When it comes to health care, our political system has been locked in a debate over Obamacare while far more modest — but crucial — reforms have gotten little attention. This policymaking failure has had real, dire consequences during the Covid-19 pandemic.
In fact, many regulations originally designed to expedite our country’s response to a health crisis have ended up delaying it. For example, the University of Washington and other research centers developed their own tests, but were delayed for weeks by arcane rules, such as a federal Food and Drug Administration requirement to send paperwork by snail mail.
Other outdated regulations proved similarly harmful. FDA regulations also initially prohibited academic labs from testing for the virus altogether. Others from the Centers for Medicare & Medicaid Services blocked most Medicare patients from using telehealth to see their doctors from the safety of their homes. Still other state-level restrictions limited the ability of doctors to treat patients across state lines and hospitals to add more beds.
To their credit, federal policymakers and governors of both parties relaxed many of the most harmful regulations, but only temporarily. Making them permanent — as well as eliminating others that have long outlived any supposed usefulness — will be a far more difficult task.
Ensuring America’s health care system is better able to respond to this pandemic — and to provide more access to affordable care in more normal times as well — requires a top-to-bottom reevaluation of the federal role in health care, with a focus on fixing regulations that act as barriers to better care.
But how can lawmakers enact reforms on such a polarizing issue — and during an election year? Our experience shows there is an effective model that could meet this challenge, one that already has the backing of groups as philosophically diverse as the Progressive Policy Institute and the free-market Mercatus Center at George Mason University — a national commission.
We served — one of us as chairman, the other as a legislative aide — on a national commission that modernized another of America’s most important, yet politically sensitive, assets: our network of domestic military bases.
When the Cold War ended, our country’s defense priorities changed from deterring a Soviet attack to confronting more modern security challenges, making many of America’s military bases obsolete. Closing them required overcoming two daunting obstacles.
First, parochial political interests tended to supersede the public interest. Members of Congress worried that if the local military base closed, it would result in economic damage their opponents would use against them. Reforms also faced “congressional inertia.” With 100 senators able to deploy procedural maneuvers and all 535 members of Congress able to trade off key details, bills would essentially get debated to death or watered down to the point of being meaningless.
Congress addressed these problems in 1988, when lawmakers from both parties agreed to impanel the Base Realignment and Closure Commission (BRAC). Made up of independent defense experts, it was charged with recommending to Congress a list of military bases no longer needed. Importantly, lawmakers were required to take an up-or-down vote on the entire package — no amendments, no gimmicks.
This proved a resounding success. Five BRACs were empaneled between 1988 and 2005, resulting in the closure of nearly 350 no-longer-needed installations. According to a 2017 Pentagon report, those closures now save $7 billion every year and, more important, they strengthen our national defense by focusing resources more efficiently.
Covid-19 represents a similar watershed moment for modernizing American health care. As with base closures, parochial political interests are a persistent barrier to health care reform. And once the immediacy of the current crisis begins to subside, congressional inertia will also set in. Even popular reforms can take years and multiple Congresses to enact. The 2018 legislation giving terminally ill patients the right to try potentially life-saving medical treatments, for example, took four years to pass — despite the fact that nearly 80 percent of Americans supported it.
A BRAC-style commission is uniquely capable of overcoming these challenges. It would be comprised not only of lawmakers, but also doctors, scientists, health care experts and innovators who have firsthand experience with the problems they are solving — and don’t have political skin in the game. Requiring an up-or-down vote on a final package of recommendations would shield commonsense reforms from needless delays.
Some say this sort of commission lacks accountability and public transparency. Not true. Lawmakers still vote on the rules for the commission. They still vote on final reforms. And the commission would be open for public comment — with all proceedings open to the public, too.
Others question whether regulatory reforms can meaningfully hold down costs and expand access to high-quality care — the top two concerns cited by Americans today, and the stated goal behind “Medicare for All,” a public insurance option, and other forms of government-run health care programs.
Multiple examples show the answer is yes.
Telehealth-based programs in the Veterans Health Administration have reduced hospitalizations by up to 40 percent and saved $6,500 for every enrollee. Beyond the VA, studies show digitally delivered care typically costs about half that provided in doctor’s offices and urgent care clinics. Others show it can dramatically reduce emergency room visits for patients with high-risk chronic conditions. Within just two months of Medicare approving more than 80 new telehealth services in response to the coronavirus, more than 11 million people had begun using them, while doctors’ offices report 50 to 175 times more tele-visits than before the pandemic.
Beyond telehealth, the regulatory waivers have sparked innovation that has saved lives. Drones are now delivering personal protective equipment and other medical equipment in North Carolina. Waivers from CMS have eased access to ventilators. These are just a couple of examples that show the revolutionary benefits of modernizing our health care.
To be sure, a BRAC-style commission will not fix every problem with Americans’ health care. But by removing a post-pandemic regulation review from the day-to-day political fray, it will better enable public servants to enact reforms that will save more lives now and in the future.
Trevor Noah and Lilly Singh Compare Notes on Politics and Comedy in Late-Night TV – Variety
Noah says he has been looking at some of Singh’s YouTube videos as he’s been hosting Comedy Central’s “Daily Show” from home, and “A Little Late’s” Singh keeps tabs on how Noah handles talk about politics and national affairs.
Here, they get to compare notes as Variety brought them together for a conversation about how to produce a late-night show during a pandemic and balance comedy with commentary on tough issues that face the nation these days.
Lilly, you just finished your first season on your show, and Trevor, not too long ago, you were the freshman late-night host. What was it like for both of you to be under so much new scrutiny?
Trevor Noah: So my first year was horrible. I will say the first two years were horrible — and it was horrible because I had taken over one of America’s most beloved institutions. And even though Jon Stewart had passed over the reins to me, it was essentially a year of people telling me I shouldn’t be doing the job and I was unworthy of being in that seat. And I continued to believe that. You step into this new role and you’re doing a new job and most of the first year was just trying to stay afloat, just trying not to get canceled and trying to find my footing. And the analogy I use is trying to learn how to fly a plane while the plane is flying. That’s what it felt like every single day.
What I’ve come to realize in hindsight is I was up against so many obstacles that I never thought of before. I was taking over a show and was a different person, which is hard enough. Any show that changes hosts is going to struggle. A new host is going to rattle people. Then you have extra factors: You come from another country. You sound different and one of the biggest things that I took for granted was you look different. A lot of people had been used to getting their late-night news from a face that looks a certain way. I see now that must have been jarring for viewers — to go from having the face that you know to having someone like, “What are you doing on my screen?” Sometimes, it’s not even something that people are consciously thinking of [but they’re] not used to having a person like you. So, yeah, the first year was just me desperately trying not to drown. It probably wasn’t the happiest year of my life, and I think the only reason I appreciate it is because my mom always says, “You don’t get stronger unless you struggle.”
Lilly Singh: To hear you had a hard time honestly, selfishly, makes me feel a little better. It’s really hard and the analogy of trying to figure out how to fly a plane is absolutely correct. Before I started my first year, in a previous interview, you told me, “Don’t let anyone tell you it’s not going to consume your life, because it’s going to consume your life.” And you were the only person bold enough to say it to me like that. I had anticipated obstacles: Yeah, it will be a lot of work, maybe there will be some scrutiny — but there were so many obstacles I never even thought about, because I just didn’t have the knowledge to know they would be obstacles. Just looking different and being different has been challenging. You’re talking about your skin color too much. You’re talking about your sexuality too much. And it’s really trying to navigate how to be authentically you when people are not used to authentically you. It really is super challenging.
For decades, late-night hosts were largely cut from the same cloth, namely white men. In recent years, that has started to change. How do you see representation evolving over time?
Noah: I don’t get angry that it’s only been white men. I also think about how American society was shaped, what people perceived a comedian to be, who people perceived a comedian to be. As audiences change, you’ll start to see diversity and as networks become more open, their audiences will adjust over time. As audiences change, you’ll start to see diversity and as networks become more open, their audiences will adjust over time. There will be a domino effect that just keeps on going. I don’t want to live in a world where there are no white late-night hosts — I’m not looking for erasure — I’m looking for a world where there are more late-night hosts.
Singh: I can only say that not every story has to be about everyone, but there should be stories for everyone. I think it’s not, “Let’s get rid of all the white late-night hosts, and let’s get rid of all the shows,” but “Let’s have shows that represent other people.” If I had this great story about this Indian girl in high school, I don’t want to hear, “Oh, but we already have Mindy Kaling’s ‘Never Have I Ever,’ so we can’t do this.” I think that part of the problem is that just because there’s a show about someone who’s brown on Netflix, it doesn’t mean that there can’t be another story.
The coronavirus pandemic has changed all of late night; Lilly, you taped many of your episodes before things spread, and Trevor, you are doing all your shows from your apartment. What do you think audiences want to see from late night?
Noah: I think audiences are less concerned by what they see on TV and more concerned by the world they are living in. I always think that entertainment is oftentimes a welcome release from the world that is real, but when the world that is, really is almost too real and happening all the time, then people and audiences are in a very different space. For me, it’s different, because I’ve said from the beginning, the one thing I’ve said about working on ‘The Daily Show,’ and I was lucky enough to join when Jon was still working, I grew up in a very political country. I grew up as a very political comedian, even though I don’t consider myself that. If you watch my earliest stand up, I’m talking about American politics, I’m talking about South African politics. That’s just been me, So that’s what ‘The Daily Show’ does. I haven’t been so stressed in terms of thinking about content during this moment, because I live in the world of the news. I try to provide context; I try to distill it. If I think people are looking for anything from my show, they are looking for a clarification — what everything means. That’s what people want because that’s what I want. We are living in a world where nobody agrees on a fact. People are allowed to live in completely different realities, and what that creates is uncertainty that I think it’s already uncomfortable for human beings, because you don’t get to establish what your base level really is.
Singh: Comedy is such a good vehicle to talk about things that are difficult to talk about. People put down their defense mechanisms a little bit more. Right now is such a challenging, difficult and unique time. Usually, when people want to escape from their day they want to dive into comedy. I just think the desire to escape is not there anymore. I think people don’t want to escape. They want to acknowledge the real world and they want to help change it and they want to address what is happening. I think a lot of other comedians have just been providing space, honestly.
Where do you think things go from here?
Singh: The good news about what I do, if there is any good news during COVID, [is] when you see late-night hosts doing things from home. I say, “Baby, that’s what I’ve been doing my whole life.” I’ve been an advocate for “story comes first.” You don’t have the high production values, but you have people saying things that matter. What I’m looking forward to is working on things that are just that — something people really care about, that I feel really good about. It’s been a little challenging, I won’t lie, not being on the air during this time, because it’s strange to see my [older] episodes that are out there, where no one is wearing a mask and sometimes I am hugging my guest. I’m literally cringing watching myself doing this.
Noah: When I chose to do the show from home, one of the interesting things I looked to was people like Lilly. People like Lilly Singh are now the veterans and I am now the amateur. How do you make this thing? How do you create something with nothing? It’s frustrating but it’s liberating. I hope that now people like Lilly will have more leeway to be more Lilly as opposed to the TV world telling Lilly to be more TV. Now we’ve all become more YouTube.
Singh: I got my start on YouTube, but I grew up with TV and I grew up with stars. When I got my late-night show of course, TV is a big crew. When I went in, there was definitely a struggle. There was a crew, so many people behind the script and so many people telling me what punchline was funniest. It definitely challenged me to kind of mesh these two worlds together. The first season really reminded me of “first video on YouTube Lilly,” like someone just trying to figure it out, not really sure. I want to bring more me. In season one, I was not completely sure how to navigate that, because I was in a world where everyone has a desk and everyone does things a certain way and everyone does a monologue, and I did not know how to do anything else. As this show progresses, It’s going to become more me and it’s not going to be easy but I am looking forward to bringing that.
Noah: I think a lot of people have allowed the studio audience to dictate the feeling of the show, when the viewing audience is infinitely larger. You have 50 or 200 people in a room versus millions of people who are watching the thing, and that smaller group of people gets to dictate the feeling of what’s happening and how it’s happening. They get to shift your mood. They get to define how a thing is or how a joke is landing or isn’t landing.
Singh: One of the things that has come up on my show is the marks you have, ‘this is the camera you are using.’ There might be some moment where I would not follow the mark or follow what we had planned out, go into the audience, crack some joke, but of course the cameras aren’t set up that way. Things are a little bit tricky. That’s something I want to bring to Season 2 — to get away from the production that puts you in such a narrow range.
How do you think your shows will tackle the 2020 election?
Noah: People spit out soundbites, but no one likes to provide context. No one thinks why things are happening, why people are saying what they are saying, why, why why? And so, for me, that’s what I’ve done. I’ve tried to provide a platform to as many organizers and activists on the ground, not pundits, not people who think they know what is happening, but actual people who are actually moving things forward. When I am talking to a farmer from Oklahoma, I want to talk to an actual farmer who may or may not support Trump, but tells me his perspective, as opposed to someone who is a pundit who tells me the perspective of a farmer.
Singh: Am I the most savvy with politics? I can try, but will I be Trevor? Absolutely not. What I think I can offer is how I talk about these issues. Maybe, especially with my show being a successful YouTube player, I can talk about when a politician talks about how they want to deal with women’s rights, or how they want to deal with the LGBTQ+ community. And I will do that through comedy, like I have in the past so many times.
Is being funny tougher in these times?
Noah: We are looking for a balanced diet. If you have too much sugar in your system, your body is going to tell you. If you have too much fiber, your body is going to tell you. What I think audiences are going to be looking for is content that connects, whether it is funny or whether it is informative.
Singh: Me and my roommate were feeling quite heavy and we’ve been going to the protests and doing whatever stuff we can do, but I can tell you we came home and I watched a video of a puppy farting. That’s why there has to be an array of content.
Hong Kong pupils banned from political activity – BBC News
Students in Hong Kong are now banned from any political activity in schools including singing, posting slogans and boycotting classes, the territory’s education minister has said.
Thousands of children became heavily involved in Hong Kong’s pro-democracy push last year.
Some 1,600 were arrested for joining the sometimes violent demonstrations.
The order came on the same day that a new national Chinese security office opened in the city.
The office is one element of a sweeping new law that makes inciting hatred of China’s central government and Hong Kong’s regional government illegal.
The law has caused alarm in Hong Kong, with opponents saying it erodes the territory’s freedoms as a semi-autonomous region of China. But officials say it will restore stability after violent protests.
Hong Kong’s sovereignty was handed back to China by Britain in 1997 and certain rights were supposed to be guaranteed for at least 50 years under the “one country, two systems” agreement.
Last year hundreds and thousands protested for weeks in Hong Kong against an extradition bill that critics said undermined the city’s special status.
The anti-government movement’s demands broadened to include full democracy and an inquiry into police brutality.
In schools many children expressed their support for the demonstrations by drowning out the Chinese national anthem with protest song Glory To Hong Kong.
Now Education Minister Kevin Yeung says schools must stamp out such demonstrations.
Mr Yeung said the song Glory to Hong Kong was “closely related to the social and political incidents, violence and illegal incidents that have lasted for months,” according to Reuters news agency.
“Schools must not allow students to play, sing or broadcast it in schools,” he said.
Additionally authorities said students must not form human chains, chant slogans or express other political messages.
Last week pro-democracy books were removed from public libraries, and authorities say they will be reviewed to see if they violate the new law.
Trump, Lopez Obrador visit is about trade, but politics too – Yahoo Canada Finance
WASHINGTON — President Donald Trump’s meeting with Andrés Manuel López Obrador of Mexico on Wednesday was billed as a celebration of economic ties and the new North American trade agreement, but critics in Mexico worry their leader is being used a political pawn to bolster Trump’s reelection effort.
Lopez Obrador, on his first foreign trip as president, arrived at the White House after morning stops at the Lincoln Memorial and a statue of Benito Juarez, a former Mexican president and national hero. Mexican and American business leaders were to join the presidents for a working dinner.
The leaders planned to discuss the United States-Mexico-Canada trade deal, which took effect July 1. It replaced the North American Free Trade Agreement, which was blamed for prompting U.S. companies to shift manufacturing to Mexico. The visit could give Trump an opening to bash his Democratic opponent, former Vice-President Joe Biden, for voting for NAFTA when he was a senator..
Trump economic adviser Larry Kudlow said López Obrador and Trump intended to sign a joint declaration of friendship and co-operation . Kudlow said the trade deal would benefit automobile and other manufacturing, agriculture and dairy farmers and cattle ranchers.
“It’s like it gets no respect, OK,” Kudlow said on Fox News Channel’s “Fox & Friends.”
He said as the three countries put the terms in place, there will be a burst of entrepreneurship and new innovation.
“I don’t know why people don’t pay more attention to it,” Kudlow lamented. “You know, we’re looking for growth following the pandemic.”
A former U.S. ambassador to Mexico, Roberta Jacobson, questioned the timing of the visit and Mexico’s decision not to meet with Democrats. In a letter to Trump last week, a dozen Democratic members of the Congressional Hispanic Caucus denounced the meeting with Mexico’s president as an effort to distract voters from rising cases of coronavirus in the United States and said it was a “blatant attempt” to politicize relations between the allies.
Jacobson, ambassador from 2016 to 2018, said she sees no important reasons for Lopez Obrador to make the trip. Canada’s prime minister and Trump rival, Justin Trudeau, decided not to come to Washington celebrate the agreement, citing scheduling conflicts.
She also noted that Democrats, whose support was needed to pass the agreement, were not invited to the White House when the deal was signed.
Jacobson expected López Obrador, who is known as AMLO, to hear that he needs to improve the investment climate in Mexico, because without it, the deal alone will not pull his economy out of its recession.
With the U.S. looking to reduce its supply chain in China, Mexico is well-positioned to step into the void, senior administration officials told reporters on a call outlining the visit. Cooperation between the two countries allowed the flow of goods to continue across the U.S.-Mexico border despite shutdowns caused by the COVID-19 pandemic, according to the White House.
Mexicans are wary of Trump, who has repeatedly taken shots at Mexico and Mexican migrants to rally his most loyal supporters. Trump has threatened crippling tariffs to strong-arm Mexico into playing an uncomfortable role in U.S. immigration policy and insisted they will pay for a border wall meant to keep migrants out of the U.S.
But López Obrador has avoided fights with Trump and the two have a surprisingly warm relationship despite coming from different ends of the political spectrum. Trump flashed a thumb’s up as he greeted Lopez Obrador to the White House and they posed for pictures.
Lopez Obrador, a veteran leftist, likes to point out that Trump helped Mexico reach a deal with other oil-producing nations to cut production and aided Mexico in obtaining more ventilators to grapple with the coronavirus pandemic. Both presidents talk about a blossoming friendship that seems to stem from their pursuit of nationalist agendas.
If Trump were to win a second term, López Obrador could be calculating he would have a friend for the remaining four years of his administration. If a Democrat were to take the White House, the Mexican leader would trust that the new president would respect the importance of the bilateral relationship and not hold a grudge.
Associated Press writer Christopher Sherman in Mexico City contributed to this report.
Deb Riechmann And Jill Colvin, The Associated Press
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