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April 12, 2021

Where's The Michigan Vaccine Surge?

Plus, more executive action options to lower drug prices

 

Gov. Gretchen Whitmer (D-MI) got her shot last week; now the rest of the
state needs their dose. (Nicole Hester/Ann Arbor News via AP)

To Recap

**** I enjoyed last week's project of breaking down key
elements of the American Jobs Plan, with pieces on electrifying the
postal fleet
,
replacing water pipes
,
and incentivizing inclusionary zoning
,
along with a piece on building economically without a consultant frenzy
. There's
so much policy packed into the Biden plan that we'll be continuing to
look at its provisions. We even got a nice shoutout from John Oliver
for one
of our pieces, about long-term care
.  

We built a mini-site, Building Back America
, for our
articles analyzing the plan, and right now there are eight of them
there, with more to come. Check it out
!

**Read all of our First 100 reports here**

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The Chief

**** The weekend yielded another record on the vaccination
front, with 4.6 million shots

in arms on Saturday. Many states are opening up vaccinations to all
adults this week, and while fewer Johnson & Johnson shots will be
distributed, I'd expect to hit a new high in the coming weekend.
Nearly 36 percent of adults have received at least one dose of the
vaccine.

In the race between the vaccine and the virus variants, some context has
to be given. Six states are experiencing caseloads of over 200 cases per
100,000 residents, and in general high caseloads are located in the
Northeast and upper Midwest. The South is looking OK (though Florida is
trending badly), the Southwest and Plains are mostly fine, and
California is third-lowest in the country. There were 10 deaths in all
of the 10 million-plus Los Angeles County

on Sunday, less than half of the national average.

Hospitalizations nationwide
are
stubbornly stuck around the mid-October level, but the deaths per
100,000 rate is both relatively mild and not necessarily correspondent
with the states where cases are rising. Cases aren't necessarily the
relevant measurement in a situation where the population most
responsible for deaths is mostly vaccinated. Still, we know that
COVID-19 packs a wallop even short of death, and the vaccines can limit
that sickness. Plus, inoculating a state with significant community
spread prevents replication that can lead to mutations.

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If you wanted to focus on a state that has a combination of all of these
factors, it's Michigan, which has the highest positivity rate
from
testing, the highest case rate

by a factor of nearly two, and a growing death rate
.
Michigan is lagging behind other states
in the upper
Midwest and Northeast on vaccinations; more of the population is
vulnerable. This has put the health system under stress
.
Gov. Gretchen Whitmer (D-MI) has asked high schools to voluntarily
suspend in-person classes and youth sports for two weeks, as this is
seen as a major vector for spread. This is someone who was almost
kidnapped the last time she called for anything mandatory, so begging
school districts to be reasonable is all that's left.

Except there's one more thing. Why isn't the White House doubling
vaccine allocations to Michigan? The governor is asking for that
.
It makes total sense and would involve next to no sacrifice from other
states. Michigan is about three percent
of the
U.S. population. The rest of the nation would get about 97 percent of
their allocation if we doubled supply to Michigan. And since state
border walls haven't gone up and anyone can travel freely anywhere
within the U.S., stopping a viral outbreak in one place will minimize
the opportunity for that outbreak to roam around the country, as we've
been seeing for over a year. (This is why "judging" state
governor's performance is totally futile; the virus moves and mutates
on its own no matter what a governor does!)

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The White House has inexplicably resisted this. COVID-19 Response Team
coordinator Jeffrey Zients has promised more vaccinators, testing kits,
and treatments for Michigan, which acknowledges that there's a big
problem there. But there are two possible solutions to something where
the spread is such that contact tracing is useless: non-pharmaceutical
interventions like a lockdown (highly unlikely), and pharmaceutical
interventions like vaccines (entirely available). Even if a lockdown
were possible, why wouldn't you add to the available vaccines if you
have the opportunity, which you do?

It's in the country's best interest to surge vaccines into Michigan.
I imagine the resistance is just a fear of bad press, worries about
"favoritism" or something. I think some critiques of the vaccination
campaign are out of bounds, and it's hard to argue with the
administration's success. But President Biden has insisted that he
would follow the science. He should try it in this case.

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Senators Beg for Executive Action

It's sad that good public servants have to use their time not devising
legislation but scouring old laws to figure out what the president can
do on their own. But that's where we're at with a resolution offered

by Sen. Jeff Merkley (D-OR), imploring the Biden administration to take
action to lower prescription drug prices. After a long preamble
describing the urgent need for action, Merkley (joined by Sens. Warren,
Sanders, and Booker) highlights specific actions that Secretary of
Health and Human Services Xavier Becerra can take to lower drug prices.

Two of them mirror what we have highlighted at the Prospect

for some time: section 1498(a) of Title 28 of the U.S. Code (known as
eminent domain for patents) and "march-in rights" under the
Bayh-Dole Act of 1980. Both involve essentially seizing drug company
patents (for just compensation) and issuing them to companies who will
distribute the medications to the public affordably. Merkley adds two
other possibilities. First, there are "royalty-free rights
," another section of the Bayh-Dole
Act that allows the government to retain patent rights on drugs funded
through public research. This is similar to march-in rights except
it's the inherent right without having to seize the patent.

Then there's the Center for Medicare and Medicaid Innovation
, a division
authorized in the Social Security Act to "test innovative payment and
service delivery models." Through CMI, you could test out something
like an international drug pricing index
, which
President Trump flirted with, that would peg a price Medicare and
Medicaid would pay for drugs to a benchmark of developed countries with
lower prices. And you could try other options to lower drug costs too.

The point is that there are many options here, and because we have an
insanely unproductive Congress it's come down to someone like Merkley
to beg the White House to use the authorities they already have. We'll
be watching at the Prospect's Executive Action Tracker
.

What Day of Biden's Presidency Is It?

Day 83.

We Can't Do This Without You

Today I Learned

* That commission on Supreme Court reform

seems worse than useless. It has 36 people on it! (Whitehouse.gov)

* A statement of priorities more than a policy that will be carried out,
the Biden budget

asks for essentially more of everything. (Washington Post)

* Raising taxes on the rich is extremely popular
,
not just a bone to throw to fiscal conservatives. (Axios)

* Everyone in Congress wants to get something out of the infrastructure
plan
,
which bodes well for its future. (New York Times)

* The fossil fuel subsidies phased out in the Biden plan are exceedingly
minor .
(Volts)

* The Biden team will have to choose between focusing on Obamacare or
expanding Medicare
.
(Washington Post)

* A trade secrets fight that almost closed a giant Georgia battery plan
has been resovled
.
(HuffPost)

* Not even 100 days in and the White House border coordinator has
stepped down
.
(New York Times)

* Biden police oversight commission on hold
.
(Politico)

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