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Trump’s Drug-Discount Cards Expected to Reach Medicare Recipients After Election

President Trump’s plan to send 33 million Medicare beneficiaries a card that can be used to help pay for as much as $200 in prescription drug costs won’t be completed until after the election, according to a person familiar with the plan.

The cards will be mailed in phases, with some likely going out later in October but most not until after the Nov. 3 presidential election, the person said. The Centers for Medicare and Medicaid Services is spending an estimated $20 million for administrative costs to print and send letters to Medicare beneficiaries informing them that they will be getting cards, the person said.

Plans for the overall drug-discount program have been sent to the Office for Management and Budget, the person said. It is unclear if or when the office will approve the program, which could cost $8 billion, the person said. The Centers for Medicare and Medicaid Services, which oversees Medicare designed for people 65 and older, is unable to say exactly when the cards will go out because the proposal is still at OMB. Beneficiaries will have two years to use the discount cards, the person said.

Low-income beneficiaries who don’t already get financial assistance for medications would likely get the cards, according to the person familiar with the planning, rather than everyone in Medicare Part D, which helps cover prescription drug costs for people 65 and older.

Mr. Trump surprised his own health-administration leaders on Sept. 24 when he announced the plan to mail out prescription drug cards. The discount cards were proposed by White House chief of staff Mark Meadows, said an administration official.

CMS officials rushed to figure out how the program could be structured and designed, according to two people familiar with the planning.

The proposed plan calls for funding the cards from two Medicare trust funds, according to the administration official. It would run out of a CMS office that tests new models for providing or paying for health care.

The program lets officials waive Medicare’s laws or standards to test if new initiatives increase efficiency and “economy of programs” without adversely affecting quality, according to CMS. These waiver programs have generally been required to show they won’t increase federal spending beyond what would have occurred without the test.

The drug-discount-card plan, for example, could be designed to test if people are more adherent to medications if they are given a discount, according to the administration official.

Democrats and other critics have said providing discounts doesn’t fit with the parameters or goals of the program, and they say it is unwise to tap the Medicare trust funds at the same time one of the funds is facing insolvency concerns.

Medicare is funded by two trust funds held by the U.S. Treasury. The trusts pay for hospital care and to administer the federal health-insurance program for people 65 and older and the disabled. They are funded through payroll taxes, income taxes paid on Social Security benefits and other sources.

The Medicare trust

Trump official says vaccine expected starting in January

A Trump administration official leading the response to the coronavirus pandemic says the U.S. can expect delivery of a vaccine starting in January 2021, despite statements from the president that inoculations could begin this month.

And a growing, bipartisan chorus of lawmakers, experts and public health officials says the country is ill prepared for a projected winter surge of COVID-19.

Dr. Robert Kadlec said in an email Friday that the administration “is accelerating production of safe and effective vaccines … to ensure delivery starting January 2021.” Kadlec is the Department of Health and Human Services’ assistant secretary of preparedness and response. HHS says a vaccine could be approved before the end of the year but will take time to distribute.

President Donald Trump has said at rallies, debates and press conferences that a vaccine could arrive within weeks. “We think we can start sometime in October,” Trump said at a White House press briefing last month.


Kadlec wasn’t the first health official to counter the president’s optimistic timeline. Health and Human Services Secretary Alex Azar said Thursday that there could be 100 million vaccine doses available by the end of the year “pending FDA authorizations.” And Dr. Moncef Slaoui, who is leading the government’s vaccine effort, told Marketwatch on Friday that researchers could know “by late October, or November, or in December” whether one of the vaccines in development is effective, but that it would then take weeks to get emergency authorization to administer it.

When asked about the disparity, the White House was not specific on a date but said Trump’s priority is to distribute a vaccine “as soon as possible.” Kadlec said, without elaborating, that it wasn’t correct to conclude that this meant the country couldn’t see a vaccine sooner than January.

Kadlec was responding to a series of questions from The Associated Press and FRONTLINE about the administration’s response to the pandemic and, in particular, about shortages of critical medical supplies.

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EDITOR’S NOTE: This story is part of an ongoing investigation by The Associated Press, the PBS series FRONTLINE and the Global Reporting Centre that examines the deadly consequences of the fragmented worldwide medical supply chain and includes the film America’s Medical Supply Crisis.

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The AP and FRONTLINE reported earlier this week that a breakdown in the supply chain for critical medical equipment including masks, gloves, gowns and ventilators hobbled the U.S. response to COVID-19 and was likely a factor in the country’s death rate, which is higher per capita than almost every other country in the world.

Experts say those shortages could now extend to the syringes, needles and glass vials that are vital to a future nationwide vaccination program.

Kadlec agrees that supply chain disruptions led to shortages. He said the administration needs more, consistent, flexible funding from Congress to shore up the Strategic National Stockpile of medical supplies and drugs and expand domestic manufacturing.

“There seems to be universal consensus from both sides of the aisle in Congress, from the health care

Official says vaccine expected in January, countering Trump

A Trump administration official leading the response to the coronavirus pandemic says the U.S. can expect delivery of a vaccine starting in January 2021, despite statements from the president that inoculations could begin this month.

Kadlec wasn’t the first health official to counter the president’s optimistic timeline. Health and Human Services Secretary Alex Azar said Thursday that there could be 100 million vaccine doses available by the end of the year “pending FDA authorizations.” And Dr. Moncef Slaoui, who is leading the government’s vaccine effort, told Marketwatch on Friday that researchers could know “by late October, or November, or in December” whether one of the vaccines in development is effective, but that it would then take weeks to get emergency authorization to administer it.

When asked about the disparity, the White House was not specific on a date but said Trump’s priority is to distribute a vaccine “as soon as possible.” Kadlec said, without elaborating, that it wasn’t correct to conclude that this meant the country couldn’t see a vaccine sooner than January.

Kadlec was responding to a series of questions from The Associated Press and FRONTLINE about the administration’s response to the pandemic and, in particular, about shortages of critical medical supplies.

———

EDITOR’S NOTE: This story is part of an ongoing investigation by The Associated Press, the PBS series FRONTLINE and the Global Reporting Centre that examines the deadly consequences of the fragmented worldwide medical supply chain and includes the film America’s Medical Supply Crisis.

———

The AP and FRONTLINE reported earlier this week that a breakdown in the supply chain for critical medical equipment including masks, gloves, gowns and ventilators hobbled the U.S. response to COVID-19 and was likely a factor in the country’s death rate, which is higher per capita than almost every other country in the world.

Experts say those shortages could now extend to the syringes, needles and glass vials that are vital to a future nationwide vaccination program.

Kadlec agrees that supply chain disruptions led to shortages. He said the administration needs more, consistent, flexible funding from Congress to shore up the Strategic National Stockpile of medical supplies and drugs and expand domestic manufacturing.

“There seems to be universal consensus from both sides of the aisle in Congress, from the health care sector and from the manufacturing base, that it is critical to move from a just-in-time manufacturing model to a

Trump Started on Dexamethasone, Has ‘Expected’ Lung Findings

President Trump was administered dexamethasone therapy for COVID-19 treatment, and had two episodes of low oxygen saturation levels that required supplemental oxygen, said doctors at Walter Reed Medical Center at a press conference on Sunday.

“In response to transient low oxygen levels, we did initiate dexamethasone therapy [and] our plan is to continue that for the time being,” said Brian Garibaldi, MD, of Johns Hopkins University. He also confirmed the president received his second dose of remdesivir.

White House physician Sean Conley, DO, said the team “debated on whether or not to start” dexamethasone, but added, “the potential benefits probably outweighed any risk at this time.”

Dexamethasone is a low-cost steroid that has shown the most benefit for the sickest patients with COVID-19. According to the U.K.’s RECOVERY trial, incidence of mortality was significantly lower for patients receiving mechanical ventilation, and those receiving supplemental oxygen without mechanical ventilation, but there was no significant benefit for those not receiving respiratory support.

The NIH currently recommends dexamethasone for hospitalized patients with “severe COVID-19.”

Doctors also said the president was receiving X-rays and CT scans. When asked by reporters if there were signs of pneumonia, lung involvement or damage to the lungs, Conley said there were some, “expected findings, but nothing of any clinical concern.”

Conley confirmed that President Trump’s oxygen levels dropped to 93%, that he did receive supplemental oxygen on Friday “for about an hour,” though he continued to stress “it wasn’t in the low 80s or anything like that.”

When pressed about the two incidences of a drop in oxygen levels, Conley said he would have to “check with the nursing staff” about the second round of supplemental oxygen.

“If he did [receive it], it was very limited,” he said.

After he was asked if the president’s oxygen levels ever dipped below 90%, Conley responded, “we don’t have any records here of that.” He described President Trump’s current oxygen levels at 98%.

Conley also confirmed the president had “a momentary episode of high fever and temporary drop in [oxygen] saturation” on Friday, which prompted the medical team to move him to Walter Reed.

Garibaldi said the president’s liver and kidney function remain normal. Conley said that like every patient, lung spirometry was performed on President Trump and it was “over 2,500 ml each time.”

When asked if the president is being treated in a negative pressure room, Conley maintained he was “not going to get into specifics” of care.

The hope is for President Trump to be discharged to the White House as early as tomorrow where he can continue his treatment course, Garibaldi noted.

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    Molly Walker is an associate editor, who covers infectious diseases for MedPage Today. She has a passion for evidence, data and public health. Follow

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Global virtual fitness expands during pandemic, expected to reach $44.7B by 2026: report

Virtual fitness is having a moment, according to a new report.

A recent analysis by market research firm Report Ocean has found that the online fitness market is expected to reach $44.7 billion globally by 2026, compared to $6 billion globally last year.

Before the coronavirus, online workouts were already gaining in popularity as a way to accommodate busy lifestyles among a growing number of “fitness-conscious people,” a press release about the report said.

However, even more people turned to online fitness classes when brick-and-mortar gyms were forced to temporarily close during the pandemic.

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According to the report, it is likely that even after life gets back to normal, people will stick with virtual workouts because “they offer flexibility of time and place.”

The online fitness market is expected to continue to grow after the pandemic because of the flexibility and accessibility of virtual workouts, according to a recent analysis by Report Ocean. (iStock)

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According to Report Ocean, on-demand streaming classes made up a majority of the global online fitness market last year and is expected to stay that way, because those classes “offer access to a variety of workout classes at clients’ suitability.”

However, live streaming is also becoming more popular “among regular fitness enthusiasts” and people who want “reliable” workouts, the report said.

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Report Ocean also found that subscription models for virtual fitness classes saw the highest growth compared to advertisement and hybrid-based revenue models.

“The client acceptance is primarily driven by its cost efficiency similar to signing up with a coach in-person,” the press release said.

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In order for the global online fitness market to continue to grow, the report said, programs should be progressive and adopt various “fitness strategies” and should help older adults, as well. The market is expected to continue to grow because online fitness has become popular among elderly people, who get “more personalized attention,” the report said.

“Elderly individuals are increasingly focusing on a healthier lifestyle, and they follow advice from qualified fitness specialists,” the report said.

“The adoption of virtual fitness is gaining momentum among this age group as they hire personal virtual trainers for the correct implementation of fitness training procedures,” it added.

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