Come for the politics, stay for the snark.

The cruelty is the point; the law be damned.

Let there be snark.

It’s not even safe to go out and pick up 2 days worth of poop anymore.

Fuck if i know. i just get yelled at when i try it.

Peak wingnut was a lie.

Come for the politics, stay for the snark.

Today in our ongoing national embarrassment…

I swear, each month of 2020 will have its own history degree.

The math demands it!

Everybody saw this coming.

If senate republicans had any shame, they’d die of it.

Naturally gregarious and alpha

When I decide to be condescending, you won’t have to dream up a fantasy about it.

‘Forty-two’ said Deep Thought, with infinite majesty and calm.

It’s always darkest before the other shoe drops.

This blog will pay for itself.

The house always wins.

Accused of treason; bitches about the ratings. I am in awe.

This really is a full service blog.

Proof that we need a blogger ethics panel.

Four legs? good! two legs? we’re not so sure…

I thought we were promised Infrastructure Week.

Balloon Juice has never been a refuge for the linguistically delicate.

Our job is not to persuade republicans but to defeat them.

You are here: Home / Archives for Healthcare / COVID-19 Coronavirus

COVID-19 Coronavirus Update (Domestic Politics) – Tuesday/Wednesday, March 10/11

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Think I’m gonna split this into three parts tonight — look for separate ‘International’ and ‘Informational’ following posts.

This story is getting retweeted a lot, read it for yourself:

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Surprise billing in a pandemic?

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The major insurers are acting in good faith in that they are moving to waive member cost sharing for COVID-19 testing.

All Blues are waiving the cost sharing.

This is a needed step so that testing and treatment do not face cost barriers.

But this is only on the consumer-insurer cost-sharing interactions.  No cost-sharing on needed testing effectively makes the demand curve nearly vertical.

However, it is an incomplete step as these actions are not addressing the insurer-provider contractual relationships of in network or out of network charges.  OON charges lead to balance billing opportunities.  Balance bills consist of the difference in what an OON provider charges and what an insurer pays.  That increment can be sent to the patient.  Not all OON provider groups will balance bill but some do and may.

The Health Care Cost Institute (HCCI) examined out of network (OON) billing for commercial groups last year.  They found different prevalence of OON billing that varied by geography and specialty. OON billing is an opportunity for a provider group to engage in balance billing and therefore the creation of surprise bills. I want to examine specialty.

From their data, the most common specialty to have an OON bill is an independent lab. The second most common Emergency Medicine.

COVID-19 requires a lot of testing.  Some people will be using lots of emergency services provided by EM docs.

We should expect a significant amount of testing and ED services to be provided by OON providers.

Some of them will be reasonable decent actors.  Others will have a strong incentive to balance bill and hope that they can get to the airport before either a mob with pitchfork and hot torches or the FBI can reach them.

 

 

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About Robert Redfield, Director Of The CDC

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We still don’t know why the CDC decided to develop its own test for SARS-CoV-2. If the dysfunction persists, it’s a danger to other decisions being made about the epidemic. But, like the number of Covid-19 cases in the United States, we just don’t know.

The director of the CDC, Robert Redfield, was involved in the decision, but we don’t know how. It could be anything from a definitive order to passing it off to someone else, which is a decision too.

Redfield’s background is in the military and a university, as a clinician and researcher. Before he came to CDC, he had no experience in directing a public health agency. His research is in the area of HIV/AIDS. While in the military, in the 1980s, he called for mandatory HIV testing of recruits and segregating HIV-positive personnel, a move opposed by medical authorities at that time.

Also in the 1980s,

Redfield worked closely with W. Shepherd Smith, Jr. and his Christian organization, Americans for a Sound AIDS/HIV Policy, or ASAP. The group maintained that AIDS was “God’s judgment” against homosexuals, spread in an America weakened by single-parent households and loss of family values.

With ASAP, Redfield backed a House bill that would have effectively quarantined people with HIV. The bill died in Congress. Redfield also backed a developmental AIDS vaccine, lobbying Congress to fund a $20 million clinical trial. The vaccine and Redfield’s lobbying failed. ASAP is now known as the Children’s AIDS Fund, and Redfield was on its board in 2018 when he was named CDC director.

In last Friday’s press conference at the CDC, Redfield offered his adulation to Trump. Not a good look for someone who is supposed to be a scientific advisor.

Before Redfield was made director, the CDC was in turmoil from a poor decision on its director and continuing budget cuts. Thomas Frieden, appointed by Barack Obama, resigned in 2017. Six months later, Donald Trump appointed Brenda Fitzgerald, state health commissioner in Georgia. Fitzgerald’s directorship dissolved in revelations of a grant to a company that she and her husband held stock in and other conflicts of interest.  

Those disruptions may have made CDC more susceptible to poor decision-making.

Cross-posted to Nuclear Diner

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COVID-19 Coronavirus Thread: Universities Face Quarantines

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Pulled all this out, as being of immediate interest to some portion of the Jackaltariat:

… Several universities have been circulating guidance to faculty about how to teach via online methods during an emergency. Guidance from the University of California, Los Angeles, to faculty noted that the administration has purchased more licenses for Zoom. The university also drew attention to a lockdown browser available for faculty to use during assessments, which provides a full audio and video recording of the test attempt.

Faculty have similarly been circulating their own guidance to peers about how to teach online on the fly, sometimes with step-by-step instructions. Instructional design and technology administrators have emphasized that temporarily moving in-person classes to remote learning is different from designing and developing a course that is completely online.

“Teaching well online requires a much more intentional arc of planning and learning around design and pedagogy,” Penelope Adams Moon, director of online learning strategy at UW’s Bothell campus, posted on Twitter. “We need stop-gap measures, but they aren’t the same as online teaching.”

Sean Michael Morris, director of the Digital Pedagogy Lab at the University of Colorado at Denver, advised instructors to rethink grading around participation and attendance…

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Harvard closing campus

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Harvard has world class epidemiology, infectious disease and public health talent readily and abundantly available.

Harvard has a global footprint.

Harvard as an institutional will not be consumed by Trumpian dignity wraiths.

Other large, globally branded universities are making similar decisions.

As the big, globe spanning and influencing private universities are making decisions, I think paying attention to their actions and decisions is a productive source of revealed preferences and good faith information.

The CDC is telling people at high risk to start getting ready for isolation in place:

“This virus is capable of spreading easily and sustainably from person to person … and there’s essentially no immunity against this virus in the population,” Dr. Nancy Messonnier, director of the CDC’s National Center for Immunization and Respiratory Diseases, told reporters on a conference call….

The CDC is recommending people with underlying conditions or who are over 60 to stock up on medications, household items and groceries to stay at home “for a period of time,” she said. The U.S. government recommended travelers with underlying health conditions avoid taking any cruises anywhere in the world. “We also recommend people at higher risk avoid non-essential travel, such as long plane trips,” she said….

a top CDC official said Monday, recommending that people over 60 and anyone with chronic medical conditions buckle down for a lengthy stay home.

Treat right now like the few days before a hurricane comes ashore in terms of prep.

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COVID-19 Coronavirus Update (Domestic) – Monday/Tuesday, March 9/10

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And here we thought alcohol killed viruses…


(So has Ireland, but TBH Paddy’s Day parades are a recent, mostly tourism-based event in the Auld Sod. They’ve been a massive fixture here in Boston, and later NYC, since the 1700s. They started as a form of political protest — like a precursor of the Black Lives Matter marches.)

Speaking of public clownshows…


Since I’ve been doing this seven days a week, and update right around close-of-business hours for Asia, arguably Balloon Juice is doing a better coverage job than the Trump admin allows the CDC. Blessed!

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