What Will Be the Top Health Issues for 2020?
By Roz Plater
It's 2020 and another year of health-related topics awaits us.
What health issues will take priority? What buzzwords will we all be talking about? How might technology change healthcare?
We asked some experts to peek into their crystal balls and make a few predictions.
They tell us that how you get access to healthcare and how you pay for it will both be hot topics this presidential election year.
In fact, one expert says healthcare could help decide political winners and losers.
"Whoever comes up with a plan that will work, is affordable, and something people can understand, that will push them ahead," said Kurt Mosley, vice president of strategic alliances for Merritt Hawkins, a physician search, consulting, and research firm.
Medicare is front and center as we kick off 2020.
That's in part because "Medicare for All" is the single payer option health plan being touted by two of the top Democratic presidential candidates.
Jeff Becker, the senior analyst for healthcare strategy at Forrester Research says there are also a number of bills in Congress looking to expand access to Medicare as a public option.
"When you look at the polling numbers, our call is that Medicare for All will die in the court of public opinion and become Medicare Advantage for more," Becker told Healthline.
Affordable Care Act
The Affordable Care Act (ACA), often referred to as Obamacare, will be in the courts again this year.
In December, a federal appeals court ruled that the health insurance law's individual mandate provision was unconstitutional.
However, the justices sent back to a federal district court in Texas the issue of whether other parts of the law could continue to exist without the mandate that requires everyone to have health insurance.
Look for some sort of Obamacare case to wind up in the U.S. Supreme Court this year.
"Our call is whether or not it goes to the Supreme Court, the ACA will survive because the individual mandate is severable," Becker told Healthline.
Experts say you'll hear a lot of debate about price transparency, a move designed to increase competition and lower costs.
President Trump signed an executive order in November that requires hospitals and insurers to publish their confidential, negotiated rates for treatments.
"The reason this would be important is you'd be able to figure out what your out-of-pocket expenses would be" said Becker.
But a coalition of hospital groups has filed a lawsuit to block the rule. They argue that the public disclosure of negotiated charges would create confusion about consumers' out-of-pocket costs.
The order is scheduled to go into effect January 1, 2021.
Lower Prescription Drug Prices
"The thing about pharmaceuticals is, if you can't afford them, they don't work," Mosley said.
He predicts the move to lower the costs of prescription drugs will again be on the front burner of the healthcare debate in 2020.
"The problem is Medicare and Medicaid can't negotiate prices with these drug companies," Mosley told Healthline.
The House of Representatives has approved a bill that would do just that. The legislation also caps out-of-pocket expenses for people enrolled in Medicare Part D.
However, the prognosis for this bill becoming law isn't good.
Political observers say the legislation won't go anywhere in the Senate, and the White House has indicated the president would veto it.
Republicans in the Senate have crafted their own prescription drug price plan. The president has indicated he would sign this bill, but it would need to be approved by the Democrat-controlled House.
Access to Health Services
"One of the cross-cutting issues we see as a priority in 2020 is the social determinants in health disparities in our patients," said Amy Mullins, MD, FAAFP, medical director for quality improvement for the American Academy of Family Physicians.
"Patients need more than just access to a physician," she told Healthline. "They need access to good food, safe places to live, to exercise, transportation, community resources, access to medication."
"If you don't address those, it's really difficult to treat your patients effectively," she added.
Mullins says her group has an internal division called the Center for Diversity and Health Equity whose mission is to look at healthcare through that lens.
Mullins also says the issue of vaccine myths is one you'll continue to hear about in 2020.
"We want to do more to counter the misinformation that's out there around vaccines that may be holding some people back from getting what they need," said Mullins.
A recent study concluded that a lot of the false information is being spread on social media by a handful of anti-vaccine ad buyers.
"We're promoting vaccine education to physicians, their healthcare teams, patients, and communities" Mullins said.
A 2020 National Vaccine Plan is currently being developed by the Department of Health and Human Services' Office of Infectious Disease and HIV/AIDS Policy.
"Another of the big priorities for health providers in 2020 is vaping and e-cigarettes," Mullins said.
"We really applaud and support the work the Centers for Disease Control and Prevention and the Food and Drug Administration is doing to try and get a handle on this crisis," she said. "But these products target adolescents and we think the marketing needs more regulation."
A study released last month from the National Institute on Drug Abuse reported that more teens are vaping marijuana.
That's despite a lung illness linked to vaping that's killed more than 50 people nationwide.
Virtual Care Visits
On the digital front, Becker predicts there will be aggressive growth in virtual care visits.
That's where you interact with your doctor via text, video, or phone call.
Becker's group crunched the numbers after looking at outpatient visit data as well as talking to virtual vendors and tracking healthcare investments.
"The result was 36 million net new virtual care visits in 2020," he said.
He points to how employers and insurers are already embracing the concept. Amazon recently launched a pilot program called "Amazon Care," a virtual clinic for its employees in Seattle.
Walmart recently expanded its telehealth services to workers in Colorado, Minnesota, and Wisconsin with $4 online or video care visits.
Humana has teamed up with "Doctor on Demand" to offer a virtual primary care plan at significantly lower monthly premiums.
"Everybody is moving toward a model where we're not using high-cost care centers like emergency rooms," Becker said.
"And consumers are demanding more cost effective services, too," he added. "In 2018, consumers took out $88 billion in personal loans just to pay for out-of-pocket medical costs."
- Natural Medicine: More Doctors Prescribing Time Outdoors ... ›
- Half of All American Adults Could Be Obese in 10 Years, Study Finds ›
- 23 Healthy New Year's Resolutions You Can Actually Keep ... ›
EcoWatch Daily Newsletter
Democrats in the House and Senate have introduced legislation to ban some of the most toxic pesticides currently in use in the U.S. D-Keine / E+ / Getty Images
By Jake Johnson
Democrats in the House and Senate on Tuesday introduced sweeping legislation that would ban some of the most toxic pesticides currently in use in the U.S. and institute stronger protections for farmworkers and communities that have been exposed to damaging chemicals by the agriculture industry.
- California Bans Pesticide Linked to Brain Damage in Children ... ›
- Hawaii Bans Use of Toxic Pesticide Chlorpyrifos - EcoWatch ›
- Trump EPA OKs 'Emergency' Use of Bee-Killing Pesticide on 13.9 ... ›
BP, the energy giant that grew from oil and gas production, is taking its business in a new direction, announcing Tuesday that it will slash its oil and gas production by 40 percent and increase its annual investment in low-carbon technology to $5 billion, a ten-fold increase over its current level, according to CNN.
- World's Largest Fund Manager to 'Reshape' Investment Portfolio to ... ›
- Oil Companies Are Thinking About a Low-Carbon Future, but Aren't ... ›
- BP Announces Net Zero Emissions by 2050 Target, but Offers No ... ›
By Alex Thornton
The Australian government has announced a A$190 million (US$130 million) investment in the nation's first Recycling Modernization Fund, with the aim of transforming the country's waste and recycling industry. The hope is that as many as 10,000 jobs can be created in what is being called a "once in a generation" opportunity to remodel the way Australia deals with its waste.
Waste Mountain<p>The need for a dramatic increase in Australia's recycling capacity pre-dates the COVID-19 pandemic. <a href="https://www.abc.net.au/news/2019-12-27/where-does-all-australias-waste-go/11755424" target="_blank">Australians create approximately 67 million tons of waste a year</a>, and like in many wealthy countries, much of that was sent overseas. That all changed when China announced it was <a href="https://www.weforum.org/agenda/2017/10/china-has-banned-foreign-waste-so-whats-the-future-of-world-recycling" target="_blank">banning the import of a huge range of foreign waste</a> and recyclables. Soon <a href="https://www.weforum.org/agenda/2019/05/malaysia-flooded-with-plastic-waste-to-send-back-some-scrap-to-source" target="_blank">other countries followed suit</a>, and Australia was forced to look for alternative solutions.</p>
Biggest exporters of plastic. Statista
Waste Export Ban<p>Australia has adopted a strategy of taking responsibility for its own waste. Starting in January 2021, it is phasing in <a href="http://www.environment.gov.au/protection/waste-resource-recovery/waste-export-ban" target="_blank">bans on the export of different forms of waste</a>. By mid 2024, Australia's home-grown recycling industry will have to deal with an extra 650,000 tons of waste plastic, paper, glass and tires.</p><p>"As we cease shipping our waste overseas, the waste and recycling transformation will reshape our domestic waste industry, driving job creation and putting valuable materials back into the economy," federal environment minister Sussan Ley said in a <a href="https://uk.reuters.com/article/us-australia-waste/australia-to-set-up-132-million-fund-to-boost-recycling-following-export-curbs-idUKKBN247060" target="_blank">statement to Reuters</a>.</p>
Timeline for Australia's waste export ban. Australian Government
Trash Into Treasure<p>The benefits to the environment of boosting recycling rates are well known – less landfill, less plastic in our ocean, reduced need for virgin materials, and lower carbon emissions. The Recycling Modernization Fund initiative aims to divert more than 10 million tons of waste from landfill, part of an <a href="http://www.environment.gov.au/protection/waste-resource-recovery/publications/national-waste-policy-action-plan" target="_blank">overall strategy to reduce the total waste generated per person by 10%</a>, and push <a href="https://www.environment.gov.au/system/files/resources/7381c1de-31d0-429b-912c-91a6dbc83af7/files/national-waste-report-2018.pdf" target="_blank">Australia's total resource recovery rate from 58% in 2017</a> to 80% by 2030.</p><p>But like many countries, Australia is focusing on the economic benefits of better waste management as well.</p><p>"This will mean Australia converts more waste into higher valued resources ready for reuse locally by manufacturers and brands in their packaging and products," Rose Read, CEO of the National Waste and Recycling Industry Council, <a href="https://uk.reuters.com/article/us-australia-waste/australia-to-set-up-132-million-fund-to-boost-recycling-following-export-curbs-idUKKBN247060" target="_blank">told Reuters</a>.</p>
Green Jobs<p>The great potential of the circular economy to create green jobs is being recognized across the world.</p><p>In the UK, the Waste and Resources Action Program has launched a <a href="https://wrap.org.uk/buildbackbetter" target="_blank">six-point plan which it claims could add $90 billion to the economy, and create 500,000 new jobs</a>. Investment in the circular economy forms a significant part of the <a href="https://www.nytimes.com/2020/07/14/us/politics/biden-climate-plan.html" target="_blank">$2 trillion climate plan that Democratic candidate Joe Biden</a> is taking into November's US presidential election. And the <a href="https://ec.europa.eu/commission/presscorner/detail/en/ip_20_940" target="_blank">European Union has put its Green New Deal at the heart of its plans for recovery</a> from the economic shock of COVID-19.</p><p>The World Economic Forum's <a href="http://www3.weforum.org/docs/WEF_The_Future_Of_Nature_And_Business_2020.pdf" target="_blank">Future of Nature and Business</a> report identifies 15 systemic transitions with annual business opportunities worth $10 billion a year that could create 395 million jobs by 2030.</p><p>As is the case with Australia's Recycling Modernization Fund, a combination of private enterprise and government investment can offer ways to get people back to work by building a more environmentally sustainable economy.</p>
- The Complex and Frustrating Reality of Recycling Plastic - EcoWatch ›
- U.S. Products Labeled Recyclable Really Aren't, Greenpeace ... ›
- Mutant Enzyme Recycles Plastic in Hours, Could Revolutionize ... ›
The Great American Outdoors Act is now the law of the land.
<div id="e0008" class="rm-shortcode" data-rm-shortcode-id="ffc07febbf5d2d585ad06d3f43e2be56"><blockquote class="twitter-tweet twitter-custom-tweet" data-twitter-tweet-id="1290667833999929344" data-partner="rebelmouse"><div style="margin:1em 0">🚨Breaking News: The President has just signed the bipartisan #GreatAmericanOutdoorsAct. It will help: 🏗️ Restore… https://t.co/RPefKPMn7S</div> — Fix Our Parks (@Fix Our Parks)<a href="https://twitter.com/FixOurParksUS/statuses/1290667833999929344">1596554165.0</a></blockquote></div>
- Judge Rebukes Trump's Attack on Public Lands, Rules Coal Mining ... ›
- Great American Outdoors Act Passes House With Bipartisan Support ... ›
- Great American Outdoors Act Approved by Senate in Major ... ›
By Andrew J. Whelton and Caitlin R. Proctor
In recent years wildfires have entered urban areas, causing breathtaking destruction.
Survivors left everything to flee the Camp Fire's path. Andrew Whelton / Purdue University
Wildfires and Water<p>Both the Tubbs and Camp fires destroyed fire hydrants, water pipes and meter boxes. Water leaks and ruptured hydrants were common. The Camp Fire inferno spread at a speed of one football field per second, chasing everyone – including water system operators – out of town.</p><p>After the fires passed, testing ultimately revealed widespread hazardous drinking water contamination. Evidence suggests that the toxic chemicals originated from a combination of <a href="https://doi.org/10.1002/aws2.1183" target="_blank">burning vegetation, structures and plastic materials</a>.</p>
Pipes, water meters and meter covers after wildfires destroyed them. Caitlin Proctor, Amisha Shah, David Yu, and Andrew Whelton/Purdue University
Dangerous Contamination Levels<p>Benzene was found at concentrations of 40,000 parts per billion (ppb) in drinking water after the Tubbs Fire and at more than 2,217 ppb after the Camp Fire. According to the California Office of Environmental Health Hazard Assessment, children exposed to benzene for a single day can suffer <a href="https://engineering.purdue.edu/PlumbingSafety/resources/Benzene-Levels-in-Water.pdf" target="_blank">harm at levels as low as 26 ppb</a>.</p><p>The U.S. Environmental Protection Agency recommends limiting children's short-term acute exposure to <a href="https://www.epa.gov/sites/production/files/2018-03/documents/dwtable2018.pdf" target="_blank">200 ppb</a>, and long-term exposure to less than <a href="https://www.epa.gov/ground-water-and-drinking-water/national-primary-drinking-water-regulations" target="_blank">5 ppb</a>. The EPA regulatory level for what constitutes a hazardous waste is <a href="https://19january2017snapshot.epa.gov/sites/production/files/2015-06/documents/tclp.pdf" target="_blank">500 ppb</a>.</p><p>In early 2019, California conducted contaminated water testing on humans by taking contaminated water from the Paradise Irrigation District and asking persons to smell it. The state found that even when people smelled contaminated water that had less than 200 ppb benzene, <a href="https://engineering.purdue.edu/PlumbingSafety/resources/Dissipatiion-of-Burn-Related-VOC-From-Water.pdf" target="_blank">at least one person reported nausea and throat irritation</a>. The test also showed that water contained a variety of other benzene-like compounds that first responders had not sampled for.</p><p>The officials who carried out this small-scale test did not appear to realize the significance of what they had done, until we asked whether they had had their action approved in advance by an institutional review board. In response, they asserted that such a review was not needed.</p><p>In our view, this episode is telling for two reasons. First, one subject reported an adverse health effect after being exposed to water that contained benzene at a level below the EPA's recommended one-day limit for children. Second, doing this kind of test without proper oversight suggests that officials greatly underestimated the potential for serious contamination of local water supplies and public harm. After the Camp Fire, together with the EPA, we estimated that some plastic pipes needed <a href="https://engineering.purdue.edu/PlumbingSafety/opinions/Final-HDPE-Service-Line-Decontamination-2019-03-18.pdf" target="_blank">more than 280 days</a> of flushing to make them safe again.</p>
Plastic pipes can be damaged by heat and fire contact. Andrew Whelton / Purdue University
Building Codes Could Make Areas Disaster-Ready<p>Our research underscores that community building codes are inadequate to prevent wildfire-caused pollution of drinking water and homes.</p><p>Installing one-way valves, called backflow prevention devices, at each water meter can prevent contamination rushing out of the damaged building from flowing into the larger buried pipe network.</p><p>Adopting codes that required builders to install fire-resistant meter boxes and place them farther from vegetation would help prevent infrastructure from burning so readily in wildfires. Concrete meter boxes and water meters with minimal plastic components would be less likely to ignite. Some plastics may be practically impossible to make safe again, since all types are susceptible to fire and heat.</p><p>Water main shutoff valves and water sampling taps should exist at every water meter box. Sample taps can help responders quickly determine water safety.</p>
<span style="display:block;position:relative;padding-top:56.25%;" class="rm-shortcode" data-rm-shortcode-id="9540d7e271306ed417112042a3efc9a4"><iframe lazy-loadable="true" src="https://www.youtube.com/embed/GnlrzI1wdAI?rel=0" width="100%" height="auto" frameborder="0" scrolling="no" style="position:absolute;top:0;left:0;width:100%;height:100%;"></iframe></span>
The Smell Test Doesn’t Work<p>Under no circumstance should people be told to <a href="https://www.waterboards.ca.gov/press_room/press_releases/2018/pr122418_voc.pdf" target="_blank">smell the water</a> to determine its safety, as was recommended for months after the Camp Fire. Many chemicals have no odor when they are harmful. Only testing can determine safety.</p><p>Ordering people to boil their water will not make it safe if it contains toxic chemicals that enter the air. Boiling just transmits those substances into the air faster. "Do not use" orders can keep people safe until agencies can test the water. Before such advisories are lifted or modified, regulators should be required to carry out a full chemical screen of the water systems. Yet, <a href="https://doi.org/10.1002/aws2.1183" target="_blank">disaster</a> after <a href="https://pubs.rsc.org/en/content/articlehtml/2017/ew/c5ew00294j" target="_blank">disaster</a>, government agencies have failed to take this step.</p><p>Buildings should be tested to find contamination. <a href="https://www.purdue.edu/newsroom/releases/2020/Q1/study-your-homes-water-quality-could-vary-by-the-room-and-the-season.html" target="_blank">Home drinking water quality can differ from room to room</a>, so reliable testing should sample both cold and hot water at many locations within each building.</p><p>While infrastructure is being repaired, survivors need a safe water supply. Water treatment devices sold for home use, such as refrigerator and faucet water filters, are not approved for extremely contaminated water, although product sales representatives and government officials may <a href="https://undark.org/2019/09/19/camp-fire-california-drinking-water-carcinogens/" target="_blank">mistakenly think</a> the devices can be used for that purpose.</p><p>To avoid this kind of confusion, external technical experts should be called in assist local public health departments, which can quickly become overwhelmed after disasters.</p>
<div id="71cf9" class="rm-shortcode" data-rm-shortcode-id="e059d199e8368d282a31601e372e4dda"><blockquote class="twitter-tweet twitter-custom-tweet" data-twitter-tweet-id="1204068265980547075" data-partner="rebelmouse"><div style="margin:1em 0">The Los Angeles City Council's Planning and Land Use Committee signed off on an effort to expand the city's fire-re… https://t.co/fP8Z8mUq7R</div> — IntlCodeCouncil (@IntlCodeCouncil)<a href="https://twitter.com/IntlCodeCouncil/statuses/1204068265980547075">1575907219.0</a></blockquote></div>
Preparing for Future Fires<p>The damage that the Tubbs and Camp fires caused to local water systems was preventable. We believe that urban and rural communities, as well as state legislatures, should establish codes and lists of authorized construction materials for high-risk areas. They also should establish rapid methods to assess health, prepare for water testing and decontamination, and set aside emergency water supplies.</p><p>Wildfires are coming to urban areas. Protecting drinking water systems, buried underground or in buildings, is one thing communities can do to prepare for that reality.</p>
- After a Quiet Summer, 'Dangerous' California Wildfire Burns ... ›
- California Wildfires: One of 'Greatest Tragedies' State Has Ever Faced ›
- Losses From California Wildfires Top $1 Billion, Expected to Rise ... ›
New satellite images have revealed 11 new throngs of emperor penguin colonies, lifting the number of known emperor penguin colonies by 20 percent and their total population by 5 to 10 percent, according to The Guardian.
- This Penguin Colony Has Fallen by 77% on Antarctic Islands ... ›
- Antarctica's Ice Is Melting 5 Times Faster Than in the 90s - EcoWatch ›
- Green Snow Is Spreading in Antarctica Due to the Climate Crisis ... ›
- Antarctic Penguin Poop Emits Laughing Gas - EcoWatch ›
By Zulfikar Abbany
"We don't have a definition of life," says Kevin Peter Hand, one early California morning when we speak via video. "We don't actually know what life is."