Confusion and fear mounting over healthcare

Doctors, care providers and pharmacies are being inundated by patients scared they will be unable to get their 25-26 COVID vaccination. Patients are in scramble mode, making phone calls to get appointments and prescriptions, since pharmacies in our state currently will not provide COVID shots without a prescription.

One doctor told me he spent 30 minutes one recent morning just returning calls to patients who were scared they couldn’t get a COVID inoculation. “Had I reviewed their histories and written vaccine prescriptions it would have taken all day. I would have had to reschedule 18 future appointments to make up that lost day. This has to stop, or it will bankrupt us all.”

The reason behind the chaos is easy to identify: HHS Secretary Robert Kennedy. His ant-vax, anti-science, anti-trust any authority philosophy is creating havoc throughout our healthcare system. Kennedy fired the entire membership of the Advisory Panel on Immunization Practices (ACIP), the group that approves immunization recommendations for the U.S. Without that approval most states won’t allow the COVID shot without the written prescription.

ACIP meets September 17-18 to make recommendations, but since RFK has loaded the committee with his new “MAHA” appointees, many worry about their decision-making.

And if Medicaid or the government does not pay the costs for COVID inoculations (or childhood immunizations), many parents will be forced to decide between paying hundreds of dollars to immunize their children or leaving them unprotected – a frightening choice.

In addition to these concerns are heightened worries about the firings and massive changes to the Centers for Disease Control, the National Institute of Health (NIH) and The Food and Drug Administration. CDC had cuts of nearly half the agency’s funding, eroding the confidence of healthcare professionals and the public as we head into flu and RSV season. Coupled with the more than $2 billion in canceled grants and 1300 job losses, valuable research and clinical trials are being canceled at NIH, universities and other agencies.

Let us remember back to December of 2020, when the Moderna and Pfizer COVID vaccines were given emergency authorization in the height of the pandemic. That authorization not only eased our fears but saved untold lives. What we perhaps didn’t know was that the research on these drugs was begun about 10 years earlier, before we ever heard about COVID.  Originally, the mRNA drug was intended to prevent the flu but when COVID slammed us, researchers were redeployed in round-the-clock efforts to modify the drug, ensure its efficacy, and ramp up unprecedented manufacturing efforts, bringing these vaccines to us in quantities sufficient to spare most of us from infection. It is fair to wonder if these same resources would be available today.

And, by the way, there is a new COVID strain, Stratus, now surging in South Carolina and other southern states.

Further, North Carolinians don’t even know what to expect when the projected $1 billion in cuts to Medicaid from Trump’s Big Beautiful Bill take effect in October 2026. But even before those impacts are known there is a more urgent and immediate problem.

Due to increased enrollments, increased drug prices and other cost hikes North Carolina’s Department of Health and Human Services (DHHS) recommended that the legislature increase funding for Medicaid (called rebasing) by some $819 million in this budget year. But the stopgap budget recently approved only authorized $500 million more, forcing DHHS to make a minimum of  3 percent reductions in payments to Medicaid care providers to balance the budget. Some providers of inpatient and residential services, as well as behavioral therapy and analysis for Autism, got 10 percent reductions.

Meanwhile, everyone is waiting to see how our legislature determines how to deal with the Big Beautiful Bill cuts, but it is safe to say that many of the 600,000-plus who received health insurance through Medicaid expansion will lose some or all benefits, forcing them to turn to the emergency departments at hospitals for care. The resultant deluge of patients will further slowdown already slow emergency room service.

And there is one ultimately frightening possible repercussion not being discussed publicly. Chances are you never heard of the EMTALA act. It stands for the Emergency Medical Treatment and Labor Act, a federal law that essentially says that anyone who shows up at a hospital emergency room will be given treatment, regardless of their ability to pay.

All hospitals with emergency departments are required to follow EMTALA. But with increased numbers seeking care, escalating costs and the reductions in federal funding hospitals will face extreme financial pressures. Five or more rural hospitals in North Carolina are barely solvent; more will likely close.

You won’t hear this being discussed publicly but some in the healthcare sector are already speculating how all these factors might force EMTALA to be revised or even repealed, creating major upheaval.

These are indeed confusing and scary times for healthcare.

Tom Campbell is a Hall of Fame North Carolina broadcaster and columnist who has covered North Carolina public policy issues since 1965.  Contact him at tomcamp@ncspin.com