5 Things Arizona: Suicide data, Siman Qaasim, My COVID experience

We are building towards our 2020 Arizona State of Reform Virtual Health Policy Conference coming up on December 3rd, and expect to release our full list of speakers we’ve curated for you next week! It’s building out to be a great list of some of the smartest folks in Arizona health care

Take a look at our Topical Agenda for a sense of the conversations we have teed up. And, if you have suggestions for smart voices to include, we’d love to hear about it..!

 

 

 

 

With help from Michael Goldberg

1. The implications of an overturned ACA in Arizona

If the Affordable Care Act were to be overturned, what unique challenges does that pose for the health policy landscape in Arizona? Reporter Michael Goldberg asked Anne Winter, Managing Principal at Health Management Associates, who said re-creating the comprehensive nature of the ACA in Arizona is not possible.

“We may see attrition, where people eventually roll off and aren’t made eligible again. Some states, like California and New Jersey, in anticipation of this have implemented their own individual mandate to continue coverage and are building their own state-based exchanges. Here in Arizona, there is a law that says we can’t even implement a state-based exchange. We would have to overturn that law to even have a state-based exchange. To then pair that up with an individual mandate, it just doesn’t seem politically feasible in Arizona.”

2. Disparities observed in Arizona suicide data

With mental health problems on the rise due to COVID-19, a recent AHCCCS report to Gov. Ducey notes several new trends related to suicide. Rural areas have a rate of 32.2 suicides per 100,000 population as compared to urban areas with 17.2 suicides per 100,000 population. Native Americans have a rate of 36.5 suicides per 100,000 population as compared to European Americans with 23.7 suicides per 100,000 population.

From 2008-2018, all rates across age groups have increased. Children under 15 have had a 2-fold increase in the suicide rate. At the onset of the pandemic, AHCCCS and ADHS urge economic supports for Arizona families to help offset the stress caused by financial distress.

 

3.  Video: Siman Qaasim

Siman Qaasim is the President and CEO at Children’s Action Alliance.  In this pre-COVID edition of ‘What They’re Watching,” Qaasim discusses oral health, delivery system transformation, increasing public benefits, and legislative strategy toward health care investment.

“I’ve heard this phrase said at the capitol all the time and I wish that more of us lived by it, which is, ‘don’t step over a dollar to save a dime.’ When we look at these investments in health care – like $178,000 for oral health adult benefit for pregnant women, or a $1.6 million to keep KidsCare open for 35,000 children – let’s not step over a dollar to save a dime right now. It’s about looking at health and those expenditures as investments and cost savings.”

4. I got COVID. Here’s what I learned.

Over the last few weeks, I was diagnosed with COVID. I quarantined in my home office with only light but still-worrying symptoms. Wearing a mask didn’t prevent me from getting sick, but I think it kept my viral dosage down to levels my body could manage. I’ve written before about how good the care was for my uncle when he was 38 days on a ventilator, but my personal experience with our public health and primary care systems was disappointing.

But, it’s clear to me now that if you get COVID, outside of an inpatient setting, you’re mostly on your own. Testing is still a mess in many cases, and seemed to vary across county lines. Even the protocols don’t seem to make sense. For example, if you come in contact with someone with COVID, but you test negative, the protocol is to quarantine for 14 days. If you test positive, you only need to quarantine for 10 days. I understand why folks argue this makes sense. But two negative tests a few days apart is still the gold standard, statistically. Better testing would make a huge difference.

 

5. US senator says Dems want to ‘unrig’ the system

Last week, I got the opportunity for an extended interview with US Sen. Jeff Merkley, Oregon’s junior senator and one of the primary drivers of institutional reform in the US Senate. The conversation – which touched on leadership, the filibuster, and what it’s like to serve in Congress in 2020 – was candid, unique, and informative.

Merkley says its time to “unrig” how the Senate works, as he puts it. He means ending the supermajority requirement baked into the filibuster. “The Republican priorities take 51 votes, or 50 plus the vice president,” he said. “The Democrat priorities take 60 votes. The Senate is fundamentally rigged against policies to invest in the American people. In health care, housing, education, infrastructure, or to create quality of opportunity in civil rights, or LBGTQ rights or dreamers, or to take on the climate. So that inequality in how the Senate operates, that rigged Senate, has to be unrigged.”