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For ACA Plans, It’s Time to Store Round


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Mary Agnes Carey
KFF Well being Information


Learn Mary Agnes’ tales

Partnerships Editor and Senior Correspondent, oversees placement of KFF Well being Information content material in publications nationwide and covers well being reform and federal well being coverage. Earlier than becoming a member of KFF Well being Information, Mary Agnes was affiliate editor of CQ HealthBeat, Capitol Hill Bureau Chief for Congressional Quarterly, and a reporter with Dow Jones Newswires. A frequent radio and tv commentator, she has appeared on CNN, C-SPAN, the PBS NewsHour, and on NPR associates nationwide. Her tales have appeared in The Washington Submit, USA At the moment, TheAtlantic.com, Time.com, Cash.com, and The Every day Beast, amongst different publications. She labored for newspapers in Connecticut and Pennsylvania, and has a grasp’s diploma in journalism from Columbia College.

In most states, open enrollment for plans on the Reasonably priced Care Act alternate — often known as Obamacare — started Nov. 1 and lasts till Dec. 15, although some states go longer. With premiums anticipated to extend by a median of 6%, customers who get their well being protection by way of the federal or state ACA marketplaces are inspired to buy round. Due to enhanced subsidies and cost-sharing help, they may lower your expenses by switching plans.

In the meantime, Ohio is but once more an election-year battleground state. A poll problem that would offer constitutional safety to reproductive well being selections has change into a flashpoint for misinformation and message testing.

This week’s panelists are Mary Agnes Carey of KFF Well being Information, Jessie Hellmann of CQ Roll Name, Joanne Kenen of the Johns Hopkins Bloomberg College of Public Well being and Politico, and Rachana Pradhan of KFF Well being Information.


Jessie Hellmann
CQ Roll Name


Learn Jessie’s tales

Joanne Kenen
Johns Hopkins Bloomberg College of Public Well being and Politico


Learn Joanne’s tales

Rachana Pradhan
KFF Well being Information


Learn Rachana’s tales

Among the many takeaways from this week’s episode:

  • Open enrollment for many plans on the Reasonably priced Care Act alternate — often known as Obamacare — started Nov. 1 and lasts till Dec. 15, although enrollment lasts longer in some states. With premiums anticipated to extend by a median of 6%, customers are suggested to buy round. Enhanced subsidies are nonetheless in place post-pandemic, and enhanced cost-sharing help is offered to those that qualify. Many individuals who’ve misplaced well being protection could also be eligible for subsidies.
  • In Ohio, voters will contemplate a poll problem that may shield abortion rights beneath the state structure. This intently watched contest is considered by anti-abortion advocates as a testing floor for messaging on the problem. Abortion can also be key in different races, comparable to for Pennsylvania’s Supreme Court docket and Virginia’s state meeting, the place all the legislature is up for election.
  • Earlier this week, President Joe Biden issued an government order that calls on federal businesses, together with the Division of Well being and Human Providers, to step into the substitute intelligence area. AI is a buzzword at each well being care convention or panel today, and the applied sciences are already in use in well being care, with insurers utilizing AI to assist make protection selections. There may be additionally the recurring query, after many hearings and far dialogue: Why hasn’t Congress acted to manage AI but?
  • Our well being care system — particularly the docs, nurses, and different medical personnel — hasn’t recovered from the pandemic. Employees are nonetheless burned out, and a few have participated in work stoppages to make the purpose that they’ll’t take far more. Will this be the subsequent space for organized labor, contemporary from profitable strikes towards automakers, to develop union membership? Take pharmacy employees, as an illustration, who’re starting to stage walkouts to push for enhancements.
  • And, in fact, for the subsequent installment of the brand new podcast function, “This Week in Medical Misinformation:” The official authorities web site of the Republican-controlled Ohio Senate is attacking the proposed abortion modification in what some consultants have stated is a extremely uncommon and deceptive method. Headlines on its “On The Report” weblog embrace “Abortion Is Killing the Black Group” and say the poll measure would trigger “unimaginable atrocities.” The Related Press termed the weblog’s language “inflammatory.”

Plus, for “additional credit score,” the panelists counsel well being coverage tales they learn this week they suppose you must learn, too:

Mary Agnes Carey: Stat Information’ “The Well being Care Concern Democrats Can’t Resolve: Hospital Reform,” by Rachel Cohrs.

Jessie Hellmann: The Washington Submit’s “Drugstore Closures Are Leaving Hundreds of thousands With out Straightforward Entry to a Pharmacy,” by Aaron Gregg and Jaclyn Peiser.

Joanne Kenen: The Washington Submit’s “Older People Are Dominating Like By no means Earlier than, however What Comes Subsequent?” by Marc Fisher.

Rachana Pradhan: The New York Instances’ “How a Profitable Surgical procedure Took Off On-line and Disfigured Sufferers,” by Sarah Kliff and Katie Thomas.

Click on to open the Transcript

Transcript: For ACA Plans, It’s Time to Store Round

[Editor’s note: This transcript was generated using both transcription software and a human’s light touch. It has been edited for style and clarity.]

Mary Agnes Carey: Howdy, and welcome again to “What the Well being?” I’m Mary Agnes Carey, partnerships editor for KFF Well being Information, filling on this week for Julie Rovner. I’m joined by among the greatest and smartest well being reporters in Washington. We’re taping this week on Thursday, Nov. 2, at 10 a.m. ET. As at all times, information occurs quick, and issues may’ve modified by the point you hear this.

We’re joined right this moment by way of video convention by Joanne Kenen of the Johns Hopkins Bloomberg College of Public Well being and Politico.

Joanne Kenen: Hello, everyone.

Carey: Jessie Hellmann, of CQ Roll Name.

Jessie Hellmann: Hey there.

Carey: And my KFF Well being Information colleague Rachana Pradhan.

Rachana Pradhan: Thanks for having me.

Carey: It’s nice to have you ever right here. It’s nice to have all of you right here. Let’s begin right this moment with the Reasonably priced Care Act. When you’re curious about enrolling in an ACA plan for protection that begins Jan. 1, it’s time so that you can join. The ACA’s open enrollment interval started Nov. 1 and lasts by way of Dec. 15 for plans provided on the federal alternate, however some state-based ACA exchanges have longer enrollment intervals. Customers can log on, name an 800 quantity, get assist from an insurance coverage dealer or from different ACA navigators and others who’re educated that will help you analysis your protection choices, allow you to discover out in the event you qualify for a subsidy, or in the event you ought to contemplate altering your ACA plan.

What can customers count on this yr throughout open enrollment? Are there extra or fewer decisions? Are premiums rising?

Hellmann: So, I noticed the common premium will enhance about 6%. So persons are positively going to need to store round and won’t essentially simply need to follow the identical plan that that they had final yr. And we’re additionally going to proceed seeing the improved premiums, subsidies, that Congress handed final yr that they form of caught with after the pandemic. So subsidies is perhaps extra reasonably priced for individuals — I’m sorry, premiums is perhaps extra reasonably priced for individuals. There’s additionally some enhanced cost-sharing help.

Carey: So it form of underscores the concept in the event you’re on the ACA alternate, you actually ought to return and have a look, proper? As a result of there is perhaps a unique deal on the market ready.

Kenen: I feel the wrinkle — this can be what you have been nearly to ask — however the wrinkle this yr is the Medicaid disenroll, the unwinding. There are roughly 10 million, 10 million individuals, who’ve been disenrolled from Medicaid. A lot of them are eligible for Medicaid, and in some unspecified time in the future hopefully they’ll determine find out how to get them again on. However a few of those that are now not eligible for Medicaid will most likely be eligible for closely backed ACA plans in the event that they perceive that and go search for it.

This inhabitants has been onerous to succeed in and onerous to speak with for quite a lot of causes, some attributable to the well being system, not the individuals, or the Medicaid system, the states. They do have a fallback; they’ve some additional choices. However lots of these individuals ought to click on and see what they’re eligible for.

Pradhan: One factor, form of piggybacking on what Joanne stated, that I’m actually curious about: After all, proper now could be a time when individuals can actively join ACA plans. However the individuals who misplaced Medicaid, or are shedding Medicaid — technically, the state Medicaid company, in the event that they suppose that an individual may qualify for an ACA plan, they’re speculated to routinely switch these individuals’s purposes to their market, whether or not it’s healthcare.gov or a state-based alternate. However the knowledge now we have to this point exhibits actually low enrollment charges into ACA plans from these batches of individuals which are being routinely transferred. So I’m actually inquisitive about whether or not that’s going to enhance and what does enrollment appear to be in a number of months to see if these charges really enhance.

Carey: I’m additionally questioning what you’re all choosing up on the problem of the supplier networks. What number of docs and hospitals and different suppliers are included in these plans? Are they prone to be smaller for 2024? Are they getting larger? Is there a selected development you possibly can level to?

I do know that generally insurers may scale back the variety of suppliers, slender that community, for instance to decrease prices. So I assume that is still to be seen right here.

Kenen: I haven’t seen knowledge on the ACA plans, and perhaps one of many different podcasters has. I haven’t seen that. However we do know that in sure cities, together with the one all of us reside in [Washington, D.C.], many docs are stopping, are now not taking insurance coverage. I imply, it’s not most, however the variety of people who find themselves dropping being in-network in among the main networks that we’re used to, I feel now we have all encountered that in our personal lives and our pals’ and households’ lives. There are docs opting out, or they’re in however their practices are closed; they’re not taking extra sufferers, they’re full.

I don’t need to faux I understand how a lot worse it’s or isn’t in ACA plans, however we do know that this can be a development for a number of years. In some elements of the nation, it’s getting worse.

Hellmann: Yeah, the Biden administration has been performing some stuff to attempt to deal with a few of these issues. Final yr there have been some guidelines requiring well being plans have sufficient in-network suppliers that meet particular driving time and distance necessities. So, they’re attempting to deal with this, however I wouldn’t be stunned if a few of these plans’ networks are nonetheless fairly slender.

Pradhan: Yeah. I imply, I feel the priority for some time now with ACA plans is as a result of insurance coverage firms can’t do the issues that they did a decade in the past to restrict premium will increase, and so on., one of many methods they’ll hold their prices down is to curtail the variety of obtainable suppliers for somebody who indicators up for one in every of these plans. So, like Jessie, I’m inquisitive about how these new guidelines from final yr will have an effect on whether or not individuals see significant variations within the availability of in-network suppliers beneath particular plans.

Carey: That and lots of different traits are value watching as we head into the open enrollment season. However proper now, I’d like to show to a different subject within the information, and that’s abortion. “What the Well being?” listeners know that final week your host, Julie Rovner, created a brand new phase that she’s calling “This Week in Well being Care Misinformation.” Right here’s this week’s entry.

A measure earlier than Ohio voters subsequent Tuesday, that’s Nov. 7, would amend Ohio’s structure to ensure the correct to reproductive well being care selections, together with abortion. Abortion rights opponents say the measure is crafted too broadly and shouldn’t be accepted. The official authorities web site of the Republican-controlled Ohio Senate is attacking the proposed abortion modification in what some consultants have stated is a extremely uncommon and deceptive method. Headlines on the “On The Report” weblog — and that’s what it’s referred to as, “On The Report”; that is on the Ohio state web site — it makes a number of claims concerning the measure that authorized and medical consultants have informed The Related Press have been false or deceptive. Headlines on this web site embrace, and I’m quoting right here, “Abortion Is Killing the Black Group” and that the proposal would trigger, once more, one other quote, “unimaginable atrocities.” Isn’t it uncommon for an official authorities web site to function on this method?

Pradhan: I feel sure, so far as we all know, and that’s actually scary. It’s onerous sufficient today to type out what’s legit and what isn’t. We’ve seen AI [artificial intelligence] utilized in different political marketing campaign supplies within the types of altered movies, pictures, and so on. However now this can be a actually terrifying prospect, I feel, that you could possibly present misinformation to voters — significantly in shut races, I might say, that you could possibly actually swing an consequence based mostly on what persons are being informed.

Kenen: The opposite factor that’s being stated in Ohio by the Republicans is that the measure would enable, quote, “partial-birth abortions,” which is a selected — it’s a phrase used to explain a selected sort of late-term abortion that’s unlawful. Congress handed laws, I feel it’s 15 to twenty years in the past now, and it went by way of the courts and it’s been upheld by the courts. This measure in Ohio doesn’t undo federal legislation within the state of Ohio or wherever else. In order that’s not true. And that’s one other factor circulating.

Carey: This dialogue is essential. And to Rachana’s level, how voters understand this is essential as a result of Ohio is serving as a testing floor for political messaging headed into the presidential race subsequent yr. And abortion teams are attempting to qualify initiatives in additional states in 2024, probably together with Arizona. So even in the event you haven’t adopted this story intently, I imply, how do you suppose this tactic might affect voters? Once more, you’re speaking about one thing — once you hit a information tab on an official state web site, you come to this weblog. Do you suppose voters will reject it? May it presumably affect them — as you have been speaking about earlier, tip the outcomes?

Kenen: Properly, I don’t suppose we all know the way it’s going to tip, as a result of I don’t know the way many individuals really learn the state legislature weblog.

Carey: Yeah, that might be a difficulty.

Kenen: Though, and the protection of it, one would hope, within the state media would level out that a few of these claims are unfaithful. However I imply, it’s taking — you realize, the Republicans have misplaced each single state poll initiative on abortion, and it’s been a successful problem for the Democrats and so they’re attempting to reframe it just a little bit, as a result of whereas polls have proven — not simply polls, however voting habits has proven — many People need abortion to stay authorized, they aren’t as snug with late-term abortions, with abortions within the last weeks or months of being pregnant. So that is attempting to shift it from a common debate over banning abortion, which isn’t well-liked within the U.S., to an space the place there’s softer assist for abortions later throughout being pregnant.

And polls have proven actually sturdy assist for abortion rights. However that is an space that’s not as sturdy, or just a little bit extra open to perhaps transferring individuals. And if the Republicans reach portraying this as falsely permitting a process that the nation has determined to ban, I feel that’s a part of what’s happening, is to shift the definition, shift the phrases of debate.

Carey: As we all know, Ohio shouldn’t be the one state the place abortion is taking middle stage. For instance, in Pennsylvania, abortion is a key problem within the state Supreme Court docket justice election, and it’s a take a look at case of political fallout from the Supreme Court docket, the US Supreme Court docket’s choice final summer time to overrule Roe v. Wade. In Texas, the state is accusing Deliberate Parenthood of defrauding the Republican-led state’s Medicaid medical health insurance program. And in Kansas, in a victory for abortion rights advocates, a choose put a brand new state legislation on remedy abortions on maintain and blocked different restrictions governing the use and distribution of those drugs and imposed ready intervals.

And naturally, abortion stays an enormous problem on Capitol Hill, with Home Republicans inserting language into many spending payments to limit abortion entry, to dam funding for HIV prevention, contraception, world well being applications, and so forth. So, which of those circumstances, or others perhaps that you’re watching, do you suppose would be the strongest indicators of how the abortion battle will shake out for the remainder of this yr and into 2024?

Pradhan: I’m really going to make a plug for an additional one which we didn’t point out, which is for our native, D.C.-area listeners, Virginia subsequent week has a state legislative election. So, Gov. [Glenn] Youngkin in fact continues to be — he’s not up for reelection; he’ll sit one single four-year time period, however all the Virginia Common Meeting is up for election. So at present Gov. Youngkin says that he desires to institute a 15-week abortion ban, however Republicans would want to regulate each department of presidency, which they don’t at present, however it’s doable that they’ll after subsequent week. So that may be an enormous change as you see abortion restrictions which have proliferated, particularly all through the South and the Midwest. However now Virginia to this point has not, within the wake of final yr’s Dobbs [v. Jackson Women’s Health Organization] choice, has not imposed higher restrictions on entry to abortion.

However I feel the 15-week restrict additionally gives form of a take a look at case, I feel, for whether or not Republicans may have the ability to coalesce round that commonplace versus one thing extra aggressive like, say, a complete ban or a six-week ban that’s clearly been instituted in sure states however I feel at a nationwide degree proper now could be a nonstarter. I’m fairly curious about seeing what occurs even in lots of our personal yard.

Kenen: As a result of Virginia’s actually tightly divided. I imply, the previous couple of elections. This was a conventional Republican state that has change into a purple state. And the previous couple of state legislature elections, didn’t they as soon as resolve by drawing tons? It was so shut. I imply it’s flipped again. It’s actually, actually, actually tiny margins in each homes. I feel Rachana lives there and is aware of the small print higher than I do. Nevertheless it’s razor-thin, and it was Republican-controlled for a very long time and Democrats, what, have one-seat-in-the-Senate management? One thing like that, a really slender margin. They usually might or might not hold it.

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Pradhan: Joanne, your reminiscence’s so good, as a result of that they had —

Kenen: As a result of I edited your tales.

Pradhan: You probably did. I do know. They usually had to attract names out of a bowl that was— it was in a museum. It was one thing {that a} Virginia potter had made and so they needed to take it out of a museum exhibit. I imply, it was essentially the most — it’s actually fascinating what democracy can appear to be on this nation when it comes right down to it. It was such a weird scenario to resolve management of the state Home. So that you’re very proper, so it’s very shut.

Kenen: It’s additionally value declaring, as now we have in prior weeks, that 15 weeks is now being provided as this kind of reasonable place, when 15 weeks — a yr in the past, that’s what the Supreme Court docket case was actually about, the case we all know as Dobbs. It was a few legislation in Mississippi that was a 15-week ban. And what occurred is as soon as the courts gave the states the go-ahead, they went manner additional than 15 weeks. I don’t know what number of states have a 15-week ban, not many. The anti-abortion states now have kind of six weeks-ish or much less. North Carolina has 12, with some situations. So 15 weeks is now Youngkin saying, “Right here’s the center floor.” I imply, even when Congress was attempting to do a ban, it was 20, so — once they had these symbolic votes, I feel it was at all times 20. He’s modified the parameters of what we’re speaking about politically.

Carey: Jessie, how do you see the abortion riders on these appropriations payments, significantly within the Home. Home Republicans have put lots of this abortion language into the approps payments. How do you see that shaking out, resolving itself, as we glance ahead?

Hellmann: It’s onerous to see how a few of these riders may change into legislation, just like the one within the FDA-Ag approps invoice that may mainly ban mailing of mifepristone, which can be utilized for abortions. Even some reasonable Republicans who’re actually towards that rider — I imply only a handful, nevertheless it’s sufficient the place it ought to simply be a nonstarter. So I’m simply unsure how I can see a compromise on that proper now. And I positively don’t see how that might go the Senate. So it’s simply every thing has change into a lot extra contentious for the reason that Roe choice. And issues that weren’t contentious earlier than, just like the PEPFAR [The United States President’s Emergency Plan for AIDS Relief] reauthorization, at the moment are being slowed down in abortion politics. It’s onerous to see how the 2 sides can come to an settlement at this level.

Carey: Sure, contentious points are all over the place. So, let’s swap from abortion to AI. Earlier this week, President Biden issued an government order that calls on a number of federal businesses, together with the Division of Well being and Human Providers, to create laws governing the usage of AI, together with in well being care. What makes use of of AI now in well being care, and even future makes use of, are inflicting the best concern and is perhaps the best focus of this government order? And I’m considering of issues that work properly in AI or are accepted, and issues that perhaps aren’t accepted at this level or persons are involved about.

Kenen: I feel that none of us on the panel are tremendous AI consultants.

Carey: Nor am I, nor am I.

Kenen: However we’re all following it and studying about it the best way everyone else is. I feel that is one thing that Vice President Harris identified in a summit in London on AI yesterday. There’s lots of give attention to the existential, cosmic scary stuff, like: Is it going to kill us all? However there’s additionally sensible issues proper now, significantly in well being care, like utilizing algorithms to disclaim individuals care. And there’s been some exposés of insurance coverage doing batch denials based mostly on an AI method. There’s issues about — since AI is predicated on the information now we have and the information, that’s the muse, that’s the edifice. So the information now we have is flawed, there’s racial bias within the knowledge now we have. So how do you make certain the algorithms sooner or later don’t bake within the inequities we have already got? And there’s questions too about AI is already getting used clinically, and the way properly does it actually work? How dependable are the research and the information? What do we all know or not know earlier than we begin?

I imply, it has large potential. There are dangers, nevertheless it additionally has large potential. So how will we make it possible for we don’t have exaggerated happy-go-lucky distrust in expertise earlier than we really perceive what it could possibly and can’t do and how much safeguards the federal government —and the European governments as properly; it’s not simply us, and so they might do a greater job — are going to be in place in order that now we have the great with out … The aim is kind of, to be actually simplistic about it, is let’s have the great with out the unhealthy, however doing it’s difficult.

Carey: Oh, Rachana, please.

Pradhan: Properly, all I used to be going to say was these days you can’t go to a well being care convention or a panel dialogue with out there being some session about AI. I assume it demonstrates the extent of curiosity. It form of jogs my memory of each few years there’s a brand new well being care unicorn. So there was ACOs [accountable care organizations] for a very long time; that’s all individuals would discuss. Or value-based care, like each convention you went to. After which with covid, and for different causes, everybody is actually large on fairness, fairness, fairness for a very long time. And now it’s like AI is all over the place.

So like Joanne stated, I imply, now we have every thing from a chatbot that pops up in your display screen to reply even benign questions on insurance coverage. That’s AI. It’s a type of AI. It’s not generative AI, however it’s. And yeah, I imply, insurance coverage firms use all kinds of algorithms and knowledge to make selections about what claims they’re going to pay and never pay. So yeah, I feel all of us simply need to train some skepticism once we’re attempting to look at how this is perhaps used for good or unhealthy.

Kenen: I simply need a robotic to wash my kitchen. Why doesn’t anybody simply deal with the … Silicon Valley does the actually essential stuff.

Carey: That will be a use for good in your home, in my home, in all our homes.

Kenen: Yeah.

Carey: So, whereas we’re understandably and admittedly not AI consultants, we’re consultants on Congress right here. And the president did say in his announcement earlier this week that Congress nonetheless must act on this problem. Why haven’t they finished it but? They’ve had all these hearings and all this dialog about crafting guidelines round privateness, on-line security, and rising applied sciences. Why no motion to this point? And any bets on whether or not it could or might not occur within the close to future?

Hellmann: I feel they don’t know what to do. We’ve solely, as a rustic, began actually speaking about AI at kitchen tables, to make use of a cliche, this yr. And so Congress is at all times behind the eight ball on these points. And even when they’re having these member conferences and speaking about it, I feel it may take a very long time for them to truly go any significant laws that isn’t simply directing an company to do a examine or directing an company to problem laws or one thing that might have a extremely large impression.

Carey: Glorious. Thanks. So let’s contact briefly — earlier than we wrap, I actually do need to get thus far and among the stuff we proceed to see within the information about well being care employees beneath hearth. It’s actually not straightforward to be a well being care employee today. New findings printed by the Facilities for Illness Management and Prevention present that, in 2022, 13.4% of well being employees stated that they had been harassed at work. That’s up from 6.4% in 2018. That’s greater than double the speed of office harassment in comparison with pre-pandemic instances, the CDC discovered.

We’ve talked about this earlier than. It’s value revisiting once more. What’s going on with our well being care workforce? And what do these form of findings imply for maintaining proficient individuals within the workforce, attracting new individuals to hitch?

Hellmann: Has anybody really caught a break after the pandemic?

Carey: That’s a very good level.

Hellmann: I imply, covid continues to be on the market, however I don’t suppose that our well being care system has actually recovered from that. Individuals have left the workforce as a result of they’re burned out. Individuals nonetheless really feel burned out who caught round, and I don’t know in the event that they actually acquired any breaks or the assist that they wanted. There’s simply form of this recognition of individuals being burned out. However I don’t know the way a lot motion there’s to deal with the problem.

I really feel like generally that results in extra burnout, once you see executives and leaders acknowledging the issue however then not likely doing a lot to deal with it.

Carey: Properly, that’s actually been the grievance by pharmacy employees and others and pharmacists at among the massive drugstore chains, retail chains, which have gone out on strike. They’ve had these two- and three-day strikes not too long ago. So, I’m assuming that can proceed, sadly, for all the explanations that Jessie simply laid out.

Pradhan: Truly, form of going again to the strikes from pharmacists, I used to be fascinated with this earlier as a result of we’ve seen not too long ago, I feel individually within the information with regards to labor unions, and perhaps this can have some bearing, perhaps not, however the United Auto Employees strike — I imply, they extracted among the largest concessions from automakers so far as pay will increase. And persons are seeing, they actually acquired a victory after hanging for weeks. And I feel individuals, a minimum of the protection that I’ve seen has talked about how that union win won’t simply catalyze higher labor union involvement, not simply within the auto business however in different elements of the nation and different sectors.

And so, I’m unsure what proportion of pharmacists are a part of labor unions, however I feel individuals have kind of stated extra not too long ago that organized labor is having a second, or has been, that it has not shortly. And so, I’ll be fascinated to see whether or not there’s a higher urge for food amongst pharmacists to truly be a part of a labor union and kind of whether or not that ends in higher calls for of a few of these company chains. As we all know — we are able to discuss this I feel in just a little bit — however the company chains have actually taken over pharmacies in America, and rural pharmacies are actually dying off. And in order that has lots of essential implications for the nation.

Kenen: I feel the issues with the well being care workforce should not all issues that labor unions can deal with, as a result of a few of it’s what number of hours you’re employed and how much shifts you’ve gotten and the way typically they alter and issues that — yeah, I imply, labor is having a second, Rachana’s proper. However they’re additionally tied to bigger demographic traits, with an growing old society. It’s tied to, our complete system is geared towards the, like dean of nursing at [Johns] Hopkins Sarah Szanton is at all times speaking about, it’s not a lot not having sufficient nurses; we’ve acquired them within the improper locations. If we did extra preventive care and neighborhood care and power illness administration in the neighborhood, you wouldn’t have so many individuals within the hospital within the first place the place the workforce disaster is.

So a few of these bigger problems with how do now we have a greater well being care system; labor negotiations can deal with points of it. Nursing ratios are controversial, however that’s a labor problem. It’s a regulatory problem as properly. However our complete system’s so screwed up now that Jessie’s proper, no person recovered from the strains of the pandemic in lots of sectors, most likely all sectors of society, however clearly significantly brutal on the well being care workforce. We didn’t get to hit pause and say, OK, no person get sick for six months whereas all of us recuperate. The unmet psychiatric wants. I imply, it’s simply tons of stuff is improper, and it’s manifesting itself in a workforce disaster. So perhaps in the event you don’t have anybody to handle you, perhaps individuals will take note of the bigger underlying causes for that.

Carey: That’s a difficulty I’m positive we’ll discuss extra about sooner or later as a result of it’s simply not going wherever. However for now, we’re going to show to our additional credit score phase. That’s once we every suggest a narrative we learn this week and suppose you must learn, too. As at all times, don’t fear in the event you miss it. We are going to put up the hyperlinks on the podcast web page at kffhealthnews.org and in our present notes in your cellphone or different cell machine.

Joanne, why don’t you go first this week?

Kenen: Properly, talking of which, after we simply talked about, there’s a bit in The Washington Submit by Marc Fisher. It has an extended headline: “Older People Are Dominating Like By no means Earlier than, however What Comes Subsequent?” And mainly it’s speaking about not a lot the nursing and doctor workforce, though that’s a part of it, simply the workforce basically. Now we have extra individuals working longer, and in areas the place there’s shortages, there’s nothing improper with having outdated individuals. Loads of communities have shortages of faculty bus drivers. So when you have lots of older college bus drivers and so they’re secure and like children and like driving the bus, extra energy to them. When you’re 55 and you’ll drive a college bus stuffed with nine-year-olds, center schoolers, a lot extra.

Carey: Good luck with that one.

Kenen: However among the doctor specialties — one of many individuals within the story is a palliative care doctor who retired and isn’t blissful retired and desires to return to work. And that’s one other space the place we’d like extra individuals. Nevertheless it’s a cultural shift, like, who’s doing what when, and the way does it have an effect on the youthful technology? Though there was a reference to Angelina Jolie being on the outdated facet at 48. I assume for an actress that is perhaps outdated. However that wasn’t the gist of it. However now we have this shift towards older individuals in lots of locations, not simply Trump and Biden. It’s kind of the entire workforce.

Carey: Obtained it. Jessie.

Hellmann: My additional credit score can also be a narrative from The Washington Submit. It’s referred to as “Drugstore Closures Are Leaving Hundreds of thousands With out Straightforward Entry to a Pharmacy.” Centered particularly on among the large nationwide chains like CVS and Walgreens and Ceremony Support, which have actually form of dominated the pharmacy house over the previous few a long time. However now they’re coping with the repercussions from all these lawsuits which are being filed alleging that they had a job within the opioid epidemic. And the story simply form of appears to be like on the penalties of that.

These aren’t simply locations individuals get prescriptions. They depend on them for meals, for medical recommendation, particularly in rural and underserved areas. So yeah, I simply thought it was a extremely attention-grabbing take a look at that problem.

Carey: Rachana?

Pradhan: So my additional credit score is a narrative in The New York Instances referred to as “How a Profitable Surgical procedure Took Off On-line and Disfigured Sufferers.” It’s horrifying. It’s a narrative about surgeons who’re performing a posh sort of hernia surgical procedure and evidently are studying their methods, or a minimum of a big share of them are studying their methods, by watching movies on social media. And the methods which are demonstrated there should not precisely prime quality. So the story digs into ensuing hurt to sufferers.

Kenen: And it’s pointless surgical procedure within the first place — for a lot of, not all. Nevertheless it’s a extra sophisticated process than they even want in a big portion of those sufferers.

Carey: My additional credit score is written by Rachel Cohrs of Stat, and she or he’s a frequent visitor on this program. Her story known as “The Well being Care Concern Democrats Can’t Resolve: Hospital Reform.” Whereas Democrats have seized on decreasing well being care prices as a politically successful problem — they’ve taken on insurers and the drug business, for instance — Rachel writes that hospitals could also be a well being care big they’re unable to confront alone, and so they being the Democrats. As we all know, hospitals are main employers in lots of congressional districts. There’s been lots of consolidation within the business in recent times. And hospital business lobbyists have labored onerous to protect the picture that they’re the great guys within the well being care business, Rachel writes, whereas others, like pharma, should not.

Properly, that’s our present. As at all times, in the event you benefit from the podcast, you possibly can subscribe wherever you get your podcasts. We’d respect it in the event you left us a assessment; that helps others discover us too. Particular thanks, as at all times, to our engineer, Francis Ying. Additionally, as at all times, you possibly can e mail us your feedback or questions. We’re at whatthehealth@kff.org, or you could possibly nonetheless discover me on X. I’m @maryagnescarey. Rachana?

Pradhan: I’m @rachanadpradhan on X.

Carey: Jessie.

Hellmann: @jessiehellmann.

Carey: And Joanne.

Kenen: I’m sometimes on X, @JoanneKenen, and I’m attempting to get extra on Threads, @joannekenen1.

Carey: We’ll be again in your feed subsequent week, and till then, be wholesome.


Francis Ying
Audio producer

Stephanie Stapleton

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