Page 9 - SF HOSPITAL NEWS NOVEMBER 2020

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A message from our President

If There Is a National Change in Leadership,

What Might It Mean?

By the time you read this, the national elections may be over. So, just in case reducing the eligibility age for Medicare from 65
there has been a change in leadership, what might it mean for us? So far we have to 60 could have serious financial implications as
heard a lot or rhetoric from both camps, but what does the evidence say? more profitable commercially insured patients are
In a recent assessment, FiveThirtyEight estimated that there is a 72 percent displaced by expanding numbers of Medicare
chance that Democrats could control the presidency, Senate, and House. Not patients. Jaime Caldwell
since the first two years of the Obama Administration has that happened and, Candidate Biden has also talked about two other
what might we expect if it happens this month. ways to stimulate the economy that have implica-
A historical perspective on this subject might be helpful. As we have seen, tions for hospitals. First, support for increasing the federal minimum wage from
houses of Congress controlled by opposing parties leads to not much getting the current $7.25 to a discussed $15.00. While this will impose an economic
done. We saw the Affordable Care Act being passed during those first two years burden on hospitals, growing transition to artificial intelligence for many basic
in the Obama Administration with veto-proof majorities, but what might happen functions will bring greater value to many of the positions that formerly per-
tomorrow? formed these repetitive tasks. Plus, innovation will occur that will help reduce
In reading many authors’ opinions on this subject, hardly one suggests that a the impact of this increase in salary expense. On the positive side, more families
Blue Wave would radically change what we are seeing today. With, at best, a slim will be able to purchase healthcare coverage that covers more than just the bare
majority in the Senate, that body would continue to take a more conservative essentials.
approach, maybe just left of center, and would not likely advocate for significant Second, candidate Biden has also talked about extending the enhanced unem-
change like some of the proposals calling for Medicare for All, reducing the ployment insurance benefits. Personal income has grown considerably during
Medicare age to 60, or dramatic drug pricing legislation. these COVID-19 times as people have spent less and have paid down existing
So, what might we see? Expansion of the Affordable Care Act is likely. debt. Many economists believe that the double-barrel approach of increasing the
Foremost, pressing the case for the remaining states that have not expanded minimum wage and extending enhanced benefits will lead to the unleashing of
Medicaid, to do so. Also, the Biden Administration would likely move to restore pent-up demand that will lead to a consumer led economic recovery.
many of the administrative changes enacted by Executive Order during the These are interesting times and, sometimes, it is fun to just sit back and see
Trump Administration. And, also likely, a move to fix some of the issues identi- how right, or wrong, the prognosticators are! What is for sure, whichever party
fied by the US Supreme Court as being problematic. What that means is that we is successful, hospitals will continue to face challenges. COVID-19 is not going
will see the restoration of the individual mandate requiring coverage and estab- away, and more recent announcements seem to indicate that vaccines will not be
lishing penalties for lack of thereof. In discussions about the Biden agenda, it is generally available until the end of the first quarter or second quarter on 2021.
also mentioned that the public option and tax credits would also be back on the Then, we must overcome the growing hurdle of the distrust by the general pub-
table. lic concerning the expedited process used to verify vaccine safety.
With the moderation that might be imposed by a scant Democratic majority in Hospitals and other healthcare providers must continue to operate at high lev-
the Senate, candidate Biden has talked frequently about allowing Medicare to els despite the fact that patient volumes and revenues are down significantly
negotiate drug prices. His stated platform would also limit price increases for all from 2019. Months and months of no, or limited elective procedures and tests
brand-name, biotech, and “abusively priced” generic drugs. These changes might have left a lasting mark and it will take time for healthcare providers to recover.
be muted by the Senate as big pharma has gotten good public press for their Regardless of the administration, healthcare needs a continued infusion of
COVID-19 response. supplemental funding to ensure the availability of care for all. Healthcare
The healthcare industry would also benefit from the positive COVID-19 press providers are non-partisan, and render lifesaving care to all races, creeds, reli-
and would likely experience positive changes in governmental spending through gions, or countries of origin. They provide this care regardless of the party in
additional CARES Act funding, but that will be tempered by likely increases in power. We have a long road ahead of us, but I think I can just see the lights of
existing tax rates and more regulation. And, while expanded Medicaid coverage the next town.
would be a positive force in this state, proposals like Medicare-For-All and Thank you for voting!

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