then rebound completely?
Life expectancy is the average number of years a group of infants would live if they were to experience prevailing age-specific death rates throughout their life