reject efforts to adopt Medicare for All in response to COVID-19 and instead eliminate the tax subsidies that encourage people to obtain health insurance through their employers and let people purchase health insurance that covers only catastrophes. COVID-19 showed that the CDC was not up to the task. WASHINGTON, D.C. 20001 Plans for dealing with an epidemic should therefore include financial incentives encouraging people to participate in testing programs and waivers of copayments and deductibles for people requiring treatment. 1000 Massachusetts Ave. NW We offer discounts on bulk orders (orders over 100 copies). Experience with LASIK eye surgery, cosmetic surgeries and procedures, blood tests and body scans, and most recently with walk‐​in clinics run by Walmart and other retailers show this conclusively. Sponsorship is one way you can defend, in a concrete way, America’s heritage of individual liberty, free markets, and constitutionally limited government. Experience with COVID-19 in Other Countries, Creative Unsurprisingly, there were problems, including allegations of excessive prices, failure to deliver the goods in question, and fraud. Promoting an American public policy based on individual liberty, limited government, free markets and peaceful international relations. Which is why in 1978 Congress passed the Indian Child Welfare Act (or ICWA), a law which sets standards for the placement of Native children in foster or adoptive homes. Unfortunately, the H1N1 epidemic depleted the SNS’s inventory of masks and other equipment, and neither President Obama nor President Trump expended the political capital needed to obtain sufficient funds to replenish it. German researchers developed one in mid‐​January, but the CDC decided not to use it, and the Food and Drug Administration (FDA), another agency within HHS, prevented private laboratories from developing tests of their own. Employment‐​based health insurance does not do this. The SNS proved its value in responding to Hurricane Katrina in 2005 and the H1N1 epidemic in 2009. Like the United States, countries with national health care systems also sought to “flatten the curve” so that their systems could manage the spike in demand for treatments. When people pay for medical services directly, prices decline and health care is convenient and accessible. David A. Hyman is a law professor at Georgetown. Hollis Cato is on Facebook. In a 2018 report, the GAO noted that “since 2009, [it had] identified broad, cross‐​cutting issues in leadership, coordination, and collaboration that arise from fragmentation throughout the complex interagency, intergovernmental, and intersectoral biodefense enterprise.” The GAO also observed that HHS officials were still “unsure how decisions would be made, especially if addressing gaps or opportunities to leverage resources involved redirecting resources across agency boundaries.” As the GAO dryly noted, “Without clearly documented methods, guidance, processes, and roles and responsibilities for enterprise‐​wide decision‐​making,” a transition “from traditional mission stovepipes toward a strategic enterprise‐​wide approach that meaningfully enhances national capabilities” was unlikely to occur. This special level is available to first‐​time Sponsors only. A successful plan would also encourage people to respect quarantine orders and create arrangements to monitor compliance. Commons Attribution-NonCommercial-ShareAlike 4.0 International License. Sign Up. When COVID-19 reached America’s shores, the SNS had only 10 million N95 masks. An enormous amount of effort went into these plans, but even so the Government Accountability Office (GAO) had long been concerned that the federal government was ill‐​prepared for an epidemic or pandemic. Every year, fraud, waste, and abuse consume hundreds of billions of Medicare dollars. ... Cato Unbound; Unlawful Shield; Overlawyered; ElCato.org; Alt-M; Social Media. Since 1977, Cato scholars have been influential in a range of policy debates, including Social Security reform, medical savings accounts, term limits, welfare reform, fundamental tax reform, free trade, constitutional rights in the courts, school choice, civil liberties, and foreign policy issues. In reality, European states also experienced shortages of tests, hospital beds, doctors and nurses, personal protective equipment, and ventilators. Who Should Be Allowed To Adopt Native American Children? The U.S. response to the COVID-19 pandemic is a master class in government failure. Every time you direct your Amazon purchases through AmazonSmile, 0.5% of the price of your eligible items will be donated to Cato on your behalf, with no extra cost to you. In addition, many of the ventilators that were in the SNS did not work, owing to a contract dispute between the government and the company that maintained them. Cato depends solely on tax‐​deductible contributions from Sponsors who share our commitment to a free and prosperous society. What explains the enthusiasm with which advocates have argued that COVID-19 proves the need for Medicare for All? It is certainly true that the American health care system has no shortage of pathologies and needs a complete overhaul. Cato Institute, a private U.S.-based nonprofit organization devoted to public-policy research, founded in 1974. Cato Institute. For more information about becoming a Cato Sponsor, please contact the Development Team: CATO SPONSORSHIP CATO INSTITUTE 1000 MASSACHUSETTS AVENUE, N.W. Australia was forced to ration masks and other personal protective equipment. Medicare for All would be vastly more expensive than predicted because special interests dominate the political process. Cato Institute In July 1976, the name was changed to the Cato Institute. Accountability rests squarely with federal, state, and local governments, which neither prepared for the pandemic sufficiently nor deployed a sensible strategy for getting through it. Cato At Liberty RSS December 10, 2020 4:55PM New York vs. Florida . But Medicare for All is not the reform it needs. But the existence of a short‐​term crisis such as the COVID-19 pandemic should not blind us to the long‐​term (and far greater) need for incentives to moderate health care consumption in ordinary times. Many of the politicians and commentators who are making a COVID‐​19‐​based case for Medicare for All have always been enthusiastic proponents of Medicare for All. We offer discounts on bulk orders (orders over 100 individual copies). Cato's objective is to reawaken interest in America's founding ideals: personal liberty, private property, free markets, free trade, limited government, and nonintervention in foreign affairs. Proponents who seek to create a COVID‐​19‐​based case for Medicare for All would fix a short‐​term problem by creating a long‐​term disaster. The Cato Institute provides a consistent voice for individual liberty and limited government in the Washington policy arena. Needing to conserve scarce resources, some European countries released triage guidelines recommending prioritization of treatment for patients who were determined to have a higher likelihood of survival. They point out that COVID-19 exposed the fragility of employment‐​based health insurance coverage. HHS oversees the Strategic National Stockpile (SNS), which originally maintained a supply of pharmaceuticals and vaccines for use in situations such as biological and chemical attacks that would quickly exhaust state authorities’ supplies. Join Facebook to connect with Hollis Cato and others you may know. You aren’t merely supporting our mission, you become a part of Cato. The question is whether the country’s experience with COVID-19 tips the scale in favor of Medicare for All by showing that universal coverage is needed despite its enormous downsides. “Lee scored poorly in this study because he has supported large spending increases,” the analysis reads. Consider its attempt to screen passengers and facilitate contact tracing by designating a small number of airports as entry points for Americans returning from China. Then, the need to track the spread of disease may require people who would not ordinarily seek treatments, including both healthy people and infected people whose symptoms are mild, to be tested. The Cato Institute is an American libertarian think tank headquartered in Washington, D.C. 6 talking about this. That is as true for health care as it is for goods and services of other types, such as sanitary wipes, toilet paper, peanut butter, bottled water, and other items that stores ran out of when millions of panicked buyers decided to stock up. Then, market forces would pressure providers to compete for customers by offering better services at lower prices. Countries with universal health care systems experienced these problems for the same reason the United States did. A response plan that subsidizes testing and treatment would make this problem less severe, at least for medical needs attributable to the epidemic. This danger is addressed with deductibles, copayments, and other arrangements that encourage moderation. The federal government was not ready for COVID-19, even though it has dealt with epidemics and pandemics for more than a century. Please call 1-800-767-1241 or email catostore@cato.org for discounted rates. Native American children have been removed from their families and communities for generations. The agency struggled to calibrate its own imperative to be cautious and the need to move fast as the coronavirus ravaged the country. … It failed to provide timely counts of infections and deaths, hindered by aging technology and a fractured public health reporting system. Twitter. Proponents believe that if Medicare for All had been in place when the pandemic hit, more people would have been tested, the spread of the disease would have been easier to track, and many lives would have been saved. ProPublica notes, “But it wasn’t until the week of Feb. 24—the same week that the U.S. would discover its first case of community‐​acquired COVID-19—that the CDC scheduled a training [session] for states on how to use the platform.” Getting the names and email addresses of the state employees who would use DCIPHER took even longer. Headlines Ron DeSantis wants E-Verify bill in 2020 for ‘public safety’ SB 664 has already been filed in the Senate and awaits a House companion bill. The cost of COVID-19 testing and treatment compounded the problem by discouraging people from seeking medical care. The primary lesson to be drawn from America’s experience with COVID-19 is that putting the federal government in charge of the health care system would saddle it with administrative responsibilities that it could not possibly handle. 1000 Massachusetts Ave. NW The CDC’s coordination with state and local public health authorities was also poor. Similarly, Congress and the president should reform the federal agencies that were responsible for the country’s fragmented and ineffective response to COVID-19, starting with the Department of Health and Human Services (HHS), which along with its component agencies has primary responsibility for responding to epidemics and pandemics. This essay is a part of the Pandemics and Policy series. The COVID-19 pandemic neither justifies putting the manufacturing sector under government control nor warrants a government‐​run health care system. Facebook. Canada ran short of drugs. The economic shutdown and resulting job losses meant that many people lost their health insurance coverage when they needed it the most. By Chris Edwards. In 2010, HHS sought to close the gap by hiring Newport Medical Instruments to build a fleet of inexpensive portable devices. “Attaining a 4‐​star rating verifies that Cato Institute exceeds industry standards and outperforms most charities in your area of work.”. Log into Facebook to start sharing and connecting with your friends, family, and people you know. The first lesson the pandemic teaches is that when the federal government mishandles a core responsibility, it should not be saddled with additional administrative burdens. Although failures occurred throughout the federal government and at the state and local levels, this discussion focuses on HHS because it would oversee Medicare for All. The government’s record of mismanaging the existing Medicare program makes the same point. Several governmental reports also noted that the SNS had far too few N95 masks. It was founded as the Charles Koch Foundation in 1974 by Ed Crane, Murray Rothbard, and Charles Koch, chairman of the board and chief executive officer of the conglomerate Koch Industries. Washington, DC 20001-5403, Invitations to exclusive online briefings with Cato scholars, Invitation to exclusive annual Cato Benefactor Summit, Invitation to an exclusive weekend retreat every fall with senior Institute policy staff, Mailings and emails from Institute President and senior staff. Admittedly, though, epidemics and pandemics do invert the ordinary logic of health policy. Rushed efforts to obtain ventilators and other medical equipment proved to be costly. It took HHS five years to finalize a new contract—too late to have the ventilators ready for COVID-19. Some of the failures involved inadequate or ineffective preparation for a pandemic, while others involved ineffective or irrational responses to COVID-19 once it appeared on our shores. Cato Institute It is magical thinking to believe that the same federal government that wasn’t ready for COVID-19 could efficiently handle the massive administrative burden associated with Medicare for All. The federal government also has never been able to control Medicare’s cost because special interests dominate the policymaking process. CATO SPONSORSHIP CATO INSTITUTE 1000 MASSACHUSETTS AVENUE, N.W. Overcharged: Why Americans Pay Too Much for Health Care. The initial version of the COVID-19 diagnostic test was faulty because of problems at the CDC’s lab. COVID-19 came out of the blue, but epidemics are an old problem. Receive periodic updates on Cato research, events, Third, epidemics and pandemics are exceptional events: arrangements meant to handle the normal level of demand for medical services should not be expected to address extraordinary situations. For example, it asked state officials to use a web platform called DCIPHER to report information about persons with suspected or confirmed infections. The C.D.C., long considered the world’s premier health agency, made early testing mistakes that contributed to a cascade of problems that persist today. The CDC also distributed the few kits that it produced equally to labs across the country without regard to the size of local populations. Join Facebook to connect with Joey Cato and others you may know. You can support the Cato Institute by shopping online through Amazon’s new AmazonSmile program. When its system went offline in mid‐​February and the flow of data stopped, local officials who asked how to handle incoming passengers were reportedly told, “Just let them go.” After reviewing hundreds of pages of internal correspondence, ProPublica wrote, “What comes through clearly is confusion, as the CDC underestimated the threat from the virus and stumbled in communicating to local public health officials what should be done.”. Policies designed to make health care as affordable as possible would serve the country well in ordinary times and during epidemics or pandemics. Receive periodic updates on Cato research, events, Official government reports going back to the early 2000s warned that the supply of ventilators in hospitals and the SNS fell far short of the number that would be needed in the event of an epidemic or pandemic. Since yellow fever killed about 10 percent of Philadelphia’s population in 1793, the United States has experienced over a dozen major epidemics, including scarlet fever, typhoid fever, Spanish flu, polio, measles, whooping cough, HIV, and H1N1. Washington, DC 20001-5403. But during an epidemic or pandemic, tracking and limiting the spread of disease require everyone’s participation—including uninfected people and people with mild symptoms who would not ordinarily seek medical treatment. Even though the federal government has dealt with epidemics and pandemics for more than a century, it was not ready for COVID-19. The Centers for Disease Control and Prevention (CDC), which is within HHS, has primary responsibility for responding to epidemics and pandemics. Daily dose of liberty delivered straight to your inbox. The effort was hampered by the CDC’s “decades‐​old notification system,” which could not handle the flood of information. In the short run, supply is fixed. You’ll have access to the latest Cato publications, reports, newsletters, and invitations to Cato events. A successful plan for dealing with an epidemic or pandemic would therefore subsidize (and might even reward) testing, treatment, and vaccination. The adage “never let a good crisis go to waste” provides one reason. A good start would be to improve the federal government’s ability to respond to epidemics and pandemics. The federal government was not ready for COVID-19, even though it has dealt with epidemics and pandemics for more than a century. Indeed, the CDC, originally called the Communicable Disease Center, was created to address the risk of an epidemic. To encourage people everywhere to better understand and appreciate the principles of government that are set forth in America’s founding documents, the Cato Institute published this p Thank you for supporting the Cato Institute through AmazonSmile! Its plan for scaling up production “didn’t envision engaging commercial lab companies for up to six months.”. Ordinarily, deductibles and copays are desirable means of encouraging people to use medical services wisely. The federal government “had dozens of such plans, totaling thousands of pages, issued by different agencies and different presidential administrations, with little thought to how they would be combined or who would implement them.” When critics condemned the Trump administration for ignoring the pandemic plans that the Obama administration left behind, the Trump administration responded by pointing to other plans that were developed more recently. When COVID-19 brought these shortcomings to the surface, a GAO representative told ABC News that it was “‘surreal’ to watch ‘many of the things we had predicted’ … take place.”. Twitter. Second, the U.S. response to the COVID-19 pandemic is a master class in government failure. Charles Silver is a law professor at the University of Texas at Austin. Cato relies on tax‐ deductible contributions from generous Sponsors who share our commitment to a free and prosperous society. No system that is sensibly designed to meet a population’s health care needs during ordinary times will have the capacity needed to handle an epidemic. The answer is “no,” for several reasons. Rather than give the federal government more things to do, we should ask it to do fewer things better. Before production started, Newport Medical Instruments was purchased by Covidien, a large device maker, which backed out of the contract in 2014. America’s health care system was not responsible for these problems. Because SARS‐​CoV‐​2, the virus that causes COVID-19, is a new variant, a new test was needed to diagnose patients and track its spread. First, the pandemic strained the health care systems of many countries, including those with universal coverage of the sort envisioned by Medicare for All’s proponents. And it hesitated in absorbing the lessons of other countries, including the perils of silent carriers spreading the infection. “At one point, a Food and Drug Administration official tore into lab officials … telling them their lapses in protocol, including concerns that the lab did not meet the criteria for sterile conditions, were so serious that the FDA would ‘shut you down’ if CDC were a commercial, rather than government, entity.” Also, because the CDC had not involved private labs, academic institutions, or other organizations capable of creating tests, there was no alternative development pipeline. work with the president to reform the federal agencies that were responsible for the country’s fragmented and ineffective response to COVID-19; ensure that the Strategic National Stockpile is supplied at a level sufficient to meet the immediate needs for medical equipment and supplies that an epidemic such as COVID-19 can be expected to generate; fund financial incentives that encourage people to be tested for COVID-19, to seek available treatments, to self‐​quarantine, and to participate in contract tracing efforts; and. It would also be wildly inefficient because it would increase losses from fraud, waste, and abuse by hundreds of billions of dollars. View the profiles of people named Joey Cato. But they may be counterproductive when an epidemic occurs. They see the pandemic as an opportunity to advance their preferred policy agenda. COVID-19 also revealed to many people a long‐​standing problem with employment‐​based health insurance. When you support the Cato Institute, you are … Disaster preparation is a core responsibility of government. sponsors@​cato.​org. When patients arrived at hospitals, overworked medical professionals did the best that they could with the available resources. Facebook. In 2015, the government projected that between 1 billion and 7 billion masks would be required in the event of a flu‐​like pandemic, depending on the severity of the outbreak. Instead, reform should focus on improving the performance of the federal agencies that were responsible for the country’s fragmented and ineffective response to COVID-19. If Medicare for All were a cure‐​all, then countries with universal coverage should have fared better than the United States in adapting to the surge in demand caused by COVID-19.
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