Tuesday, March 10, 2020

Will the Trump Administration's Testing Snafus for Coronavirus Be Their Political Version of the Democrats' Catastrophic Launch of Obamacare?

As I have watched the Trump administration fumble the ball on getting mass coronavirus testing available to communities, I am reminded of the way the Obama administration fumbled their own ball during the Obamacare launch in 2013:

  • Repeated statements on how well things were going in the face of facts that did not match their rhetoric.
  • Not having a handle on what could go wrong and what did go wrong from beginning to end.
  • Delays that led to a public lack of confidence in the administration.

The difference this time is that the Obamacare fiasco was ultimately brought under control and, while people not being able to sign up for their health insurance for a few weeks was not a small deal, it wasn't the life and death scenario we are facing today.

Epidemiologists tell us that in order to get the coronavirus under control, we need to quickly know who is sick, where they are sick, and where they got it.

U.S. health officials have been hamstrung from the beginning because tests have not been readily available.

And, they may not be readily available at the community health center level for weeks to come.

It has been one Trump administration screw-up after another––and no this is not the fault of a President that left office over three years ago:
  • The first test kits were faulty.
  • There never were enough test kits to go around.
  • Health authorities tested only a very restricted part of the population––primarily those already presenting with symptoms, or who had been to China, or were exposed to a known carrier.
  • As a result, local health officials have been working largely blind against a virus that can take two weeks to show outward symptoms––in the meantime people with the virus have been circulating in their communities for weeks.
Trump's public denial of the problem reminded me of then HHS Secretary Sebelius telling us the Obamacare enrollment system was working just fine when in fact it wasn't working at all. Trump recently said, “Anybody that needs a test, gets a test. They’re there. They have the tests. And the tests are beautiful.”

Finally, this week, after giving the virus more than a month to spread wide and far, major labs are beginning to ramp up.

But, two months after it became clear the planet was on the precipice of a pandemic, community health centers, the backbone of health care in many communities, still can't test because, get this, the computer system isn't working!

As reported in the Washington Post, according to Ron Yee, chief medical officer of the National Association of Community Health Centers, "The billing codes are not yet in place on electronic medical records, so medical professionals haven't been ordering them [coronavirus tests] yet."

The 1,400 community health centers in the U.S. serve about one-in-twelve Americans. That's a lot of people walking around coughing and sneezing and not able to be tested.

To date, only 5,000 Americans have been tested.

By comparison, the Associated Press is reporting that both South Korea and Germany are currently able to do 15,000 tests a day.

President Trump and his senior people can claim that things like the efficacy of the first coronavirus test kits are not something they should have been expected to know about––just as the Obama people pleaded the same thing about the trouble with the Obamacare computer system.

But it is the job of a senior manager, in the face of something as important as the Obamacare launch, and certainly in the face of clear signals in early January that a crisis was brewing, to launch a top to bottom review and rehearsal for how things were going to play out.

The first question a good manager asks is, What could go wrong?

The biggest difference between the Obama administration's Obamacare launch screw up and this is that there is no evidence the Obama administration killed anybody in 2013.

If this were 2016 and Trump were a candidate running against the Democrats, can you imagine what he would be tweeting about this?


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