Skip to main content
Sister Publication Links
  • ESG: THE IMPLEMENTATION IMPERATIVE
Subscribe
  • Sign Up Free
  • Login
  • Subscribe
  • News
    • Current News
    • Providers
    • Insurance
    • Digital Health
    • Government
    • Finance
    • Technology
    • Safety & Quality
    • Transformation
    • People
    • Regional News
    • Digital Edition (Web Version)
    • Patients
    • Operations
    • Care Delivery
    • Payment
    • Midwest
    • Northeast
    • South
    • West
  • Unwell in America
  • Opinion
    • Bold Moves
    • Breaking Bias
    • Commentaries
    • Letters
    • Vital Signs Blog
    • From the Editor
  • Events & Awards
    • Awards
    • Conferences
    • Galas
    • Virtual Briefings
    • Webinars
    • Nominate/Eligibility
    • 100 Most Influential People
    • 50 Most Influential Clinical Executives
    • Best Places to Work in Healthcare
    • Excellence in Governance
    • Health Care Hall of Fame
    • Healthcare Marketing Impact Awards
    • Top 25 Emerging Leaders
    • Top 25 Innovators
    • Diversity in Healthcare
      • - Luminaries
      • - Top 25 Diversity Leaders
      • - Leaders to Watch
    • Women in Healthcare
      • - Luminaries
      • - Top 25 Women Leaders
      • - Women to Watch
    • Digital Health Transformation Summit
    • ESG: The Implementation Imperative Summit
    • Leadership Symposium
    • Social Determinants of Health Symposium
    • Women Leaders in Healthcare Conference
    • Best Places to Work Awards Gala
    • Health Care Hall of Fame Gala
    • Top 25 Diversity Leaders Gala
    • Top 25 Women Leaders Gala
    • - Hospital of the Future
    • - Value Based Care
    • - Hospital at Home
    • - Workplace of the Future
    • - Digital Health
    • - Future of Staffing
    • - Hospital of the Future (Fall)
  • Multimedia
    • Podcast - Beyond the Byline
    • Sponsored Podcast - Healthcare Insider
    • Video Series - The Check Up
    • Sponsored Video Series - One on One
  • Data Center
    • Data Center Home
    • Hospital Financials
    • Staffing & Compensation
    • Quality & Safety
    • Mergers & Acquisitions
    • Data Archive
    • Resource Guide: By the Numbers
    • Surveys
    • Data Points
  • MORE+
    • Contact Us
    • Advertise
    • Media Kit
    • Newsletters
    • Jobs
    • People on the Move
    • Reprints & Licensing
MENU
Breadcrumb
  1. Home
  2. Government
December 26, 2018 12:00 AM

Absence of government action on public health issues pushed industry to act in 2018

Steven Ross Johnson
  • Tweet
  • Share
  • Share
  • Email
  • More
    Reprints Print
    Getty Images

    Support for population health gained steam in 2018 from healthcare organizations that prioritized wellness and prevention initiatives despite decreased federal funding.

    Providers this year invested in housing, anti-poverty and food insecurity efforts with the goal of long-term cost savings by creating conditions for patients to better manage their health.

    But as interest in addressing social determinants has grown, action on broader public health issues has not kept up with the pace.

    “Healthcare moved from downstream interventions to what I would call mid-stream interventions, but we have still failed to go upstream,” said Brian Castrucci, CEO of the de Beaumont Foundation, an organization that supports local and state public health programs to advance public health.

    Meanwhile, federal funding for social services that were created to lift people out of poverty have been slashed.

    In February, the White House for the second year proposed to cut funding to safety-net programs. President Donald Trump's fiscal 2019 budget sought to trim the Supplemental Nutrition Assistance Program by 27% and Section 8 housing assistance by 20% over the next 10 years.

    Republican lawmakers also lobbied to include work requirements for SNAP recipients as part of a massive bill reauthorizing payments to farmers. Ultimately, that provision—which the Congressional Budget Office estimated would eliminate up to 1.2 million people from the program—did not make its way into the farm bill that passed Congress late in the year.

    The opioid crisis

    In perhaps his boldest move toward combating the opioid epidemic to date, Trump in October signed the SUPPORT for Patients and Communities Act. The bipartisan package included provisions aimed at expanding telehealth for substance abuse treatment, cracking down on shipments of fentanyl entering the country, expanding access to the overdose-reversal medication naloxone to first responders, allowing federal agencies to further research on addiction and pain, and amending Medicaid's rule that prohibits federal funds from paying for substance use disorder treatment provided by treatment facilities with more than 16 beds to patient between the ages of 21 and 64.

    The law came as the industry was making important strides in curbing opioid overprescribing, as more providers set best practices and restrictions.

    “2018 was an important year. We started to push back on the epidemic,” said Dr. Bruce Siegel, CEO of America's Essential Hospitals, the leading organization representing safety-net providers. “Hospitals and doctors are now embracing the idea that opioids have been overused.”

    Yet experts say it's large-scale federal funding of expanded treatment and prevention that would really make the difference. Most of the funding proposals included in the SUPPORT Act either helped to expand or maintain existing grant programs but offered little new funding.

    Public health advocates have called for a sustained funding mechanism like the Ryan White HIV/AIDS program, which since 1990 has received more than $2 billion a year for medical care and support services for impoverished people living with HIV.

    In the latest data from the Centers for Disease Control and Prevention, an estimated 70,000 people died from an overdose in 2017.

    “The opioid epidemic is the size the AIDS epidemic at its peak,” Siegel said. “Tens of thousands of people are dying every year and we need to show the same commitment to opioids that we did to HIV.”

    Gun violence

    The federal response to the opioid epidemic has arguably gone further toward addressing the problem than efforts to reduce gun violence, which stalled on the policy front despite mass protests following the death of 17 people during a shooting at Marjory Stoneman Douglas High School in Parkland, Fla., in February.

    Congress failed to provide the CDC with funding to conduct research on gun violence and several healthcare providers filled the gap by starting their own initiatives.

    In April, Kaiser Permanente invested $2 million to research gun violence, an amount nearly equal to the $2.6 million the CDC allocated to research gun violence in 1996. It was that year the Dickey Amendment passed, essentially banning federal funding to research the topic.

    While Congress agreed to include a provision within the omnibus funding bill in March to clarify that the CDC was not barred from researching gun violence, the legislation did not appropriate money for the agency to conduct that work. In July, the House Appropriations Committee rejected a proposal to allocate $10 million to the CDC for gun violence research.

    Climate change

    One of the most frustrating areas for healthcare organizations was undoubtedly climate change.

    The Fourth National Climate Assessment, released in late November, found the effects of climate change are already taking a toll on human health, with increases in extreme weather events such as wildfires and hurricanes, a rise in infectious diseases transmitted by insects, and eroding water and air quality. Those problems are all projected to increase mortality and strain the health system.

    Trump denied the conclusions found in the report, saying “I don't believe it.” His administration has actively sought to roll back environmental protections to limit fossil fuel emissions from coal power plants, do away with clean water rules to protect waterways and wetlands, and eliminate vehicle fuel emission standards, to name a few.

    The issue of climate change has been a particular vexing one for providers, as studies have shown the nation's healthcare system alone is the world's seventh-largest producer of carbon dioxide.

    The year saw a growing number of health systems and hospitals respond by seeking to decrease their environmental footprint by investing in efforts to be more efficient in their water and energy use, while creating positions such as chief sustainability officers. In California, the largest systems in the state formed a healthcare climate alliance in August to lobby for regulations and laws that addressed climate change.

    Ultimately, Castrucci said making progress on any of the major public health concerns came down to a matter of political will. He felt such an effort would ultimately require the kind of resources to successfully lobby for better health in the same way industries have lobbied for years on issues that have been detrimental to health.

    “Alcohol has a lobby, soda has a lobby, guns have a lobby,” Castrucci said. “They're all really well funded. Where's the health lobby?”

    RELATED YEAR IN REVIEW STORIES:

    • Healthcare organizations turned to unexpected partners in 2018
    • Dealmaking stayed hot in 2018, with a focus on physician practices
    • Greater flexibility, new alliances define insurance industry in 2018
    • Medicaid expansion battle shifted in 2018 to the executive branch and the states
    • Bookended by Obamacare, 2018 was the year of policy change
    • In 2018, interoperability remained just beyond the horizon
    • CMS amps up value-based payments in 2018 as other quality issues fall by the wayside
    • Back to main page

    Letter
    to the
    Editor

    Send us a letter

    Have an opinion about this story? Click here to submit a Letter to the Editor, and we may publish it in print.

    Recommended for You
    Abortion clinic
    Idaho hospital halts obstetrical care as abortion laws become stricter
    mh_20160711p29_bills_i.jpg
    State, local governments pay off medical debt relief with COVID funds
    Most Popular
    1
    More healthcare organizations at risk of credit default, Moody's says
    2
    Centene fills out senior executive team with new president, COO
    3
    SCAN, CareOregon plan to merge into the HealthRight Group
    4
    Blue Cross Blue Shield of Michigan unveils big push that lets physicians take on risk, reap rewards
    5
    Bright Health weighs reverse stock split as delisting looms
    Sponsored Content
    Modern Healthcare Alert: Sign up for this breaking news email to be kept in the loop as urgent healthcare business news unfolds.
    Get Newsletters

    Sign up for enewsletters and alerts to receive breaking news and in-depth coverage of healthcare events and trends, as they happen, right to your inbox.

    Subscribe Today
    MH Magazine Cover

    MH magazine offers content that sheds light on healthcare leaders’ complex choices and touch points—from strategy, governance, leadership development and finance to operations, clinical care, and marketing.

    Subscribe
    Connect with Us
    • LinkedIn
    • Twitter
    • Facebook
    • RSS

    Our Mission

    Modern Healthcare empowers industry leaders to succeed by providing unbiased reporting of the news, insights, analysis and data.

    Contact Us

    (877) 812-1581

    Email us

     

    Resources
    • Contact Us
    • Advertise with Us
    • Ad Choices Ad Choices
    • Sitemap
    Editorial Dept
    • Submission Guidelines
    • Code of Ethics
    • Awards
    • About Us
    Legal
    • Terms and Conditions
    • Privacy Policy
    • Privacy Request
    Modern Healthcare
    Copyright © 1996-2023. Crain Communications, Inc. All Rights Reserved.
    • News
      • Current News
      • Providers
      • Insurance
      • Digital Health
      • Government
      • Finance
      • Technology
      • Safety & Quality
      • Transformation
        • Patients
        • Operations
        • Care Delivery
        • Payment
      • People
      • Regional News
        • Midwest
        • Northeast
        • South
        • West
      • Digital Edition (Web Version)
    • Unwell in America
    • Opinion
      • Bold Moves
      • Breaking Bias
      • Commentaries
      • Letters
      • Vital Signs Blog
      • From the Editor
    • Events & Awards
      • Awards
        • Nominate/Eligibility
        • 100 Most Influential People
        • 50 Most Influential Clinical Executives
        • Best Places to Work in Healthcare
        • Excellence in Governance
        • Health Care Hall of Fame
        • Healthcare Marketing Impact Awards
        • Top 25 Emerging Leaders
        • Top 25 Innovators
        • Diversity in Healthcare
          • - Luminaries
          • - Top 25 Diversity Leaders
          • - Leaders to Watch
        • Women in Healthcare
          • - Luminaries
          • - Top 25 Women Leaders
          • - Women to Watch
      • Conferences
        • Digital Health Transformation Summit
        • ESG: The Implementation Imperative Summit
        • Leadership Symposium
        • Social Determinants of Health Symposium
        • Women Leaders in Healthcare Conference
      • Galas
        • Best Places to Work Awards Gala
        • Health Care Hall of Fame Gala
        • Top 25 Diversity Leaders Gala
        • Top 25 Women Leaders Gala
      • Virtual Briefings
        • - Hospital of the Future
        • - Value Based Care
        • - Hospital at Home
        • - Workplace of the Future
        • - Digital Health
        • - Future of Staffing
        • - Hospital of the Future (Fall)
      • Webinars
    • Multimedia
      • Podcast - Beyond the Byline
      • Sponsored Podcast - Healthcare Insider
      • Video Series - The Check Up
      • Sponsored Video Series - One on One
    • Data Center
      • Data Center Home
      • Hospital Financials
      • Staffing & Compensation
      • Quality & Safety
      • Mergers & Acquisitions
      • Data Archive
      • Resource Guide: By the Numbers
      • Surveys
      • Data Points
    • MORE+
      • Contact Us
      • Advertise
      • Media Kit
      • Newsletters
      • Jobs
      • People on the Move
      • Reprints & Licensing