Becerra needs to open up to the press

About Joyce Frieden

Joyce Frieden is a member of AHCJ's board of directors and oversees MedPage Today's coverage of Washington and health policy.

Letter to Xavier Becerra

AHCJ is calling on Health and Human Services Secretary Xavier Becerra to make himself available for questioning by reporters.

In a letter to Becerra sent Friday, the association urges regular, open press briefings similar to those held by his predecessor.

In his seven months in office, the leader of one of the largest federal departments has kept a low profile, even though the agencies he oversees, which include the CDC, the FDA, the NIH, and Medicare, make decisions affecting the lives of virtually all Americans.

“It’s time for Secretary Becerra to come out of hiding,” said AHCJ President Felice J. Freyer, who signed the letter along with fellow board members Sabriya Rice and Joyce Frieden. “The public deserves to hear from the cabinet member responsible for the programs and policies that affect our health.”

Although Becerra holds press conferences on limited topics when he travels, they are not live-streamed or open to reporters outside of the regions he visits. And he has yet to hold an open-ended press conference, at which reporters can ask him about a variety of topics.

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When covering drug-price reform, be sure to follow the money

About Joseph Burns

Joseph Burns (@jburns18), a Massachusetts-based independent journalist, is AHCJ’s topic leader on health reform. He welcomes questions and suggestions and tip sheets at joseph@healthjournalism.org.

Source: Aimee Cicchiello and Lovisa Gustafsson, “Brand-Name Drug Prices: The Key Driver of High Pharmaceutical Spending in the U.S. — An International Comparison of Prescription Drug Spending and Costs,” chartpack, Commonwealth Fund, November 2021.

Last week, when the U.S. House of Representatives passed and sent to the U.S. Senate H.R.5376, the Build Back Better Act, speculation began on which parts of the bill would survive a vote in the senate.

For journalists covering the health care elements in the bill (including provisions that would affect what consumers pay for prescription drugs), the question of which parts will remain will require following the money. As we’ve seen in recent years, the health care industry has spent multiple millions of dollars on lobbying and advertising to get members of Congress to water down various parts of the bill they don’t like.

 Reporting on spending for advertising and lobbying shows how much the pharmaceutical industry has spent in Congress to weaken provisions designed to make health care and prescription drugs more affordable for consumers.

Story angles to consider

Among the angles to cover in this story are how much money members of Congress in your district or state have received from pharmaceutical companies. One way to identify how much members of Congress have received is to use the Pharma Cash to Congress database from Kaiser Health News. This data set shows who’s received the most money this cycle, who’s in the million-dollar club and how much each member has received, and from which pharma companies.

Other angles to cover include how some of the advertisements from pharmaceutical companies can mislead consumers and how some consumers have been affected by high costs for prescription drugs. To find consumers willing to discuss high prescription drug costs, call patient-advocacy organizations such as Patients for Affordable Drugs and the Leukemia and Lymphoma Society.

When covering this story, keep in mind two reports that came out this year: In U.S., an Estimated 18 Million Can’t Pay for Needed Drugs, from Gallup in September; and, Prescription Drug Prices in the United States Are 2.56 Times Those in Other Countries, from RAND in January.

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Report: Home care workers deserve more pay, benefits

About Liz Seegert

Liz Seegert (@lseegert), is AHCJ’s topic leader on aging. Her work has appeared in NextAvenue.com, Journal of Active Aging, Cancer Today, Kaiser Health News and other outlets. She is a senior fellow at the Center for Health Policy and Media Engagement at George Washington University and co-produces the HealthCetera podcast.

Two SEIU home care workers at a rally with Labor Secretary Marty
Walsh (Photo courtesy of Wikimedia Commons)

A new report from the Economic Policy Institute (EPI) paints a stark picture of the financial plight of home care workers. Most of these workers — who care for sick, frail, vulnerable older adults and those with serious disabilities, are significantly undervalued and underpaid and deserve a higher wage.

The Biden Build Back Better Act, which recently passed the House and awaits passage by the Senate, would make an unprecedented investment of $150 billion in home and community-based services over 10 years. It will also increase the demand for qualified home care workers. However, finding people willing to do these jobs will likely get more challenging.

Many employers already can’t find qualified workers at current rates. If workers quit due to job dissatisfaction or burnout or because they can make more money at a big box store, what happens to those who need their help? Journalists can use the data in this report to delve into pay rates, workforce composition and investigate potential worker shortages and solutions in their communities. 

EPI report key findings 

The EPI report revealed that home care workers earn a mean of $13.81/hour, about half of what the average U.S. worker is paid ($27.31). Home care workers are primarily women (88.6%) and disproportionately Black (23.9%) and Hispanic (21.8%). Roughly three in 10 home care workers were born outside the U.S., according to the report.

The authors call for boosting the hourly wage at minimum, to between $21.11 and $25.95, depending on the benchmark applied, to help recruit and retain high-quality, skilled home care workers. Contrary to what some may believe, traditional Medicare typically does not pay for home care unless skilled nursing is also needed. Some Medicare Advantage (MA) plans now cover some in-home help annually, but it’s often far less than what’s needed to help an older person remain independent at home.

Medicaid, on the other hand, does pay for needed home care for people who qualify, but states must apply for waivers to implement home and community-based programs. Currently, there are over 800,000 people across the U.S. who are on waiting lists for home care programs like PACE, a Medicaid-funded state-run initiative that provides comprehensive medical care and assistance with activities like bathing, eating and dressing. (What is the waiting list like in your state for these highly in-demand home and community-based programs?)

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Antibiotic resistance: How to cover this ongoing health story beyond the COVID-19 pandemic

About Bara Vaida

Bara Vaida (@barav) is AHCJ's core topic leader on infectious diseases. An independent journalist, she has written extensively about health policy and infectious diseases. Her work has appeared in the National Journal, Agence France-Presse, Bloomberg News, McClatchy News Service, MSNBC, NPR, Politico, The Washington Post and other outlets.

Image courtesy of Photos for Class.

The problem of superbugs was brewing before the pandemic and has only worsened in the past two years in some parts of the country. In 2019, the CDC said about 35,000 people a year in the U.S. die from a drug-resistant infection, up from 2013 when the agency estimated about 21,000 were dying annually from a superbug. (This is the latest national data available from the CDC.)

“We’ve seen a rise in broad-spectrum antibacterial use nationwide during this pandemic,” said Shruti Gohil, M.D., M.P.H., associate medical director of epidemiology and infection prevention at the University of California, Irvine School of Medicine. And “there has also been a rise in multidrug-resistant organism infections, specifically” in hospitals.

If you’re looking for important health stories that will endure post-COVID-19, get up to speed on covering antibiotic resistance. Let’s start with some background information and explore the latest data.

A deep dive into antibiotic resistance

Antibiotic resistance is a natural phenomenon. When a patient sick with a bacteria or fungus is given an antibiotic, the drug kills most of the pathogens — enough for a patient to develop an immune response to get better. But a few pathogens may survive, and those ‘superbugs’ then multiply and spread in the environment. Older patients and those with compromised immune systems are among the most vulnerable to these resistant bacteria.

In the fourth quarter of 2020, hospitals reported a 41% increase in infection events caused by bacteriemia, a type of bloodstream, and often drug-resistant pathogen, according to the CDC. The rise in infection event was likely related to the large increase in COVID-19 patients admitted to hospitals that needed ventilators and catheters and other equipment to keep them alive, but also create opportunities for bacteria to enter the body.

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Community health workers are key to revamping U.S. mental health care system, AHCJ keynoter and Rand researchers say

About Katti Gray

Katti Gray (@kattigray) is AHCJ's core topic leader for behavioral and mental health. A former Rosalynn Carter Mental Health Journalism Fellow, Gray is providing resources to help AHCJ members expand their coverage of mental health amid ongoing efforts to de-stigmatize mental illness and to place mental health care on par with all health care.

Community health workers in Luxor, Egypt, practice their counseling skills through role play at a local clinic. (Photo courtesy of USAID Egypt via Flickr)

Several speakers at AHCJ’s Mental Health Summit lauded the Rand Corp.’s recently released “Transforming Mental Health Care in the United States,” a research brief whose 15 recommendations, among other things, call for:

  • More formalized mental health education for schoolkids.
  • More programs that keep homeless persons with mental illness in supportive housing.
  • Increased efforts to stem incarceration of the mentally ill.
  • Nationwide standards for prescribing and paying for mental and behavioral health services.
  • Financial and other incentives that expand the number of medical school-trained. psychiatrists, psychiatric nurses who can prescribe medication, and so forth, while also raising the count of on-the-ground community-health workers who are critical to filling gaps in mental health care access.

The report comes as the nation’s mental health care system continues to struggle to meet many goals of the Mental Health and Addiction Equity Act, passed in 2008 to expand the Mental Health Parity Act of 1996. 

Amid current bipartisan efforts aimed at shoring up that system, how to build and adequately compensate a lay workforce of community health workers and peer, support specialists, is a question that increasingly comes up, said public health researcher Ryan McBain, Ph.D., M.P.H.  

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