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Tough job: Keeping 8 billion of us healthy

Presented by Blue Cross Blue Shield Association: The ideas and innovators shaping health care
Nov 16, 2022 View in browser
 
Future Pulse

By Carmen Paun , Ben Leonard , Shawn Zeller , Ruth Reader and Grace Scullion

Presented by Blue Cross Blue Shield Association

WORLD VIEW

Indian commuters leave at Chhatrapati Shivaji Maharaj train terminus in Mumbai, India, Monday, Nov. 14, 2022. The world's population is projected to hit an estimated 8 billion people on Tuesday, Nov. 15, according to a United Nations projection. (AP Photo/Rafiq Maqbool)

India is on track to pass China as the world's most populous country next year. | AP

"It is a momentous milestone for humanity. And it is the combination of longer life expectancies, fewer maternal and child deaths and increasingly effective health care systems."

— Natalia Kanem, executive director of the United Nations Population Fund, on the world population's increase

Eight billion people are living on Earth as of yesterday, according to the United Nations. And humans will continue to grow in numbers to about 10.4 billion by the end of the century, at which point the world's population will start declining, the latest U.N. projections show.

This number's rise and fall has implications for everything from health and old-age care to the economy, Carmen reports. The number of people of working and retirement age is growing, while the number of children is starting to decrease, according to Our World in Data.

Rich countries face the challenges brought by an aging population, in which more people are retired than working, putting pressure on social safety nets. Those countries should improve the sustainability of pension systems and establish universal health care and long-term care systems, the U.N. recommends.

Poorer countries, many in sub-Saharan Africa, have more and more people of working age, which should help their economic development over the next few decades.

Still, the rise in the number of people isn't a cause for fear, even if it comes at a time of mass migration caused by poverty, conflict and climate change, Natalia Kanem, the executive director of the United Nations Population Fund, said. "People in positions of power have to work together to address these great challenges that threaten the world," she said.

A line graph showing the growth in the world's population since 1900.

How we got here: The world population exploded over the past two centuries, going from 1 billion in the 1800s to 8 billion today.

Despite the deaths of at least 6.5 million people from Covid-19, the world's population grew by nearly 1 percent last year.

Where we're going: More than half of the projected increase in global population until 2050 will come in just eight countries: the Democratic Republic of the Congo, Egypt, Ethiopia, India, Nigeria, Pakistan, the Philippines and Tanzania.

India is expected to overtake China next year as the world's most populous country.

In the U.S., the Congressional Budget Office projects an immigration-driven increase in the population to nearly 370 million by 2052, up from 335 million today.

 

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WELCOME TO FUTURE PULSE

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This is where we explore the ideas and innovators shaping health care. 

Doctors are already using gene and cell therapies to treat degenerative disease and cancer and they think these treatments could do even more. But will insurers pay for it? Tell us your experience.

Share news, tips and feedback with Ben Leonard at bleonard@politico.com, Ruth Reader at rreader@politico.com, Carmen Paun at cpaun@politico.com or Grace Scullion at gscullion@politico.com. 

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Today on our Pulse Check podcast, Ruth talks with Carmen about the multitude of views that lawmakers, lobbyists and the Biden administration have on how to protect health data, particularly data not covered by the federal health privacy law, HIPAA.

Plus, Alison Galvani, the director of the Yale Center for Infectious Disease Modeling and Analysis, on her research that suggests a Covid booster could prevent 22 million days of missed school and more than 38,000 pediatric hospitalizations.

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INFLUENCERS

$670,000

The amount Guarding Against Pandemics has spent on lobbying since September 2021

Congress hasn't shown much willingness to keep funding the fight against Covid-19, and there could be one less group pressing it to do so.

That's because the pandemic preparedness advocacy group Guarding Against Pandemics has fallen on hard times following the downfall of its funder, Sam Bankman-Fried, whose cryptocurrency exchange, FTX, went bankrupt in a spectacular flameout last week.

Earlier this year, Guarding Against Pandemics' lobbyists pressed unsuccessfully to get $30 billion in Covid funding included in budget legislation, Ben reports. It also endorsed candidates concerned about fighting disease in this year's elections. Bankman-Fried was a major Democratic party donor.

But at least four of the five lobbying firms on its payroll since its founding — Capitol Counsel, Ogilvy Government Relations, Ridge Policy Group and Van Scoyoc Associates — aren't anymore. Kate Mills, a partner at the fifth firm, Monument Advocacy, declined to comment. And Bankman-Fried's brother, Gabriel, who ran Guarding Against Pandemics, left this week.

WASHINGTON WATCH

WASHINGTON, DC - DECEMBER 2:  Sen. Roger Marshall (R-KS) talks with reporters on his way to a vote at the U.S. Capitol on December 2, 2021 in Washington, DC. With a deadline at midnight on Friday, Congressional leaders are working to pass a continuing resolution to fund the government and avoid a government shutdown. (Photo by Drew Angerer/Getty Images)

Twelve senators in the Democratic caucus agree with their Kansas Republican colleague Roger Marshall that the Covid emergency is over. | Getty Images

The bipartisan Senate vote yesterday on a resolution to end the Covid-19 public health emergency has no force in law.

But it revealed fissures among Democrats over HHS's decision this month to extend the emergency beyond the date it was scheduled to expire, Jan. 11, and could be a harbinger of President Joe Biden's first veto, Shawn reports.

Despite calling the pandemic over in an interview with CBS's "60 Minutes "in September, Biden issued a veto threat for the resolution by Sen. Roger Marshall (R-Kan.).

What's next: The House hasn't passed Marshall's resolution, and won't this year while the chamber is under Democratic control. But the GOP is likely to press the issue if Republicans take the House majority next year, as now seems likely.

Senate rules allow the minority party to call up such resolutions for votes, while the House majority controls what bills go to the floor.

If both chambers pass the resolution next year, it would force Biden's hand.

Democratic divide: In the meantime, the vote on Marshall's resolution shows support among Democratic lawmakers for ending the emergency is growing.

Marshall got a vote on his resolution in March and the Senate passed it 48-47, with a united GOP defeating a united Democratic caucus because three Democrats were absent.

But this time around, 12 senators in the Democratic caucus voted to end the Covid emergency: Catherine Cortez Masto and Jacky Rosen of Nevada, John Hickenlooper of Colorado, Tim Kaine and Mark Warner of Virginia, Angus King of Maine, Amy Klobuchar of Minnesota, Joe Manchin of West Virginia, Chris Murphy of Connecticut, Jeanne Shaheen of New Hampshire, Kyrsten Sinema of Arizona, and Jon Tester of Montana.

What's at stake: Keeping the emergency in place allows the government to continue to provide expanded Medicaid benefits, increased payments to doctors and hospitals, and telehealth for Medicare patients.

 

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FOLLOW THE MONEY

Dr. Lisa Ravindra conducts a telehealth visit with patient Jenny Thomas.

Rules allowing high deductible health plans to cover telehealth before people hit their deductibles could expire at year's end. | Antonio Perez/Getty Images

An alliance of hundreds of firms and industry groups is lobbying Congress to include a provision in an end-of-year spending package allowing high-deductible health plans to offer telehealth before patients hit their deductibles, Ben reports.

In a letter to House and Senate leaders Tuesday, more than 350 groups under the banner of the Alliance to Fight for Health Care called on Congress to take action before the current rule permitting the coverage expires on Dec. 31. More than 30 million Americans are on high-deductible plans.

Signers included the ERISA Industry Committee, which represents the employee benefit interests of large employers, AHIP, the trade group for health insurers, and the U.S. Chamber of Commerce.

The backstory: Congress first allowed high-deductible plans to pay for virtual visits before patients hit their deductibles in a March 2020 Covid-19 relief law. Lawmakers allowed the provision to expire at the end of 2021 before passing another extension in March.

 

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