What COVID Couldn't Change

By: Daniel Payne, Politico Pulse

The “new normal” of post-pandemic U.S. health care is shaping up to be similar to the old normal, [the author] reports.

As the U.S. takes another step toward the end of the pandemic, policymakers and public health experts realize that even a catastrophe like Covid-19 can’t shake up the entrenched health care system that’s stymied with roadblocks like deep-pocketed lobbyists and unmovable partisan divides.

Hopes that a pandemic could change U.S. health care at its core — whether by bolstering arguments for more government involvement or a permanent rollback of regulations — are fading.

Money talks: Public health experts and policymakers said that, as much as the pandemic changed health delivery, it didn’t change the interests of the big players in the business of care.

Lobbyists for hospitals, doctors, insurers and drugmakers have largely been pushing for the same changes they pushed for before the pandemic like boosted government payments and fewer rules to follow.

Political divides: Though the government’s pandemic response began with broad agreement between Democrats and Republicans, politics has again quickly divided lawmakers on how much the government should be involved in Covid responses — and health care more generally.

Covid is more politicized than most health care issues, making the continuation of pandemic programs less likely.

Equity issues: The rush of pandemic funding to close gaps in health outcomes is drying up, and programs stood up with that money are struggling.

Though some health-equity activists use the progress from the pandemic to argue for funding increases, many said they’re concerned Covid-era funding won’t come back.

Hopes for change: Some areas could see long-term changes from Covid. Though telehealth and vaccine development policies probably won’t fundamentally change U.S. health care, they seem to have legs beyond the pandemic.

But even those issues — largely because of the entrenched forces — face significant hurdles to survive beyond Covid.