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Journal of Science Policy & Governance | Volume 17, Issue 01 | September 30, 2020

Policy Memo: COVID-19 Exposes Urgent Inequities: A Call to Action for Healthcare Reform

Priyanka Bushana (1,4), Brandy Seignemartin (2,4,5), Ravneet Kaur Waraich (3,4) Whitney W. Wood (3,4)
  1. Washington State University Health Sciences, Elson S. Floyd College of Medicine, Department of Biomedical Sciences, Spokane, WA
  2. Washington State University Health Sciences, College of Pharmacy and Pharmaceutical Sciences, Program in Pharmacy, Spokane, WA
  3. Washington State University Health Sciences, Elson S. Floyd College of Medicine, Program in Medicine, Spokane, WA
  4. Washington State University Health Sciences, Health Sciences Student Advocacy Association, Spokane, WA
  5. Washington State University Health Sciences, Associated Students of WSU Health Sciences, Spokane, WA
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https://doi.org/10.38126/JSPG170101
Keywords: health equity; health policy; health advocacy; COVID-19; healthcare reform; HHS
Executive Summary: The COVID-19 pandemic has exposed undeniable health inequities among marginalized communities (MC), including black, indigenous, and other people of color (BIPOC) in the United States (Forno and Celedón 2012, Kaiser Family Foundation 2017, US National Center for Health Statistics 2019, Glasgow 2020). The lack of centralized support for local health responses has jeopardized many MC/BIPOC (Baah, Teitelman, and Riegel 2019). We propose the Department of Health and Human Services (HHS) implement the following policy steps:
 
  1. Centrally collect patient data on social determinants of health and equity and post-COVID-19 health outcomes (Paradies et al. 2015, Jones et al. 2009, Magnan 2017). Real-time data collection allows for real-time quality improvement and implementation of policies to mitigate inequities in the short-term.
  2. Expand and implement Centers for Medicare and Medicaid (CMS) value-based care models (VBCM) to address inequities in the long-term. VBCMs institutionalize data collection initiated in Step 1 while concurrently implementing interventions.
  3. Temporarily expand Medicaid coverage for individuals needing subsidized insurance. This provides a safety net for those suffering employment instability during the crisis, alleviating some root causes of health inequities.
 
These steps will centralize resources, empowering local health systems to control and contain outbreaks disproportionately occurring among MC/BIPOC. HHS is positioned to implement these policies and mitigate further damage from COVID-19. HHS agencies such as the Food and Drug Administration (FDA) and Centers for Disease Control and Prevention (CDC) have successfully implemented centralization responses, such as the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) in response to the HIV/AIDS epidemic, effectively targeting disparities (Valdiserri and Holtgrave 2020). These previous successful responses by the HHS should compel intervention in the present crisis.

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Priyanka Bushana is a Ph.D. candidate in the Neuroscience program at Washington State University. Her research is focused on the brain oscillations which support cognitive function and their relationships with oxidative stress and sleep. She is a co-founder and the president of the Health Sciences Student Advocacy Association (HSSAA), which connects science trainees and professional students to health and science policymakers.
 
Brandy Seignemartin is a recent Doctor of Pharmacy graduate from the Washington State University College of Pharmacy and Pharmaceutical Sciences. As a student pharmacist, she served as the VP of Legislative Affairs for the Associated Students of WSU Health Sciences (ASWSUHS). She is currently an Executive Fellow at the Washington State Pharmacy Association, practicing pharmacy at an independent community pharmacy, and working to improve our healthcare delivery system in both practice and policy.
 
Ravneet Waraich is a third-year medical student at the Elson S. Floyd College of Medicine at Washington State University. Previously, she obtained her Master's in Applied Bioengineering (MAB) from the University of Washington and a B.A. in Biochemistry, Biophysics, and Molecular Biology (BBMB) from Whitman College. She has a passion for social justice and health equity.
 
Whitney Wood is a third-year medical student at the Elson S. Floyd College of Medicine Medicine at Washington State University. Whitney is interested in practicing full scope family medicine with focuses in behavioral health and community organizing for health equity.
 
Acknowledgements
The authors of this memo were brought together by their work through the Civic Engagement Council (CEC), an initiative sponsored by the Associated Students of WSU Health Sciences (ASWSUHS). Their work has been supported by two CEC member organizations: the Health Sciences Student Advocacy Association (HSSAA) and the Health Equity Circle (HEC). We would also like to acknowledge the support and guidance of Jack Downs and Ilene Friedman, J.D. in completing this work.
DISCLAIMER: The findings and conclusions published herein are solely attributed to the author and not necessarily endorsed or adopted by the Journal of Science Policy and Governance. Articles are distributed in compliance with copyright and trademark agreements.

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