It is so extensive that they cannot afford to have extra beds hanging around, waiting for something to happen. This is part of the idea between the National Strategic stockpile that the federal government would stockpile supplies and medications. As we have heard recently, ventilators. Is, in placeseing that are very hardhit, people with a lot of complications, hospitals are completely overwhelmed. At the same time, we are seeing the rest of the Health System come to a grinding halt. Hospitals have stopped doing elective surgeries with things like hip replacements. Things that they make most of their money from. People are afraid to go to the doctor unless they have covid19. We are seeing primary care practices and specialty practices and things that are not respiratory basically start to lay people off. Host looking at the Health Insurance, is this overwhelming the Health Insurance part . Keeping in mind, as i understand it, didnt tested or having covid19 related expenses will be covered i most Health Insurances, correct . Guest yes. That was in the thing that Congress Passed a couple of weeks ago that patients should not have to pay for testing. Someone said that money may throw flow through the government. It is not clear how much of a hit that this will be on Health Insurance. Tomiums next year would have go up a lot to make up for the extra costs that Insurance Companies are facing this year. They will step in and pay a fair bit of that. It is not entirely clear how much premiums will go up as a result of this. There are many more people who are getting sick and going to the hospital and getting very expensive care. That is obviously going to do something to the Nation Health care tab. Hospitals poised to get massive infusion of cash. A 350 billionad had 350 billion for small businesses. That is beginning to be tapped with nitatalked lowey. How are hospitals going to get this money . Is there a concern that there may not be enough for hospitals nationwide . Guest there is concern hospitals will not get enough money. The department of health and Human Services announced that 30 billion, 100 billion in that bill will go to hospitals around the country, based on from last year. There are hospitals that are upset about that. Particularly hospitals with a lot of covid19 patients will get less than other hospitals. All hospitals are in need because many, if not most of them, have stopped doing other things that bring in money. Even if they dont have a huge percentage of covid19 patients, they are still hurting initially. The hospitals in the hardhit areas are hurting more because they are losing the money that they normally make from routine things that they do and they are having to spend this extra money to care for extra patients. Here is how we are breaking up the phone lines. For those of you on the afford will care act. 202 7488001 if you get your employers insurance. If you are uninsured, 202 7488002. Others, 202 7488003. On the Affordable Care act, the open upt client to options for the aca. Guest a number of states run their own aca exchanges. There is a couple of things that reopening enrollment does. If you lose your job and your job Health Insurance, youre automatically entitled to what is called a special enrollment period. You can go on to the exchange and by insurance. In order to do that, you have to have documentation, including to your employer. If there is a regular reopening of enrollments, it is much simpler and there is a lot less paperwork. People are at home and people do not always have access to documents or our transmitting document. The other thing is there are people last year at last years opening enrollment, which was in december, people might not have bought insurance who do not have insurance. They might have bought these shortterm plans that the president had been touting that do not cover a lot of things. Hospital care. If you get sick, you will end up in the hospital. A lot of people are rethinking those decisions now. Under current laws, they are not eligible to sign up for Health Insurance again until middecember. Health care providers and the Insurance Industry and the openc Health Officials are to reopening enrollment nationwide. These are extraordinary circumstances where people who did not buy insurance before but want to now would like to have that opportunity. What they said instead is that they will use the money we are talking about inhospital money. O help pay for the care that is not what the hospitals had hoped the money was for. There is some disc insertion about that too. Oncertion about that too. Host remind us again the number of states that expanded medicaid in those states. Certainly, this crisis has tapped those programs in the state. When lots of people lose their jobs and lose their income, medicaid has to go up. Have expanded their medicare program. In those 14 states, there is still a lot of people who will not be able to get Health Insurance, even if they did reopen the exchanges, because get on the Exchange Rate the way the law was originally written in 2010, everyone would be covered by the medicare expansion or by the Affordable Care act. In states without the medicare expansion, there are people who do not have many options. Welcome. Ie rovner, if you want to send us a text, that is 202 7488003. Tell us your name and where youre texting from. We will go to eddie in baltimore. Hi. Caller yes. How are you doing this morning . Host fine. Thanks. Caller i just want to make a statement that since trump came into office, he tore apart the aca. Limitations are so dire. I cannot understand the republican party. They were protecting the trump protecting trump. Denial about what has happened since this man came into office. Hopefully they wake up and see that this man is not qualified to do this job. Thats all ive got to say. I hope god touches their hearts. All right, eddie. Julie rovner, your reaction. Guest there is obviously people watching the president and seeing how he is reacting to this and seeing what the administration is doing and making their judgment. People who support trump think he is doing a great job. People who do not support trump do not think he is doing a great job. Host let me ask you about dr. Anthony fauci. You had a chance to meet him and interview him or at least cover him. Guest many times. Host tell me what youre thinking is, your granted this virus is bigger than anything we have seen, is this a typical response from Anthony Fauci compared to previous pandemics this country has encountered . Guest i have known dr. Fauci since the late 1980s when he was working on aids. He has always been a very straight shooter. Very calm. He has been through a lot of health crises. Obviously has Infectious Disease is part of andjob that makes it public stressful at times during Public Health crises. He has been good with journalists. He is very free with his time. Take scientific information and explain it to laypeople. That is important during a Public Health crisis. Things are more partisan. I have covered a number of crises. I covered aids and september 11 and the anthrax attack. H1n1d the h one i flu. I have seen this play out before. I do not remember that it i do not render it being this partisan. When the u. S. Was in a crisis, the parties tend to come together. I feel like the country is so divided right now that we are seeing a division in this response to covid19. Host lets hear from detroit. This is clements. Good morning. I would like to ask the question , how much money did your industry make in 2019 . I understand you made over 3 trillion last year. Ast clement, our guest is reporter with Kaiser Health news. Are you talking about the journalism industry or the Health Care Industry . Caller i am talking about the health care. They are talking about wanting to charge us for Health Insurance when they dont make the profits. In 2013, they made over 3 trillion. What is going on . They are asking us, the taxpayers, for money . Thanks for your comment. Just to be clear, because our guest julie rovner is from Kaiser Health news. She is the chief washington correspondent. Guest we are not affiliated with kaiser permanente. We are an editorial independent project that is not affiliate with kaiser permanente. I do not think it is three choi in dollars. We spend about 18 of gdp on health care. Way more than the next high spending country. It is distributed unevenly. There are a lot of hospitals and Family Practice doctors and nurses and health aides who do not make a lot of money. Then there are people who are making enormous profits off the Health Care Industry. With the covid19 outbreak, that is what washington is most concerned with. Even people in and unsuspecting patients. There is an enormous amount of money in the Health Care System. That does not mean that there are not corners of health care in dire straits. Host have you had a chance to look at what other countries are doing well in their responses and others not so well . Guest yes. Everybody seems to be doing similar types of things, because there is still no treatment and there is no vaccine. The best way to keep the virus from spreading is to keep people from getting too close to one another. That is how it spreads. There is a lot of sheltering in place and a lot of closed pools and a lot of closed businesses. Obviously, in italy, it turned out to be more difficult than it was in china, because italy is not so much an authoritarian regime as china is. Even in china, we are seeing that they are a couple of months ahead of us. We are seeing them tentatively try to reopen things. Now, they are concerned about cases coming in from other countries. It is really difficult in a inin people get on which people get on airplanes and go across continents. The president talks about what a great job he did, shutting down travel from china in late january. As it turns out, according to the New York Times, what happened is that Chinese Tourists went to europe and the virus got embedded in your europe and americans went to europe and brought it back within. It is hard to say we will shut down our borders and keep it from coming in. Notwithstanding, a lot of it has to do with how good public Health Systems are in some other countries. Some have done a better job of testing and tracing so that you dont have to quarantine everybody. You can try to figure out who has the virus and keep them from going out and spreading it to , keeping them quarantined until after the notential period for a infection is up. People who are not showing symptoms can spread it. That makes things much harder, more than just staying home if you are sick. It is stay home if you might be spreading it and dont even know. That is why we are at the everybody stayathome face. Host lets hear from cal. Caller good morning pray thank you for taking my call. The representative made a mistake preach she criticized. He president the Obama Administration cut funding. My question is will we see an increase in premiums because of this problem . Host thanks, cal. Guest we do not know yet. Tend to bereases regional increases tend to be regional. States tend to regulate insurance if you have employer insurance. It will vary. There will be more federal health. Two your first question, there is an article in Political Administration, going back to a Political Administration magazine going back to clinton. Premuch every administration tried to do something and it was ignored by the administration after them. Particularlyn trump or obama. It really is sort of a bipartisan, we tend not to think about Public Health until we need it. Every time something happens, we tend to Pay Attention to it for a while. Then it floats into the background again. Something happens and everybody starts pointing fingers about why werent you ready for this . Host our line is 202 7488000. On that line from seattle is james. Good morning. Caller good morning. The reason why this pandemic was not nipped in the bud earlier is because trump and republicans were trying to get phase one of the trade deal signed during this time in january, even while impeachment was going on. The democrats and republicans tried to sign phase one. Going to comeoney from . It seems like the republicans and trump have found where the money can come from. It is coming from the treasury department, it is coming from the taxpayers. Health care for all as Bernie Sanders was saying. This is the only way the pandemic will be nipped in the bud. We have Homeless People in airports. Upave Homeless People coming and giving them a cup of coffee. Socialism, it is a socialism type of system that is going on now. The money is being spent. Why are you people not talking about socializing the Health Care System, where everyone has these andn these types of issues going on now, the money is being spent. How do you rovner, think a medicare for all or a singlepayer system would have responded to this pandemic differently . How might that system absorb or not absorb patients any better . Guest we are seeing that happen in other countries. I did see Boris Johnson last night basically singing the praises of Britains NationalHealth System, which is extremely popular in britain. Whichnservatives, in Boris Johnson is one, have not funded adequately pray there are Serious Problems with produce with the British Health care system. Adequately. There are Serious Problems with the British Health care system. They have Health Insurance for everyone is what people are saying great it obviously makes a difference. There is a concern that people who do not have insurance are afraid to seek out care when they need it because they are afraid that they will not be able to pay for it. That is a problem. That is one of the reasons that congress made testing free at the point of service, so that people who think they might be ill or passing it on to others may not be afraid to come forward. I think that this is over, we as a society will look at our Health Care System differently. I dont know what that will mean in terms of policy. I dont think it is possible to know yet. I think the debate is going to change. Host there is a story this morning at the front page of the Washington Post about another area of shortage. A shortage of drugs. Iny say that hospitals regions experiencing a surge of coronavirus patients are struggling to maintain andbiotics, antivirals other drugs produced in countries where they are curved manufacturing. Hospitals are increasingly concerned about future shortages of lifesaving drugs, as authorities in india and other countries producing them try to guarantee supplies for their own people. Ofargument i guess in favor more of that production coming back to the United States. Guest this is a huge concern. It has been a concern for several weeks. I saw that story. There have been a few stories along those lines, that so much of our medical systems supply chains now come from other countries. For drugs and sort of the pieces that go into making drugs. Much of that comes from india and china. We are seeing this with ppe. A lot of that is coming from china. We are having a worldwide pandemic. Every country wants to keep what they are making for themselves. It is kind of a problem with the Global Supply chain. We are talking so much about being energy independent. We are not health care independent. I think we are finding that. I dont know what the solution will be. I think that there is a realization that this is the first real Global Pandemic in 100 years. That is not to say that there will not be more. We have seen 500 year floods that have been followed the next year by a 500 year flood. I think there will be a lot of rethinking about this Global Supply chain and what it really means to our health security, in addition to our energy. Host are you surprised the world health come under the criticism that has . Guest i think the World Health Organization always comes under criticism during times like this. The president has been with therly unhappy who. They have a difficult job. There is an argument that they were a little slow to react. They were reacting to it. There was a little bit we dont want to call it a pandemic even though it was very clear that it was in a lawful a lot of places in an awful lot of places in that at that point. Host do you find it hard at all for you to get straight information out of china . Do you trust the veracity of what is reported out of china in terms of health issues, in particular on the coronavirus . Guest that is not what i do so i am not getting a lot of information out of china. I am dubious about information thatcomes out of regimes dont have free media. It is very hard to tell. I listen to experts who also say that china is trying to be helpful. I think there is so much that we dont know. There is so much we dont know about the virus because it is so new. It is not just because it is in china. It is literally only a couple of months old. We know a surprising amount given how new it is. Frustrated that we dont know exactly how it works. How we can be spread, when it can be spread and what all of the symptoms are, who is most likely to get very sick, we just dont know that yet. Host lets hear from melvin in georgia. Good morning. Caller how are you doing . A previous color asked her to address the idea of caller asked her to address the idea of medicare. She said it would not make much of a difference. The difference when you have medicare for all or insurance for all is that you dont have the underlying conditions African Americans are experiencing in detroit, new orleans and new york because they have high Blood Pressure, they have diabetes and asthma. Difference between poverty and not having Health Insurance has created conditions where americans, people of color, are at a disadvantage when they get covid19 because the underlying conditions undermine their ability to resigned respond positively to treatment by the doctors. Guest that is absolutely all true. Health insurance is an important peoplenant of whether are and can be healthy. It is not the only term in it. Determinant. Poverty has an effect on whether people are able to eat healthy and exercise and get to Grocery Stores that have healthy foods. There are issues invented in this some of them are cultural. Insurance, if poor people had insurance, they would be less likely or more likely, even if they had preexisting conditions, to be able to control them. People have high Blood Pressure that is not wellcontrolled or asthma that is not wellcontrolled. Those are all issues. I am not saying the United States is in a better position than countries that have national Health Insurance. We are obviously in a less good condition. Ours not enough to mean Health System will not be overwhelmed by this. We have a lot of places that have national Health Insurance that are also overwhelmed. Host our guests julie rovner. She is here with us until just about 9 00. We welcome your calls. 202 7488000 for a. C. A. Enrollees. If you get employer Health Insurance, 202 7488001. For those of you who are uninsured, i should say, that line is 202 7488002. All others, 202 7488003. Andrea is next in fort washington, pennsylvania. Caller thank you for cspan. I have been listening to this show for about 15 minutes. I wanted to ask your guest, julie, about if she knows anything about Health Insurers dipping into their reserves, which, as far as we know, there are billions of dollars in Health Insurance reserve funds for an emergency, which i always thought that was what they refer. I have not heard anything declaring this an emergency for Health Insurers as far as Health Insurers stepping up to help people who, like myself, and others who have contributed for decades. High costs, it is one of the biggest bills that we get a month, to help provide insurers with masks and other things. I just i have heard nothing about whether insurers are breaking into their reserves for this pandemic. Host ok, andrea. Guest yes, they are. Health insurers has stepped up in a lot of ways have stepped up in a lot of ways. They are clarifying the costs of testing for covid19 and they will make sure that patients do not have to pay for the cost of hospitalization or treatment or if they end up in the hospital with this. This is not every health insurer. We dont know what is going to happen with bills. You go to an in network facility. The hospital bills you separately for something else, saying it is not covered or it is out of network in an in network facility. They obviously will get into them. The point is, if premiums go up next year, it will be because they need to replenish their reserves because they are required to have a certain amount for exactly the situation that we are going through now. The fact that insurers have reserves, that is not money that that is money that is there for an emergency, which this is. They will have to have that money put back for the next emergency. Host those unexcited charges back in the fall, there would seem to be bipartisan support for this legislation, against surprise billing, what was called surprise billing. The president weighed in in favor of it. Where does that stand . Guest they have given themselves until may two sort of come to an agreement on this. Some thought they might try to get a deal into the bill that was passed a few weeks ago. This is less a fight between democrats and republicans and they agree that it is a fight between insurers and doctors in washington about who is going to pay and what kind of mechanism there is to settle the dispute. That has been a big fight. Doing Television Commercials during the democratic debates if you are not embedded in this, you have no idea what they were talking about. Each side sort of tried to make their case. They are still at it. It is obviously something they want to do. There is obviously a bigger emergency in front of them right now. Host to david next in roseville, michigan, on the uninsured bind. Go ahead. Caller thanks for taking my call. Is a globalistis , populist agenda. If you go to the internet archive, there is a pdf document that was put out in 2014 by the Rockefeller Foundation that outlines this entire scenario. They talk about italy, china. Go look it up. It is mind blowing. Look up lockstep. Worldwideer a giant signoff. In our houses, we are not powerful. I think your spreading lies. You are not affiliated with the Kaiser Family . You are the Kaiser Family foundation, how are you not affiliated with the Kaiser Family . That is ridiculous. I want to know how you say you are not affiliated with the Kaiser Family when you are the Henry J Kaiser foundation. Host our guest is not affiliated with kaiser permanente. She is with Kaiser Health news. Guest we are affiliative with the Kaiser Family. We are not affiliated with kaiser permanente. People withlot of theories on how this happened but it is not like public Health Officials have not been working on plans for pandemic preparedness for three decades. As i mentioned earlier, there is a piece in politico and the New York Times. A lot has been written about this and it is hard for public officials. President is agonizing and public everyday. Public officials do not want to make people stay in their houses. This is having a dramatic and terrible effect on the economy, which is not something that one would want in an election year. We are seeing the same thing in other countries. Their economies are being ravaged. This is not something that public Health Officials are doing because they want to. It is basically the only thing that they have left to do in the race of the pandemic. Host it seems like if you look back, maybe it is hindsight, you see sars and mers. The rise of these and the increasing rise of these, are you surprised at all that the u. S. And other countries were not prepared as well as they should be for a pandemic of this size . Guest yes and no. As i say, people dont listen people do not Pay Attention to Public Health except for when we are in a crisis. And it is allowed to languish otherwise. , there was an enormous amount of time and effort in congress, it was basically all i covered for a couple of years, to sort of rebuild the nations Public Health infrastructure, create the National Refill the national stockpile. Create this publicprivate agency to develop countermeasures. There was a lot of effort put into it. Over the years, it was allowed to just sort of you know drift, essentially. We are never ready for an emergency. As i said, if you look around the world, a few countries are doing pretty well. A lot of countries are having their own kinds of difficulties. Host a question for you on twitter. You addressed this earlier with the procedures that are not being done at hospitals. This question asks how is the health of americans, the elderly being affected when all other medical services are put on hold. What are the longterm costs to health . Guest that is something we are looking at. There is a huge issue. Cancer patients are not getting treatment. There is a lot of treatment right now that is not happening. A lot of deferred care. It is a big problem. Hospitals, many of the hospitals that are being clamped are closing their doors to things. People are in pain and people that are notseases being treated. Now a huge problem. It is going to be a bigger problem, all of that deferred care as we go forward. Host lets go to gate city, virginia. This is james. Good morning. Caller yes. Know, to address, you everybody who thinks that the Insurance Companies, i know i will be booed for this. Everybody thinks Insurance Companies have these bottomless, bottomless pits of money. That is not true. We should have everything,ups for every type of situation. We dont have anything to protect the Insurance Companies. They are required to have certain amounts of backup money. Out this is going to wipe every insurance companys backup money. And yet, nobodys thinking about what is going to happen if the Insurance Companies have to go out, because they dont have any money. They cannot operate without backup money. Host all right, james. Julie rovner. Guest Insurance Companies are busy on capitol hill with the rest of the healthcare industry. There is a concern. Just like the rest of the Health Care Industry, there are Insurance Companies with deeper pockets. There are smaller Insurance Companies. There is a lot of nonprofit Health Insurance companies and community Health Insurance companies, similar to different types of hospitals and sometimes deeper pockets than others. There is worries about the continued viability of the Health Care System in general. We cannot expect nurses to be miracle workers, masks and equipment shortages push nurses to the brink across the nation. In general, are hospitals able to find the staff they need, keeping in mind of the staff exposes themselves to danger in treating covid19 patients . Guest it is a real concern. There are shortages of Health Care Personnel in lots of the country. New york did a callout for healthcare workers and healthcare workers who certainly suddenly were not working where they lived because things have shut down. The Healthcare System shut down. They got a pretty good outpouring of people who have come to new york and are living in hotels to help take care of the surge there. Majoruld assume that metropolitan areas will surge at different times and you will have people who can come and fill in. There is a worry about not just burnout but people getting sick and having to stay out. There is not enough personal protective equipment. Healthcare workers are more likely to catch the virus. And then they cannot work. It is a huge issue. Among the things that we are going to need to take a long look at after this is done, is the state of our health care workforce. Lets hear from judy in seattle, washington. You are on. Caller i wanted to bring up the way numbers are being used to obscure facts. For instance, when people talk about more people have died in america from the virus and then of oneitaly is the size of our smaller states. How many people die per capita . That is where it becomes more interesting. I know that in washington state, there are areas where it is very concerning. In seattle, and other places, it is not so concerning. Capita wouldhs per be the way to count victims of this disease. And, other news, it is being reported in very confusing ways. It is not just that what they are saying is alive, but it is a truth that is not real. Host ok, judy, thanks. Guest i agree. Every morning, i wake up and you get these numbers and they just dont mean very much. I live in marilyn. Marilyn has started reporting cases by maryland. Maryland has started reporting cases by zip code. Testing is not as universal as it was promised. It is still difficult to get a test. It is hard to know there are differences in how we need to get a test in different parts of the country. Even that starts to get you dont really know how widespread it is. People may be Walking Around with it or have just been at home and never got tested. You honestly dont know read that is why we still dont really know how deadly this is. Itdont know what percentage is of the people who get it because we do not know how may people have it yet. This is one of the big frustrations of the Public Health expert to talk about when can we open up . We cannot open up until we know who has it and who is able to spread it and who is not. Host there is reporting about the discrepancy of both disease, about itdisease and hitting the minority populations much harder. The New York Times didnt oped, called the americans we need. They said less affluent americans will bear the brunt in health and wealth. They have suffered disproportionately from diseases of labor like black lung and mesothelioma. Obesity diabetes and the Opioid Epidemic that has raged in communities. By one estimate, these patterns of poor health mean that those at the bottom of the income spectrum are twice as likely to die from covid19. Many are losing their jobs. Death to obtain the necessities of life. Risk death to obtain the necessities of life. Is that a reflection of the overall Health Care System for minority populations in general . Guest yes. We know how the Africanamerican Community has been hit in proportion to the percentage of the population. It is hard. They are much more likely to get the disease. Once they get it, they are much more likely to have serious complications or die. Those are numbers that we actually can tell. There has been more attention to this. It has been a longstanding problem as you mentioned about poverty and the types of jobs that lower income americans have, which might in this particular pandemic is more likely to expose them to the virus. About their difficulties about about withir their daily lives. There are a number of societal reasons and health reasons. The earlier caller was correct that if more people have Health Insurance, that would certainly be a good thing for this population. Not enough. But it would be a good thing. This is a huge issue. At least people are talking about it. It has been there for a long time and people have not been. The president declared a National Health emergency. Way is your opinion on the guidances have changed in terms of wearing a mask, not wearing a mask, six feet, the shifting guidances over the last month in the u. S. And longer than that worldwide. Frustrating. Been i feel for my Public Health communication collects. There is an entire branch of Public Health that is dedicated to nothing but explaining to the public how Public Health works. How we can