Politics. If 2020 is likely remembered for something other than the COVID-19 pandemic, it will be as the terminus of a reductive process in American politics spanning several decades that has distilled complexity and nuance down to mere signs and symbols. Veneration of these modern icons has been enforced by social media mobs of uncertain provenance and “experts” whose constant attendance on cable news would seem to rule out any time to nurture actual expertise.
While it seems unlikely 2021 presents many opportunities for a reformation, it is possible some modern version of Martin Luther’s 95 theses has already been metaphorically nailed to the cathedral door. Only a certain class of Americans have the luxury of real or feigned adherence to facile positions like “Zero COVID,” “Medicare-for-All,” and “Defund the Police.” The rest of the country is trying not to slip further down the letter K’s leg.
The gap between what voters want and expect from political leaders and what pollsters, talking heads and pundits say they want has only grown these last few months. As I write this my fellow Nashvillians are cheering six police officers who, in less than 15 minutes on Christmas morning, cleared a two-block area of sleepy residents before 63 year old man detonated a car bomb that carried a force second only Oklahoma City’s all the while blasting a countdown and Petula Clark’s 1965 hit, “Downtown.”
Ask anyone around this town if they support changes to criminal justice and the answer will mostly be “yes.” Defund the police? That is a hard “no.” Therein lies the opportunity in 2021 for original ideas, innovative solutions and some new faces in the wasteland that is American political discourse.
Policy. The coming year brings the promise of reversing one of the most cynical and immoral public education policies ever imposed on America’s children, particularly those in large urban public systems disproportionately serving the poor. Last week, president-elect Joe Biden named Connecticut State Education Commissioner, Miguel Cardona to be Secretary of Education.
While America’s work-from-home class has quietly adapted by moving their children to open private schools, developing learning pods or reducing work commitments to home school, Cardona has correctly pointed out the “education disaster” being served up to the economically challenged in the form of local COVID-19 responses. Cardona has consistently pushed local school districts to reopen and provided data collection and disclosure to support those decisions.
The loss of learning days and the commensurate impact on earning power; the deferral of critical health care interventions like vaccines and mental health counseling; and the termination of surveillance for physical and sexual abuse all have implications that continue to accrue, with consequences that are merely guesses at this point. Forcing a few million women out of the workforce, while a positive for $AMN, has drastically limited health care capacity and spread the effects well beyond America’s 56 million school children.
These things are all known and have been for some time. Even in a fluid environment, the data has consistently signaled low risk for school age children and even teachers and staff. Yet, in an era of bots and fake social media accounts, sketchy websites purporting to offer public health guidance and change.org petitions at the ready for those who don’t fall into line, it takes a certain amount of courage to demand state and local governments meet one of their most fundamental obligations.
To be fair, Biden’s nomination of Cardona and his pledge to have most schools open within his first 100 days is bubble-wrapped in caveat. Based on press accounts, returning most children to the classroom by April 30 is predicated on a massive testing program and additional funding for state and local governments, the latter of which has been a showstopper up on Capitol Hill.
We should also note that Cardona’s advocacy isn’t very different from that of current Education Secretary Betsy Devos.
He just stands a better chance of being believed.
Power. We are hardly nationalists here at Hedgeye. Were the summer months not the giveaway, from time to time it seems we may have moved the 49th parallel down to Long Island Sound. As everyone knows who has read this weekly review since June, our constant study of American health care makes us a bit biased. Far from perfect but better than almost everything else, the American political, economic and social systems have leant themselves well to innovation, especially in the critical areas of science, medicine and technology.
Fueled by half a trillion dollars in stimulus and relief spending, 2021 promises to be the beginning of long run for American medical, scientific and advanced manufacturing power. Yes, firing up the printing presses to make that kind of money has implications for the dollar’s strength. Unlike stimulus checks that maintain economic status quo, the money that has flowed into research at the Department of Energy and the National Institutes of Health will reverberate for years to come.
Applying the mRNA platform technology to a variety of medical needs from oncology to infectious disease and biodefense against toxins like Shiga has now been accelerated by years, perhaps decades. Similarly, advances in diagnostic testing like point-of-care and at-home PCR tests are poised to make the health care system more efficient and thus more innovative as they reduce its dependency on centralized labs like $DGX and $LH. Finally, the real-time, decentralized clinical trial approach made necessary by COVID suggests a world where discovery can move faster than ever before. These and others are all things that with reverberate for decades bringing advances in science and health at a speed unimagined before.
The timing is important. Much of the world has awoken from its somnolence to question a dependency on China that often trumped the most basic principles of western nations, like the preservation of human rights and the protection of intellectual property. Cheap goods and free infrastructure, at least historically, have been no match for advances that make humanity safer, healthier and, ultimately more prosperous.
Were it not for our dogged self-loathing, we might dare to call this the next American Century.
Happy New Year!
Emily Evans
Managing Director – Health Policy
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