Experts examine health policy and politics in a pandemic world

By Michael R. Malone

Experts examine health policy and politics in a pandemic world

By Michael R. Malone
Public health experts from the U.S. and Latin America, along with health industry representatives, convened to analyze the policy and politics relating to the pandemic as part of the “2021 Business of Health Care” conference, hosted by the Miami Herbert Business School.

With an aim to remedy the health, economic, and societal ills accentuated by the devastating COVID-19 pandemic—even as the virus again surges in different areas of the United States and Latin America—health experts explored a range of topics at the virtual half-day Business of Health Care conference on April 16.

Steven Ullmann, director of the Center for Health Management and Policy at the University of Miami Patti and Allan Herbert Business School, launched the 10th annual conference, themed “Policy, Politics, and the Pandemic—the U.S. and Beyond,” welcoming the more than 1,200 registered viewers. University President Julio Frenk provided opening remarks. 

“The most striking aspect of this pandemic is the huge variation in national responses and in their corresponding results,” said Frenk, a renowned global public health expert, adding “yet that variation provides an opportunity for shared learning.”

Frenk highlighted that the “confluence of crises” in the region—public health, financial, and social—exacerbated by the pandemic has revealed that health is “not just a result of economic development, but one of its key determinants.”

A former health minister for Mexico, Frenk said that while he expects the region will address the first two crises “within the next 12 to 18 months,” the social emergency is not going to go away anytime soon.

“There is much talk about a ‘new normal,’” Frenk said. “Yet I believe we have a once-in-a-century opportunity to build a better normal—and we shape it with the decisions we make today.”

In a headline Q&A session, Donna Shalala, the longest serving U.S. health secretary, a former congresswoman and former University of Miami president, questioned Alex Azar, health secretary for the former Trump administration, on his role in the U.S. initiative to develop a vaccine to combat the coronavirus, transparency in drug pricing, the current Biden administration’s health care agenda, and U.S. support for public health efforts in Latin America.

In detailing his participation in “Operation Warp Speed,” Azar said that his prior experience in government as legal counsel in helping biological and chemical countermeasures for a previous flu and his 10 years as an executive in the pharmaceutical industry were critical in helping to coordinate an effective response team.

“Understanding the risk-adverse nature of the pharmaceutical industry and the power of government to do industrial planning defense department-style served me to bring the many partners together and do the unprecedented—which was the largest public-private biomedical enterprise in the history of the world,” Azar said.

The notion of alliances, partnerships, and sharing information was a key component of the conference.

Carissa Etienne, director of the Pan American Health Organization, moderated the initial session on “Health and the Economy in the Americas” with health ministers Daniel Salas Paraza of Costa Rica, Enrique Paris of Chile, and Daniel Salinas of Uruguay.

Etienne noted that while the region as a whole became the epicenter of the pandemic, these three countries, “exemplars of enlightened polices,” managed the crises far better than others. The ministers highlighted that they continued to share information.

Salas noted that Costa Rica has been able to leverage its existing universal health care coverage to “enormous advantage” and emphasized the importance of leaders encouraging trust within their populations, especially in times of crisis, by providing appropriate information and showing themselves to be empathetic and having the ability to accept feedback.

Pat Geraghty, president and CEO of Florida Blue—a principal sponsor of the health care conference since its onset—moderated a panel of executives of leading professional U.S. health organizations. The session included Susan Bailey, president, American Medical Association; Matthew Eyles, president and CEO, America’s Health Insurance Plans; Joseph Fifer, president and CEO, Healthcare Financial Management Association; Halee Fischer-Wright, president and CEO, Medical Group Management Association; Ernest Grant, president, American Nurses Association; and Lisa Kidder Hrobsky, group vice president, federal relations, American Hospital Association.

The group highlighted the critical importance of federal government support to the health care system through the pandemic, yet noted the existing “sobering realities” and huge challenges ahead.

Grant detailed a series of surveys indicating increases in mental health concerns, fatigue, and burn-out among nurses and health care workers, generally.

“Burn-out was high before and has increased,” said Bailey, emphasizing that “it’s a situational issue, not a moral failing or personal weakness.” Several of the panelists highlighted that the stigma of health care workers seeking support for such issues is a problem that needs to be addressed.

In terms of vaccine hesitancy among nurses and health care workers, Grant highlighted that hesitancy, as with the general public, has been reduced by providing accurate information and education.  

“What we have seen is that once their questions were answered and they understood how vaccines work, not only are nurses and health care workers lining up to get their vaccines, but they are also becoming hugely important in encouraging consumers to sign up as well,” he said. 

And again, as they did at the last business of health care conference, the representatives of leading U.S. health care sectors expressed unanimous support for continuing and expanding the Affordable Care Act.

“We’re still bullish on the ACA and believe in its continued evolution and making permanent some of the changes,” Geraghty said. “Everyone should have coverage, and universal health coverage shouldn’t be up for debate—the only debate should be how to do it well and effectively.”