Featuring Dr. Philip Verhoef, Clinical Professor of Medicine at the University of Hawaii and ICU physician: How can we maximize our ability to confront pandemics like the coronavirus? Which strategies are working for us, and which are failing? Host Brenda Gazzar and Dr. Philip Verhoef contrast America’s failure to efficiently distribute resources like PPE with the successful adoption of telemedicine – an effort led by Medicare. Learn how a unified Medicare-for-All system could have helped the U.S. better respond to the pandemic.
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Confronting COVID – Hotspots, Telemedicine and Medicare for All
—– TRANSCRIPT —–
Welcome to Code WACK!, your podcast on America’s broken healthcare system and how Medicare for All could help. I’m your host Brenda Gazzar. Today, we’ll talk to an intensive care unit doctor about the ways Medicare for All could benefit us in a pandemic.
Dr. Philip Verhoef is a clinical assistant professor of medicine at the University of Hawaii and an ICU physician and immunology researcher in Honolulu. He cares for critically ill children and adults and has cared for COVID patients during the current pandemic.
This is the first episode in a series with Dr. Verhoef about the deadly coronavirus.
Welcome to Code WACK!, Dr. Verhoef.
Verhoef: Thanks, it’s a pleasure to be here.
— FEATURE —
What can you tell us about the spread of COVID- 19 so far in Hawaii and how this compares with other states?
Verhoef: So there are a lot of things unique about Hawaii, not the least of which it’s geographically isolated from the rest of the country and that has meant that the majority of cases early on were associated with travel, whether it was Hawaii residents going to the mainland and coming back or people coming to visit Hawaii and so that has made it relatively easier to do so-called contact tracing because there are some real geographic limitations.
I can only imagine trying to do that kind of work in a city like Chicago, where there are so many people coming in and out and from all different places, whether it’s locally or regionally or nationally, and then trying to follow all of the places they may have been. It’s a little bit different in Hawaii and I think Hawaii right now has really benefited from the intervention of staying at home. Both the mayor of Honolulu and the governor have established some restrictions on people moving around on the island of Oahu and that, I think, has really limited the spread of the disease significantly.
Got it, thank you. I know you’re an avid Medicare-for-All supporter. In what ways would Medicare for All benefit us in a pandemic like we’re seeing today?
HOTSPOTS
Verhoef: I think the first is that we’re clearly seeing hotspots in the country, right? Places that are having much more burden of taking care of COVID patients and other places that aren’t. And so under a Medicare for All system where resources are allocated to hospitals based on need, that system can then reallocate resources to places that need them, right? So right now, you’re actually hearing stories about states competing with the federal government to get ventilators, right?
RESOURCE MANAGEMENT
Verhoef: The federal government is outbidding a state and now the government has them and the state that needs them can’t get them. Under an organized distribution of resources through global budgeting of hospitals based on need, you simply say, okay, New York City needs our resources, we’re going to direct our resources to New York City and pick your favorite area, if Des Moines, Iowa is doing great, and they’re canceling all of their surgeries, they don’t need resources right now, we can redirect our resources to places that need them.
That also holds for the acquisition of things like ventilators, and Personal Protective Equipment, and gowns, because we now have sort of a government’s purchasing power to be able to acquire that stuff. We’re not each little fiefdom competing with each other to buy up masks from each other. You know, Oh, you have to buy it before this guy gets it. You have the federal government of the United States covering 330 million people saying, alright, we need masks and basically using that purchasing power to acquire the masks that are needed. So I think those are a couple of ways that this would help.
TELEMEDICINE
Verhoef: Another way is that – and we’ve actually seen this with Medicare — one of the ways that this pandemic has been managed is to move to telemedicine consults, tele-video consults, where instead of a patient coming to the doctor in person, the patient will contact their doctor via Zoom or via Skype or whatever video-based platform you want to. And early on, in the middle of March, Medicare came out and said, we will pay for those visits. This is a thing that they led the charge on. Medicare did. Prior to this, private insurance hasn’t been willing to pay for video visits as a general rule. They’ve said, no, no you have to have an in-person visit, a video visit won’t count. We’re not going to reimburse. The federal government literally led the way on this. Medicare said, hey, we’ll pay for this. Suddenly, you now have a way for physicians to continue to get paid for their services, but more importantly, for patients to continue to see their doctor. That kind of flexibility is fantastic. The government basically said ‘we will find a way for patients and doctors to continue to see each other. This is how we’ll do it.’
HEALTHY INCENTIVES
Verhoef: It’s a win-win-win situation for everybody, instead of under the current model, where the more patients you see, the more money you make. A doctor is not incentivized to closing their office….They want to keep patients coming to them. That’s the only way they get paid and that puts people in grave danger. I think that’s another way that a unified Medicare for All system would have helped in this pandemic.
Thank you so much, Dr. Verhoef. Find more Code WACK! Episodes on ProgressiveVoices.com and on the PV app. You can also listen at HEAL dash C-A dot org. This podcast is powered by HEAL California, which uplifts the voices of those fighting for healthcare reform around the country. I’m Brenda Gazzar.
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