| | | | | | | Presented By PhRMA | | | | Axios Vitals | | By Tina Reed · Nov 07, 2022 | | Welcome back to another week, Vitals readers. Today's newsletter is 1,031 words or a 4-minute read. 🤒 1 fun thing: In case you missed it, Saturday Night Live offered a case for getting COVID to preserve your mental health. | | | | | | 1 big thing: More docs unionize amid burnout, industry consolidation |  | | | Illustration: Shoshana Gordon/Axios | | | | Burnout and health industry consolidation are driving more doctors and doctors-in-training to unionize to demand better pay, benefits and working conditions, Axios' Arielle Dreher writes. Driving the news: More than 1,200 resident physicians and interns at Montefiore Medical Center last week asked the Bronx, N.Y., hospital to recognize their bargaining unit after an organizing vote. - It was another sign that 80-plus hour work weeks, combined with inflation and other stressors, are prompting more doctors to demand a seat at the table.
- The Committee of Interns and Residents, part of the Service Employees International Union, said it had a record year organizing at five hospitals across the country, and now has more than 22,000 members.
Yes, but: There are concerns that doctors taking collective action could undermine public trust and jeopardize patient safety. - And the prospect of physicians walking off the job nearly became reality over the summer, during a labor dispute involving 1,300 residents and fellows at three of Los Angeles County's biggest hospitals.
By the numbers: There were more than 67,000 physician union members, or about 7% of all practicing U.S. doctors, as of 2019, according to the American Medical Association. - The average resident physician's salary in the U.S. in 2021 was $64,000, according to Medscape. Those unionizing say that's not enough considering inflation and the increasing cost of living, especially in cities like New York and Los Angeles.
- Additionally, the workload and residents with student loan debt are also factors, per Fierce Healthcare.
Between the lines: Hospitals are facing complex financial calculations that go beyond paying for hours worked, particularly when it comes to their trainees, Association of American Medical Colleges chief health care officer Janis Orlowski said in an article posted by AAMC. - "On one hand, residents work long hours and contribute significantly to the care of patients. For this they receive a stipend," Orlowski said. "On the other hand, they're apprentices who are receiving very valuable training that is expensive for institutions to provide."
The bottom line: As health systems move beyond COVID-19 and rely less on traveling and temporary staff, relations with doctors will become a pivotal business barometer. |     | | | | | | 2. GOP's post-pandemic playbook |  | | | Illustration: Aïda Amer/Axios | | | | President Biden declared in September that the COVID-19 pandemic was "over." If Republicans win control of Congress, they'll demand U.S. policy reflects that conclusion, Axios' Andrew Solender and Victoria Knight write. Why it matters: The pandemic ushered in revolutionary changes to U.S. health and economic policy. While many pandemic-era restrictions have already been rolled back, a full reversion to pre-COVID governance would have profound consequences for American life. What we're hearing: Republicans will push to dismantle a number of lingering pandemic policies, with the U.S. military's vaccine mandate among the priorities, according to multiple GOP aides. - The effort to topple the mandate is expected to include scrutiny of the process for granting religious exemptions and, if necessary, a provision in the National Defense Authorization Act to fully rescind it.
- Also, don't count on Republicans approving the Biden administration's request for $22.4 billion in COVID funding if a package doesn't pass in the lame duck session.
What they're saying: "After nearly three years of living under this state of emergency, the American people are worn out and yearning to breathe free," Sen. Roger Marshall (R-Kansas) said in a statement to Axios. - "Considering Joe Biden said COVID is over, it's high time to stop talking about restrictions and the unknown. We must chart a new course to victory that respects the virus and our freedoms."
Go deeper. | | | | | | | | 3. Paxlovid reduces long-COVID risk, VA study finds |  | | | Illustration: Brendan Lynch/Axios | | | | Pfizer's antiviral pill Paxlovid can reduce the risk of long COVID symptoms like organ damage, according to a pre-print study the Department of Veterans Affairs released on Sunday. Driving the news: The study of 56,000 veterans who tested positive for the virus found those given the medication in the first five days of infection had a 25% decreased risk of developing 10 of 12 symptoms, such as heart, kidney or liver disease. - It's another positive data point in the back-and-forth about Paxlovid, which has been shown to reduce hospitalizations but also raised concerns about its contribution to COVID rebound.
Be smart: The study published on the pre-print server medRxiv has not yet been peer-reviewed and will need to be independently replicated. What they're saying: "Before this report, the only way we have known to reduce long COVID was to avoid a COVID infection," Eric Topol, executive vice president of Scripps Research, wrote in a blog post, adding there was also some reduction afforded by prior vaccination and boosters. - "The new VA study adds a [third] way of reducing long COVID, no less important complications across multiple organ systems, and improved survival and avoidance of hospitalizations," he wrote.
| | | | | | | | A message from PhRMA | | How insured Americans navigate unclear insurance coverage | | |  | | | | According to new findings, insured Americans favor policy solutions that improve their ability to navigate and access their care while lowering their out-of-pocket costs. An example: Tackling the barriers introduced by insurers and middlemen like pharmacy benefit managers. Read more. | | | | | | 4. The health fight at COP27 |  | | | Photo: Sean Gallup/Getty Image | | | | The health implications of climate change must be at the center of negotiations at this year's COP27 climate summit which began in Egypt on Sunday, the World Health Organization said in a statement on Sunday. - "Climate change is making millions of people sick or more vulnerable to disease all over the world and the increasing destructiveness of extreme weather events disproportionately affects poor and marginalized communities," WHO director-general Tedros Adhanom Ghebreyesus said.
COP stands for the "Conference of the Parties," meaning those countries that signed onto previous UN climate agreements, Axios' Andrew Freedman explains about the conference. - The summit will likely feature intense clashes over funding to cover the costs of climate change damages occurring in developing nations, such as the Pakistan floods.
Between the lines: The midterms will take place during the first week of COP27, likely dampening any hopes of major financial commitments from the U.S. Go deeper: Axios Climate Truths: New health crisis | | | | | | | | 5. While you were weekending | | 👉 The Florida Board of Medicine voted to ban gender-affirming care for trans youth. (Axios) 🏥 Hospital giant HCA is fending off accusations of questionable inpatient admissions. (KHN) 👀 Flu and other respiratory virus activity continues to ramp up across the U.S. (CNN) | | | | | | | | A message from PhRMA | | Americans want policy reforms that improve their insurance | | |  | | | | Did you know 39% of insured Americans say they don't understand what's covered by their insurance? Health insurance coverage should be predictable and transparent, and insured Americans agree. Learn more from PhRMA's latest Patient Experience Survey report. | | | | Thanks for reading, and thanks to senior editor Adriel Bettelheim and copy editor Nick Aspinwall for the edits. Did someone forward this email to you? Here's how to sign up. |  | | Why stop here? Let's go Pro. | | | | | | Axios thanks our partners for supporting our newsletters. If you're interested in advertising, learn more here.
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