The Daily Signal - Delivering Better Health and Human Services to Americans

Episode Date: June 10, 2020

Eric Hargan, deputy secretary of the U.S. Department of Health and Human Services, joins The Daily Signal Podcast to discuss the nation's coronavirus recovery. Hargan also describes his priorities in cutting red tape at HHS, focusing on values-based health care that is primarily about outcomes and not just services, and making health care records more accessible for Americans. We also cover these stories: Senate Majority Leader Mitch McConnell calls out the double standard of liberal Democratic leaders who have praised and even participated in protests over George Floyd’s death, but who continue to limit religious gatherings and criticized COVID-19 protests just last month.  Mourners gather in Houston for George Floyd’s funeral service.  The Los Angeles Police Department temporarily prohibits officers from using a "carotid restraint" on necks to subdue suspects.  Hosted on Acast. See acast.com/privacy for more information. Learn more about your ad choices. Visit megaphone.fm/adchoices

This is the Daily Signal podcast for Wednesday, June 10th. I'm Virginia Allen. And I'm Rachel Del Judas. Eric Hargan is the Deputy Secretary of the Department of Health and Human Services. He joins the Daily Signal podcast to give a brief update on how the agency is handling coronavirus recovery as well as how it is working toward cutting regulations and red tape. Don't forget. If you're enjoying this podcast, please be sure to leave a review or a five-star rating on Apple

podcasts and encourage others to subscribe. Now onto our top news. Senate Majority Leader Mitch McConnell is calling out the double standard of liberal Democratic leaders who have praised and even participated in protest after George Floyd's death, but continue to limit religious gatherings and criticized COVID-19 protests just a month ago. On the Senate floor Tuesday, McConnell spoke directly to the hypocrisy he sees from some leaders on the left. A month ago, small protest demonstrations were widely condemned as reckless and selfish. Now, massive rallies that fill entire cities are not just praised, but in fact are called especially brave because of the exact same health risks that brought condemnation when the

cause was different. People just spent the spring watching. their small businesses dissolve, or canceling weddings, or missing religious observances for the longest spells in their lives, or missing the last days of a loved one's life and then missing the funeral, never were the American people told about any exemption for things they felt strongly about. I have no criticism for the millions of Americans who peacefully demonstrated in recent days. Their cause is beyond righteous. It is the inconsistency from leaders that has been baffling.

The same governor of Michigan who argued that letting people carefully shop for vegetable seeds, vegetable seeds, would be too dangerous during the pandemic, now poses for photographs with groups of protesters. Here in the District of Columbia, the mayor celebrates massive street protests. She actually joins them herself. But on her command, churches and houses of worship remain shut. I believe even the largest church buildings in the district are still subject to the 10-person limit for things the mayor deems inessential.

The rights of free speech, free assembly, and the free exercise of religion are all First Amendment rights. They have the same constitutional pedigree. But apparently, while protests are now permissible, prayer is still too dangerous. Politicians are now picking and choosing within the First Amendment itself. Mourners gathered Tuesday in Houston for George Floyd's funeral service. Floyd, who died May 25th after Derek Chauvin, a Minneapolis police officer, pressed his knee against Floyd's neck for over eight minutes as Floyd lay handcuffed on his street after his arrest,

will be buried in a grave next to his mothers, according to the New York Times. Here are remarks delivered by Reverend Mary White during Floyd's funeral. We welcome your presence that's already in this place. Master, we thank you for this celebration. We thank you for the life of George Floyd, oh God, that at a moment when he called out for his mama, we believe that the ears of mamas across this nation, rear it up, that the ears of mamas across this world

heard him this world are our today master. God, we thank you for what you're doing in this place, Father. We thank you that I ask that you would ignite upon us, oh God, clove and tongues of fire, fiber. Father, because clove and tongues of fire will decree and declare and proclaim righteousness. The Los Angeles Police Department has temporarily prohibited officers' use of carotid restraints. Carotid restraints are a type of chokehold that does limit blood flow to the brain and one's ability to breathe. Traditionally, the Los Angeles County Sheriff's Department has only used these holds when someone poses a serious threat to the safety of others.

Lieutenant John Satterfield said, per Los Angeles Times, that the communities made it clear that this isn't a force option that they want where it's currently at. We hear the community and we're going to react. And Satterfield added that regarding the holds, when we use it, we use it very effectively. No one's ever died as a result. We don't apply it with a knee or a leg that would never have occurred in any of our training. The LAPD will allow for further review of carotid holds before a decision is made as to whether or not they will be allowed to be used again in the future. The president of the Minneapolis City Council wants an America without police. Here's what Lisa Bender told CNN's Chris Cuomo.

When you say you see someday being police free, that sounds aspirational in terms of a utopian concept where nobody's committing any crime. Because as long as these communities are being preyed upon, both from within and without, there's going to have to be good men and women willing to step up to keep people safe. I think the idea of having a police free future is very aspirational. And I am willing to stand with community members who are asking us to think of that as the goal because so many folks in our community have seen us work on reform. New York City Mayor Bill de Blasio said Tuesday that he will have the words, Black Lives Matter, painted on a prominent street within all five of the city's boroughs,

Speaking during a press briefing, de Blasio announced the city's plan per CBS news. It's time to do something officially representing this city to recognize the power of the fundamental idea Black Lives Matter, the idea that so much of American history has wrongly renounced but now must be affirmed. And the proposal put on table was to name streets in each borough and to paint the words on.

the streets of this city. In each borough at a crucial location, one of which will be here near City Hall. I want to thank Borough President Gail Brewer and Councilmember Margaret Chin, who are working with us on this effort. And we're going to work with these leaders and advocates and, of course, the City Council, to find the other four locations. But what will be clear on the street name and on the streets of our city is that message that now this city must fully, fully, deeply feel and this nation must as well that black lives matter. In the wake of the violence and protests following George Floyd's death, the governor of Kentucky, Andy Bashir, a Democrat,

says he's working to make sure all blacks in his state have health insurance. My commitment today is we're going to begin an effort to cover 100% of our individuals in our black and African American communities, Bashir said, according to kentucky.com, everybody, we're going to be putting dollars behind it, we're going to have a multifaceted campaign to do it. Bashir added, the inequalities have been laid bare, have been exposed by this COVID-19 pandemic. It simply can't be allowed to continue any longer, and it shouldn't have taken this type of pandemic, and it shouldn't have taken these types of demonstrations for us to commit to ending it.

Indianapolis has declared racism a public health crisis. On Monday night, the Indianapolis City County Council voted unanimously on a resolution that racism has risen to the level of a public health crisis in Marion County, Indiana. Dr. Virginia Kane, director of the Marion County Public Health Department, said per Wish TV that this is a first great step, but it is a beginning. and I'm looking forward to the city county councils to come back with some concrete recommendations that can really help address this issue, not just the symptoms, but how do we get to it systemically? The man who drove a car into a Black Lives Matter protest on Sunday is part of the Ku Klux Klan. The leading prosecutor for Henrico County and Virginia said Harry Rogers is an admitted leader of the Ku Klux Klan and a propagandist for Confederate ideology.

Rogers, who is being held without bond, has been charged with attempted malicious wounding, felony vandalism, and assault and battery, according to the Richmond Times dispatch. Race car driver Darrell Bubba Wallace Jr. wants NASCAR to ban Confederate flags from all NASCAR races. Speaking on CNN's tonight with Don Lemon on Monday, Wallace said,

my next step would be to get rid of all Confederate flags. There should be no individual that is uncomfortable showing up to our events to have a good time with their family that feels some type of way about something they have seen or an object they have seen flying. No one should feel uncomfortable when they come to a NASCAR race. So it starts with Confederate flags. Get them out of here. They have no place for them.

Now stay tuned for my conversation with Eric Hargan, Deputy Secretary of the Department of Health and Human Services, on how their department is working to deregulate the agency. Do you have an interest in public policy? Do you want to hear some of the biggest names in American politics speak? Every day, the Heritage Foundation hosts webinars called Heritage Events Live. Webinar topics range from ethics during the COVID-19 pandemic to the CARES Act and the economy. These webinars are free and open to the public. To find the latest webinar and register, visit heritage.org slash events. I'm joined today on the Daily Signal podcast by Eric Hargan.

He's the Deputy Secretary of the Department of Health and Human Services. Secretary Hargan, it's great to have you on the Daily Signal podcast. Great to be here. Well, before we launched into our full discussion, just to start off, can you give us a quick update on what's happening with coronavirus and HHS, us, how you all are endeavoring to get people back to work, working on diagnostic testing, and everything else that you all are doing. Sure.

Well, what we're doing is kind of a subset about what America is doing. I mean, we are helping out with backing up states, backing up localities, providing guidance to everyone, and kind of leadership on this issue. But a lot of it that's being done is really being done, the state and local levels, private industry, and really individual Americans who are working on this. And so besides those routine issues of kind of basic hygiene and social distancing, we've implemented the largest public health testing system in the world. At this point, over 20 million tests and counting. Between ourselves and private industry, really, the greatest mobilization we've had for production since World War II.

And just recently, we launched Operation Warp Speed, which is an operation of project here at HHS to work with private industry and so much. of our other federal counterparts to streamline the development process for vaccines, therapeutics, and diagnostics without compromising safety to have the first doses of at least the vaccines ready by the end of this year. So, you know, so far, the success we've had is we've really flattened the curve. That was our, that was the goal we set for ourselves. Now it's time to get employees back to work, our children back to school, and our nation reopened. Now that we've prepared the situation between ourselves and the fantastic productive capacity and the ingenuity of the rest of the country, now we've flatten the curve and there is going to be probably adequate ability on hospitals to respond to any appearance of the virus. So now it's not the health versus the economy.

That's really a false dichotomy at this point. It's health versus health. It's getting people back into the hospitals, back into the clinics, back into their doctor's offices to take care of the things that mostly kill Americans, which is cancer, heart disease, diabetes, COPD, all the things that are the things that day and day out cause trouble for Americans that are the cause of death for people and fatalities. We have to get people back to taking care of themselves now that we are on the downslope, God willing, of this coronavirus. Well, thank you so much, Secretary Hargan, for sharing that update. You're very passionate about deregulations and cutting red tape, and I've launched what you call a regulatory sprint to coordinated care.

So can you talk to us a little bit about this initiative? Yeah. Well, as you say, I am very passionate about this area. I came first to HHS as Deputy General Counsel for Regulations, and then as regulatory policy officer, the Department under President Bush, when I was at HHS on my first tour of duty. now I'm the chief regulatory officer and in between. I was a professor of administrative law in Chicago. So, yes, regulatory initiatives are very close to my heart.

One of the things that I've done here is this regulatory sprint to coordinated care. It's four different agencies that are revising four different sets of regulations that are all about, sort of two of them are about helping unleash information so that providers can share information with patients, and with each other. Two are about affiliations, sort of how do they deal with each other in affiliations. So how does an independent physician group deal with the hospital or anything like that? Now, it's called the Sprint because we want to gather the necessary information, and then we move to rulemaking as soon as possible, and it's about coordinating care.

So a lot of these regulations are impeding coordination among providers. They could be delivering lower-cost patient care, could be delivering better care. but they're not because in many ways, while we and the federal government have been asking them to provide value to patients to provide value to us, we then have these regulations in place that prohibit them from doing so. And in many cases, saying that they might get criminal sanctions, jail time, for violating these health care regulations. So that's very scary, obviously, to providers in the space, to doctors, to hospitals, to nurses. So we're going to revise these four sets of laws. the anti-kickback statute, HIPAA, the Stark Law, or the physician's self-referral statute,

and then this thing I won't repeat again, 42 CFR Part 2. That's only something for those of us in the regulatory arena to really care about, but two of those are information statutes, two of them are about affiliations, and fundamentally we're trying to enable Americans to get better access to higher quality care at a lower cost. And we think that this regulatory reform, in many cases, it's been done. decades since these regulations have been looked at. It's a complicated process, but it's something that we're dedicated to doing, and we're well in our way. So that's, I think, the great thing. We've issued proposals on three out of the four. I've seen the draft proposal on the fourth

one. And so, you know, we've had, believe it or not, we've been working on these all the way through. A lot of these groups aren't necessarily front center on the coronavirus pandemic, so they've been able to get a lot of work done on their own. And so watch this space, what I would say. Well, you did throw a lot of things to look out there. But looking big picture, if there's one regulation that you say has been most harmful, what would that be? Well, I would say the thing that we've seen the biggest uptick on here is really probably

the telehealth and telemedic restrictions. And I would say that the things that we've done in the pandemic to respond to kind of loosen up constraints on telehealth and telemedicine of the things that have had kind of the largest impact. We went first week of March, we had about 11,000 telehealth beneficiaries in our system. By the end of the first week of April, it was over 650,000 beneficiaries, so a 60-fold increase in that area. So I think we've seen that those were serious restrictions. If you had to look systemically, I would say, you know, we have laws that are in place. The Stark law and the any kickback statute are very important laws that deal with the integrity of the system,

that we have to obey those laws. But the regulations that have developed in those two areas, those are the things that have been most complicated. And I think those are where we're going to get the biggest bang for the buck to get these regulations. And they're kind of twinned with each other at this point, even though they're two different agencies. We're working on them at the same time. I think those will have the biggest bang for the buck systemically over time if we can get those put forward in good order. We've also been very involved on the data side of things, trying to engage with technology to remove outdated regulations or regulations that are no longer necessary.

How have you gone about doing this? Well, you know, what we did was we took an AI and we fed our regulations from HHS into the artificial intelligence as data. and we then instructed the machine, the algorithm, to how to read it. So we looked at, we had it read through all of our regulations looking for words that were clues for something that was outdated. So for example, if there was a mention of telegrams or telegraph, or if there was a requirement for quadruplicate submission of paper copies to the government. So these were examples where we found outdated terms that indicated that we could remove those regulations or alter them. And it flagged things like cross references that no longer exists or laws that don't exist anymore.

We found places where provisions haven't been edited for 30 or 40 years. So it filtered our entire code and highlighted those provisions that really needed a closer look. So then we set our team of our staff to look at them, the people that oversee these regulations, and now they're consolidating these reforms that were identified through what turns out to be kind of an human AI partnership for reforming regulations. But instead of having teams of lawyers working for years to analyze these regulations, we're just able to feed it into the computer and teach it kind of how to read the relevant parts of the regulations that we were interested in and was able to produce this in short order so we could turn to reforming these things. Well, when Secretary Azar joined HHS as Secretary, one of the big priorities, he has been involved

with his advancing values-based care, trying to move the needle, so to speak, so that cares about outcomes and not just services. Can you tell us a little bit about that? Yeah, I mean, you know, this is the third administration in a row to promote value-based care. in other words, we're trying to move away for what was the older system, is the current dominant system of fee for service to value-based care. So a big part of that is what we just talked about, is the regulatory sprint to coordinated care. That's to enable there to be more value-based care

and kind of get relief from those regulations that keep the elements of the older system in place somewhat artificially. So, you know, the president is committed to a health care system of affordable, personalized care. And that puts the patient in control. And we think a system that is truly value-based would provide everyone with the affordability that they need and then the options that they want and the quality they deserve. And we're proceeding on all of those fronts.

We're doing a quality reform initiative that I've been leading at the department. We just had the quality roadmap that was announced, I think, three weeks ago. that we dropped out that's going to be that's going to guide us to the next phase of quality reform. We've got the regulatory sprint moving forward that's going to enable a lot of the value-based reforms to take place among private sector actors. And we've enabled a lot more options on a number of different fronts, both through the regulatory reforms, but we put in place in the middle of the pandemic. And then different things like the interoperability rules, the transparency initiative,

the quality initiative, all these things that are focusing on kind of groundwork, really fundamentals in the health care system that we think are going to drive towards sort of radiate outward and really transform the health care system in a way that's going to be much more patient-focused and much more information-rich for the patients to make decisions for themselves than we've had so far in the health care system. Well, speaking of being patient-focused, something else you've been working on. I think you may have touched on very briefly is working on making electronic records available on mobile devices. That's something that has been keeping you busy as well as on top of everything you've had on your plate.

So can you tell us how this works and what your vision is for this? So this was one of those areas where it was fortunate. We were really focused on it in my office, my staff, along with two of our agencies, are really focused on this. And we actually got the rule, the final rule out on March 9th, which was just at the beginning of the, the heavy period of dealing with the coronavirus. I mean, we're right in the middle of it, but I'm really glad we got these rules out for it to start percolating through industry. Now, in these rules put out by the Office of the National Coordinator of Health IT,

and then CMS had a supplemental rule for this. Healthcare providers are going to be required to provide easy digital access to your records at no additional cost. So this is going to be available on mobile devices through an app. So you'll be able to pull all of your health records and your health claims data, no matter which provider they're from, into a single app for you and for your doctor to use. Now, we think this is going to be a pretty revolutionary step when everyone has their entire medical record and their claims record

in a single place on a single device that's theirs to have. And we think that this sort of unleashing, of the information will provide competition that will allow new business models to develop that is going to provide novel services, new choices, and also addressing patient privacy concerns. We had that in mind. That's always something that comes to an issue. When you have transmission of information, everyone's always worried, where's it going? How are you protecting it? We have put in place patient privacy sections of the rule that sort of enable there to be control over these in a way that should protect patient privacy.

But that was in mind when we put the rule forward. But this was the fruit of the Cures Act, which is almost four years old, we have gotten the final rule in place now, but it focuses on using apps to give patients access to their health records. So, and just to be clear for people who are concerned about privacy, for any patient data to be shared with an application, the patient must give approval for its release. So we have secure authentication protocols in the final rule.

And when the patient needs, wants to use an app to access their health data electronically, the app follows the same process that's used to access data elsewhere in web portals very commonly. And also, we're requiring payers as part of these rules to provide educational resources to patients to inform them about their ability to access their data per these policies. and what to look for to responsibly and safely choose an app that they want to use. Well, Health and Human Services has been one of the biggest agencies, if not the biggest, in the federal government for cost saving with having the most cost savings of all the other agencies combined, if I have that right.

How have you worked to do this? Yeah, I'm the chief regulatory officer here at HHS. Kind of my whole background is administrative and regulatory law in the health care space. So this area is something I'm very, very familiar with. The big push, though, came from the top down, really from the president who said repeatedly that deregulation was a priority, and that he would be keeping track of deregulation, and that is, in fact, what has happened. Now, point of pride for me is over the last two years, HHS was the number one cabinet agency

in deregulatory actions. Now, we believe that this is incredibly important. As everyone knows, the cost of health care has been a flashpoint for the American public and for everyone in this country for the last many years. So for us to be able to remove burdensome regulations that can drive up costs and get between doctors and patients, which reduces the quality of care, that's incredibly important. We've been leading on this issue the last two years, but we need to because the cost of health care has been an item, of constant impact on American patients, and they have indicated that concern is the top concern of theirs for years and years and years. So we're addressing it, from our point of view, we're addressing it from empowering the health

care sector by deregulating these overly burdensome regulations that inadvertently drive up the cost of care through the cost of compliance that aren't necessary to achieve safety or quality for patients. and, in fact, sometimes might do the opposite. But, yeah, we have achieved about the amount that the rest of the government has put together and more so in deregulatory savings and actions at HHS. So as I said, that's a point of pride for me as the chief regulatory officer. I'm glad we've been able to do it.

Our agencies have been great and have been very forward-leaning in terms of bringing forward deregulatory actions and proposals. So we're focused on that here at HHS and we did even through the pandemic. So that's a great thing. But as I said, it's from leadership on down. President called that out as one of his serious priorities and he and the White House have kept a close eye on it. And we are happy to comply here at HHS. Well, thank you for sharing that. Something else are passionate about is rural health care. I believe you came from a small town and your mom worked at a hospital and played a big role in where you are today. So can you tell us a little bit about your story there and your legacy when it comes to why you're so passionate to do what you do?

You know, I grew up underfoot in this rural hospital where my mother worked for 58 years before she retired. And rural health care is something that runs deeply in my family. In fact, five generations. Deep, Doc Hargan was a doctor in rural Pulaski County in Illinois in the late 1800s, same county that I grew up in. He went out in all elements to see his patients, whether by horse and buggy or a rowboat to see his patients. He would row across the Ohio River to his patients in Kentucky to provide them with care that they needed. So, and, you know, my family, probably about half of them to this day, work in rural health care, whether as doctors, nurses, pharmacists, physical therapists, occupational therapists, what have you. But I got to see all this firsthand going on call and everything

in my mother's career. So that's, you know, that and seen what happens within the hospital, which is now a clinic, a federally qualified health center, in fact, funded by HRSA, one of our agencies here at HHS. And even when I was born, I don't remember it, but the fact that we didn't have an OB unit or a delivery maternity ward in our local hospital, it had already been downsized to that extent. So my parents had to drive a long time to Cape Girada, Missouri, to another state to find a place that I could be delivered.

So those experiences from actually the very moment, of my birth, whether I remembered them or not, really give me kind of a very close firsthand look into the state of health care in rural America. And so that's why it's front and center really close to my heart and what we're doing here at HHS. Well, thank you so much for sharing that with us. As we wrap up, is there anything else you are working on at HHS that you would like to highlight? Well, you know, some of the things that we're going to be working on pretty closely is, obviously, the lessons learned from this pandemic. You know, I was involved in drafting pandemic preparedness plan many years ago when I was here

under Secretary Leavitt in the Bush administration, where we kind of started laying the framework that unfolded in response to this pandemic. You know, 06, we created what's now the Assistant Secretary for Preparedness and Response, that agency in Barta, which is the biodefense advance research and development. agency, which has been critical in the response that we've had through the strategic national stockpile, through all the procurement ability that we've been able to have working with FEMA. A lot of those groundwork was laid, the hospital preparedness program, which really hardened our hospitals and made it so that they had, they had trained, they had people on staff.

They knew, in many cases, who they needed to talk to and what they should be doing. I can see for myself. I came to HHS in the wake of 9-11, the SARS outbreak, and I could see for myself how emergency response was handled back then when we didn't have a cadre of people who knew how to do preparedness and response in emergency situations. And if you can imagine how much better the response has been when you have trained professional staff who this is their job day and day out

to do emergency preparedness, to do emergency response, We were just far better coordinated from the get-go. But there are obviously, as we've seen, there are bare patches that are revealed in any emergency situation. And so we're going to be looking into what worked, what didn't, what needs to be changed, what doesn't need to be changed as we move forward. So I say that's something that's in hand right now as kind of lessons learned, building on what worked, the foundational work that was done and kept in place, and then trying to see where things didn't work out as well and what can be improved of what didn't work. Well, Deputy Secretary Hargan,

thank you so much for joining us on the Daily Signal podcast. Thank you very much. And that'll do it for today's episode. Thanks for listening to the Daily Signal podcast. We appreciate your patience as we record remotely during these weeks. Please be sure to subscribe on Apple Podcast, Google Play, or Spotify. And please leave us a review or rating on Apple Podcasts and give us your feedback. Stay healthy and we will be back with you all tomorrow.

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