Editor's Note: This is a complimentary research note published by Healthcare Policy analyst Emily Evans. CLICK HERE to get COVID-19 analysis and alerts from our research team and access our related webcasts.
Official Washington’s four-year yearning for 12-point plans was satisfied last week when president-elect Biden released one for COVID-19 vaccinations. For many, at least those that think it’s 1932, the plan has conjured up visions of direct federal response. In fact, it is much more sensible.
Biden’s plan calls for expanding vaccine production using the Defense Production Act if necessary. It also proposes to provide better information to states on manufacturing, shipping and supply. The plan promises funding for as many points of access as can be developed like pharmacies, Federally Qualified Health Centers and mobile units. The president-elect has also proposed financial support for the National Guard’s assistance. Several states, including Texas and Tennessee have been using the Guard with great results.
What the plan does not do, as many have suggested with complaints about 50 separate responses, is alter the federal-state partnership for vaccine distribution. States will continue to coordinate their programs with perhaps more federal money and better information than they have today.
Because Joe Biden has been in politics for a very long time, his goal of 100 million vaccinations in 100 days must and will be achieved. He also knows that revamping a massive logistical operation already underway is a certain path to failure. Instead, he is following the current deployment with a bit of rebranding and a more collaborative attitude toward the states.
Although building on the work of his predecessor who-shall-not-be-named, Biden will get credit, and an early win which are both good politics and sound policy. April should be a lovely month.
American science and innovation in the service of national ambitions is forceful combination with a long history of advancing the human condition around the globe. The Human Genome Project, the Mercury and Apollo programs at NASA, and the Manhattan Project at Oak Ridge, to name a few, have made their mark on advances in energy, nutrition, medicine and manufacturing and have been driven in whole or in part by a national ambition to be first and best.
In fact, there is an argument to be made that innovation void of any purpose brings only tears. What social good does Facebook offer? If it disappeared tomorrow, would it matter?
Facebook is not much more than an electronic version of the 20th century’s News of the World that featured stories of alien abduction and two-headed babies at the grocery checkout line. As the last few weeks have demonstrated, often it is much, much worse.
President-elect Biden’s elevation of the Office of Science and Technology Policy to the cabinet level and the appointment of Eric Landers as Director seems to suggest it is long past time for American politics and policy to align themselves better with science and innovation. Landers, trained as a mathematician but with a career that meandered through cellular biology, microbiology and eventually genetics, has the stature and reputation missing from Washington debates the last decade or so.
The appointment and the elevation of the office to the cabinet level has the potential to bring into balance the heavy politicization of science and health policy, with often deleterious results. Perhaps also, innovation can be more than “snap this” or “chat that” and yet another Instagram influencer from Miami.
On Wednesday, the 59th inauguration of a U.S. president will take place under the watchful eye of 21,000 National Guardsmen/women. A depressing thought until you recall that they were sent by their governors, all of varying political persuasions, to protect a process, the people participating and the buildings that embrace both.
Not exactly a harbinger of civil war.
The first order of business is, of course, the COVID relief package the president-elect announced last week. Demonstrating that 40 years in Washington taught Biden how to use a crisis, the package is part pandemic response, part social programs and part economic relief. The pandemic relief portion would add about $160 billion for vaccine development and deployment; testing and lab capacity; an increase in public health workers; genomic surveillance; and purchase of PPE. This amount would be on top of the roughly $520 billion already injected into diagnostics, services, and research.
The proposal also includes provisions to provide one-time relief checks of $1,400 and an extension of Unemployment Insurance until Sept. 30, 2021. While not directly connected to health care these benefits are relevant to the nurse labor disruption of the last year.
Nurses, who are frequently the second income in their household and often primarily responsible for child care have been able to stay out of the workforce in part due to government assistance and driven by the need to support remote learning. An extension of unemployment assistance is likely to attenuate shortages that are now being met by $AMN and $CCRN.
The deficit hawks, badly in need of changing the subject while not alienating all of the 74 million people that voted for Domald Trump, will lament the price tag and probably fight some of the social programs. That approach should leave the health care provisions intact, which means the wave of money washing through the sector will only grow larger. It is worth arguing also that this spending is akin to an infrastructure program with muliplier effects that are hard to estimate. Advances in testing, therapeutics, research and on-shoring of PPE will ripple through the US and global economies for years to come.
Not the worst thing in the world.
In the spirit of Dr. King, whose legacy of non-violence seems especially important to ponder this weekend, I leave you with his hopeful outlook from his 1964 Nobel Lecture in Oslo:
"In spite of the tensions and uncertainties of this period something profoundly meaningful is taking place. Old systems of exploitation and oppression are passing away, and out of the womb of a frail world new systems of justice and equality are being born. Doors of opportunity are gradually being opened to those at the bottom of society."