HJNO May/Jun 2021

DIALOGUE 12 MAY / JUN 2021 I  HEALTHCARE JOURNAL OF NEW ORLEANS   to coast. There are some medications and some equipment that is sole sourced out of Asia. We’ve learned there’s a certain vulner- ability there. If China chooses to not allow the export of N95 masks, even if they’re being produced by a company like 3M, which is an American company, the United States is worse off. There needs to be a distribution of sup- ply, not just fromAsia, but some within the United States, some within Latin America, some from our European allies. We did that during the Cold War in which every NATO country had some aspect of an essen- tial supply chain, so that if ever there was a breakout of hostilities, NATO countries within themselves could supply each other whatever they needed. We have to recog- nize that sole sourcing so many things out of China creates a vulnerability. One specific example, penicillins, are now made 100% out of China. So, if ever we were to have a conflict with China, God forbid, we would not have access to the penicillins that are so essential as antibiotic therapy for a whole variety of conditions. I don’t think that’s a very good idea. I think there needs to be a national security understanding of how we supply some of these objects. Some stuff in Asia is fine, of course. We’re a global economy. But, everything in Asia or everything of a certain class of medications is risky for our health, and we need to think about that. The legislation I’m working on and have intro- duced begins to address this. Editor Have you had talks about bringing any of that to Louisiana? Dr. Cassidy When it comes to prescrip- tion drugs, and specifically generic drugs, there’ve been folks in Louisiana who’ve been interested in bringing some of that into the New Orleans area, and we have been giving them as much information as possible as to how this could happen. Editor That would be an exciting source of jobs creation, having that here. I want to switch topics with you for a second and speak about the Medicare lockbox. How is it doing? And will post-baby boomers receive the same benefits that their par- ents had? Dr. Cassidy There is no Medicare lockbox in that whatever excess dollars have been paid in or invested in the Treasury bills, and then whenever they expire, the money goes back into the Medicare trust fund. The Medi- care trust fund is going bankrupt within this decade. So, if current law holds, which is to say that when the trust fund is bankrupt, the people providing services to those onMedi- care only get paid out of what is currently coming in. It is projected that a hospital, a physician, a therapist would receive 25% to 30% less fromMedicare than they are cur- rently receiving. The challenge is, how do we preserve Medicare, making sure the benefits that are currently there will be there not just for the baby boomers but for the post-baby boom- ers as well? There’s a variety of solutions, but my office is very active on this. We have a meeting once a week to go over what we’re trying to do in order to correct this problem. There is a heck of a lot of waste in health- care. So, ideally you squeeze out the waste and you focus the good, so patients continue to get everything they need — in fact, prob- ably do a little bit better in some situations — but at the same time, you’re able to shore up the trust fund, and that’s what the legis- lation we’re working on is attempting to do. Editor Do you think Medicare reimburse- ments are fair to the healthcare industry? Dr. Cassidy There’s not one reimbursement that you can point your finger to, but what Medicare attempts to do is look at cost reports and say, “OK, this is what you’re tell- ing us is your cost of doing business; we’re going to pay you 6% more.”As a rule, pro- viders tell me that they feel like they would, of course, always like to get a little bit more, but they feel as if Medicare is not far off. On the other hand, when it comes to some prescription drugs, there are some where arguably Medicare is paying way too much. “We have to recogn i ze that sole sourc i ng so many th i ngs out of Ch i na creates a vulnerab i l i ty. One spec i f i c example , pen i c i ll i ns, are now made 100% out of Ch i na .