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Friday, February 26, 2021

Nine Ways the Coronavirus Is Speeding Change in Health Care

The pandemic has forced rapid change and altered opinions regarding health care in the U.S., and we’re not going back.

COVID-19 has taken hundreds of thousands of lives and millions of job in America alone, while initiating some deep introspection within the health care industry. Deeply held beliefs about how health care should be provided and paid for have been shaken, and experts say we will never go back to the way it used to be. 

Pepsi Launches Nighttime Drink

The pandemic is affecting much more than just health care. Not surprisingly, stress is up, and Pepsi may have found the perfect opening to launch its first beverage to help consumers relax before bed. Each blue can of Driftwell contains 200 milligrams of L-theanine and 10% of the daily value of magnesium. 

“I think we’re launching this at a time when there’s more consumer interest than there previously was, given everything that’s going on from a macro perspective,” says Emily Silver, vice president of innovation and capabilities at Pepsi’s North American beverages unit.

The enhanced water drink contains an amino acid, L-theanine, that’s found in green and black teas, as well as certain mushrooms. The 7.5-ounce mini cans in blackberry lavender flavor are, according to Silver, just the right size to offer hydration without making you get up in the middle of the night. 

Millions of unemployed people have suddenly lost health insurance, and others have been forced to delay noncritical treatment as hospitals were overwhelmed with pandemic patients. Telemedicine, considered a novelty in pre-pandemic times, has leapt in to fill gaps and maintain social distancing for services ranging from checkups to addiction counseling. 

One of the biggest changes that may occur is an end to the distinctly American custom that has bound health care coverage to employment. It could also force a reluctant nation to examine why Black people and other historically marginalized minorities have been disproportionately susceptible, not just to the coronavirus, but to many common health conditions. And it could foretell the end of the era for nursing homes and assisted living facilities as older adults have been forced into isolation.

Here are nine ways the pandemic is changing U.S. health care:

  1. Telemedicine. Virtual doctor visits have been possible for years, but prior to the pandemic, services were little used. Now, the health care community has embraced telemedicine as being safer, quicker and easier than in-person visits. Medicare has even signed on as it saw cost reductions. Patients like the convenience and affordability, too. Primary care visits were the first to go virtual, but more and more specialists have realized they can operate over a video feed as well. As one former health care adviser to two presidential administrations put it: The technology “has probably been accelerated by a decade.”
  2. Health Insurance. Typically, health care coverage has been tied to employment in this country. The Affordable Care Act sought to make coverage available whether someone was working or not, but it has been under attack. Some think the time is now right for universal coverage, or Medicare for all. Others are pushing health reimbursement arrangements (HRAs), which allow employers to reimburse workers for a set dollar amount per year, while the workers are responsible for finding coverage. HRAs allow employers to have control over cost. 
  3. Group Homes for Seniors. Older Americans in nursing homes and assisted living facilities account for over one-third of pandemic deaths in some states as the disease passed like wildfire in the close living conditions. Older adults “don’t want to be in what’s basically a nursing-home prison, as some have called it,” says Grace Marie Turner, president of the Galen Institute, a conservative health policy research group. This may lead to a wave of need for home health aides as seniors stay at home. 
  4. Racial Reckoning. COVID-19 kills people of color, in particular Black people, at much higher rates. For example, although Black people represent a mere 6% of the Wisconsin population, they represent nearly half of the state’s coronavirus deaths. “The stark disparities in COVID-19 infection rates and outcomes among different populations and different parts of the country has been hard to ignore,” says Risa Lavizzo-Mouraey, professor of health policy at the University of Pennsylvania. “While there’s a rich body of work that has demonstrated this in the past, it’s a unique moment where it’s happening all at once, and you can see it in real time.” Georges Benjamin, executive director for the American Public Health Association, agrees, noting “We need a plan now to make sure that those existing disparities are not exacerbated by inadequate access to treatment or access to vaccines.” 
  5. Big Pharma. Are pharmaceutical companies saviors or villains? For years, they’ve been reviled for profiting off of sick Americans, but they’ve ridden white horses into the pandemic fray with surprisingly effective vaccines delivered more quickly than anyone thought possible. Will lawmakers and the public still have an appetite for assaulting them over drug pricing? Only time will tell.
  6. American Manufacturing. Pandemic drug and vaccine manufacturing has found a home in the U.S., and that’s fine with former Rep. Donna Shalala, who was, until recently, a congresswoman from Florida and former health secretary. “We have to look at the supply chain,” she says. “It doesn’t mean that we don’t believe in a global market, but it does mean that we have to be able to ramp up production here quickly.” 
  7. Preparation. The public watched as governors and frontline health care workers begged for personal protective equipment and ventilators at the start of the crisis, and they waited for testing and contact tracing. COVID-19 has highlighted the need for emergency preparedness, infrastructure, supplies and health care professionals. Some have proposed networks of retired doctors and/or medical students to be at the ready: the medical counterpart of a National Guard. 
  8. Non-physician Health Care Workers. Massive pressure was exerted on emergency rooms and intensive care units while many health care workers were out with the virus or in quarantine. More care to more patients at a lower cost could be provided by nurses, nurse practitioners and physician assistants already on the payroll, particularly in rural hospitals and clinics. Shalala says, “Frankly, 70% of primary care could be handled by advanced practice nurses.” Billy Tauzin, former Republican congressman from Louisiana and former president of PhRMA, adds that skilled nursing demand will increase because there will be “a major shift to decentralize health care, and toward preventive care and home care.”
  9. Money. Doctors’ and hospitals’ revenue has been hit hard because demand for services outside of COVID-19 treatment has nearly dried up. The fee-for-service medicine model may die, in favor of lump-sum payment for caring for a group of patients or compensation for keeping patients healthy and out of the hospital. “We’ve seen physician offices that live off fee-for-service just get freakin’ killed,” says Chris Jennings, policy consultant.