Watch former Obama official Andy Slavitt discuss the effects of the coronavirus outbreak on the U.S. health care system

Texas Tribune health care reporter Edgar Walters and Andy Slavitt, the former acting administrator for the Centers for Medicare and Medicaid Services under President Barack Obama, for a discussion on the effect that the coronavirus outbreak is having nationally on the economy, the health care system and public policy.

Here are some of Slavitt’s responses to questions during the interview:

How should officials balance the economic fallout that has resulted from social distancing measures with the public health concerns of the coronavirus?

• Slavitt noted that social distancing is a key reason the need for hospital beds has been reduced in some of the major hot spots of the outbreak—such as Michigan, New Jersey and New York — and said that “everyone should feel, at some level, a sense of pride that we prevented the worst from happening.”

• Slavitt said that while he understands the pressure public officials must feel to get the economy back on track, “I don’t think that any public official, whether it’s the president or a governor, has the ability to say on their own ‘We’re going to reopen the economy,’” and that public trust in individual plans to reopen economic activity would be the determining factor for future economic recovery.
• “I wish we had a choice between the economy and public health,” Slavitt said. “[But] I don’t believe we actually do. ... The truth is for the short/intermediate term, we’re going to have [an economy fueled by government spending].” He added that while such an extended period of government spending to support the economy may not be what the federal government wants, “they also don’t have a lot of choices in the matter.”

What is needed to effectively slow or stop the spread of the virus?

• Like many others, Slavitt said that additional testing is needed to prevent further spreading of the coronavirus. However, he also noted that improving the national supply chain for testing has been complicated by the delayed response from the federal government, coupled with the fact that the current medical testing infrastructure was not designed to meet a demand of this scale.
• Slavitt said that to address the need for additional testing “by rebalancing supply, by setting a higher price, you can go from about a million tests a week to ... 2 1/2 to 3 million.” He said that there’s a great deal of lab capacity and supplies that are not being used due to low order numbers, which the federal government could address by placing orders or giving states the funds to place the orders themselves.
• Slavitt also said that he and a bipartisan group will propose a plan to Congress to hire and temporarily house roughly 180,000 contact tracers. Slavitt estimated that this would cost nearly $50 billion and would help expand the federal government's capacity to trace the spread of the virus.

How has this outbreak begun to reshape the U.S. health care system?

• One positive effect that this outbreak has had on the national health care system, according to Slavitt, is the increased use of telemedicine — which he believes will increase the overall level of access to care.
• On the subject of how the protracted economic slowdown will affect health care from a business perspective, Slavitt said, “People are slow to spend when they’ve gone through financial trauma ... so I think the demand for certain things will be lower [including medical procedures.]”

• He said he’s also concerned that rural hospitals and private practices will be disproportionately affected by decreased demand, and he added that the resulting financial instability will lead to a trend of more independent doctors’ offices either being owned by private insurance companies or going out of business.
• One of the reasons Slavitt said the national health care system has been generally so underprepared for the outbreak is that “we started planning for this after people started getting sick.”

What lessons will policymakers and the public take away from this public health crisis?

• Slavitt said that while he’s confident that the more tangible lessons of preparedness will be learned — such as shoring up personal protective equipment supplies — he believes that it remains to be seen whether the broader lessons will be learned. “The message we all should get from this ... you’re only as healthy as your healthiest neighbor. … I don’t think we’re gonna learn [that] lesson from this instantly.”
• Slavitt also said that he is somewhat skeptical that the outbreak will lead to any sort of radical rethinking of how the country approaches health care coverage. Rather, he said, “[it’s] the extent [to which this outbreak] connects to people and they feel that this was an existential threat to them and their families” that will determine how comprehensive the national policy response will be.

Slavitt oversaw Medicaid, Medicare, the Children’s Health Insurance Program and the Health Insurance Marketplace programs under President Barack Obama. He is the founder and a general partner in Town Hall Ventures, which invests in innovative health care businesses. Slavitt also serves as chairman of the nonprofit United States of Care, which focuses on increasing access to affordable health care, and as a senior adviser on health policy to the Bipartisan Policy Center.

The interview was streamed on the Tribune’s website, Facebook page and Twitter, as well as by our media partners at KXAN and KPRC2.

This event is presented by Blue Cross and Blue Shield of Texas, TEXAS 2036, Ascension Seton, Texas Association of Health Plans and AT&T. Media support is provided by KXAN.

Tribune events are also supported through contributions from our founding investors and members. Though donors and corporate sponsors underwrite Texas Tribune events, they play no role in determining the content, panelists or line of questioning.