Biden promises a new vision for health care

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NEW YORK — The presidential election has changed who will be the leader of the free world, but it hasn’t changed the fact that the COVID-19 pandemic isn’t going away and will be waiting for President-elect Joe Biden when he takes office on January 20.

As it was during the election, COVID is certain to remain a top issue as the Biden administration sets out to deal with the pandemic that since March has spread and spiked across the country with abandon. What’s also certain is that the incoming president will approach the virus — and health care in general — differently than the outgoing one.

During the campaign, candidate Biden promised to “follow the science” as well as use more aggressive federal action to combat the virus. Biden, unlike President Trump, has encouraged mask wearing and proposed a national mask mandate, although such a mandate would be hard to enforce outside of federal property. Still, the messaging itself signals a stark contrast in how Biden’s team would tackle the pandemic.

Even before the election, Biden was putting together a plan for the pandemic, and he recently unveiled the members of his COVID-19 task force, which is comprised of notable former government health officials, academics and medical professionals. The task force includes Rick Bright, the former head of the vaccine development agency BARDA, who was fired by Trump in April; Atul Gawande, surgeon and former chief executive officer of Haven, the joint JP Morgan Chase-Berkshire Hathaway-Amazon health care venture; and Luciana Borio, a former Food and Drug Administration official and biodefense specialist.

Biden has said this team will work with state and local health officials on halting the spread of the virus and safely reopening schools and the economy. The task force will also look into how the virus has disproportionately affected communities of color.

“Dealing with the coronavirus pandemic is one of the most important battles our administration will face, and I will be informed by science and by experts,” Biden said in a statement. “The advisory board will help shape my approach to managing the surge in reported infections; ensuring vaccines are safe, effective, and distributed efficiently, equitably and free; and protecting at-risk populations.”

But it’s more than just COVID. Biden has made it clear he has a different view than Trump on the issue of health care overall and that the Biden administration is almost certain to bring changes.

For one, Biden has pledged to reverse Trump’s course of scaling back federal investment and involvement in health care by building on the Affordable Care Act, or Obamacare, the landmark legislation signed into law by President Obama when Biden was vice president. Along with working on a national COVID strategy that includes testing and tracing, Biden wants to make good on a campaign promise to create a public option — essentially a Medicare-type insurance plan that Americans would be able to buy into regardless of age.

The benefit of a public option is that the cost of insurance through such a plan would be substantially less due to the government’s enormous leverage in driving down the prices of both physician and hospital visits as well as prescription drug prices.

For example, Medicare pays hospitals about half of what private insurance companies pay, so a public option at Medicare prices would be much less than private insurance plans. Also, a government-sponsored plan would not have a profit margin, which would go to further lowering premiums.

But before Biden can build upon Obamacare it has to survive its latest challenge in the Supreme Court. Justices have already begun hearing arguments in the most recent effort to strike down the ACA led by the Trump administration and several Republican-led states. The basis of the plaintiffs’ argument centers once again on the individual mandate, despite prior congressional action essentially rendering the mandate ineffective.


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