Warner: Cybersecurity shouldn't be an 'afterthought'

The ideas and innovators shaping health care

Jan 17, 2023 View in browser   By Ben Leonard, Carmen Paun, Ruth Reader and Erin Schumaker TECH MAZE Sen. Mark Warner (D-Va.) hopes to introduce health care cybersecurity legislation this quarter. | AP Sen. Mark Warner (D-Va.) says he hopes to introduce legislation this quarter to bolster health care organizations' defenses and possibly require them to meet minimum standards. Health care cybersecurity is a pressing issue. Nearly 50 million patients' data was breached in 2021 alone, according to HHS. In November, Warner, who chairs the Intelligence Committee, released a report calling on Congress to bolster health care cybersecurity, including by ordering HHS to assign a "senior leader" to oversee the issue. Ben caught up with Warner to discuss his legislation, national security and Covid-19 and what he hopes to tackle in the new Congress. This interview has been edited for length and clarity. What's the state of health care cybersecurity?  This is the most attractive or lucrative part of ransomware. People's personal health information is even more valuable than financial information. Nobody's in charge. I went to go see the org chart again, and I counted four separate Cabinet secretaries that touch health care cybersecurity. You do need somebody in charge. Cyber is always an afterthought. It has to be built into health care as new applications and even treatment modalities are created. Do you have an idea of what the senior cyber leader at HHS you've proposed might look like?  Even if you put someone in charge at HHS, how will that person have enough purview? We may even need to elevate this above HHS to some White House level so you can really have some juice with other secretaries. How should Congress set minimum standards for health care cybersecurity as you've proposed?  The amount of damage that's being done is going to require standards. Parts of the industry will resist that and say then you've got to replace all of our reimbursements. That's just part of the normal process and back and forth. Maybe you make some reimbursements contingent on meeting minimum standards. Then we've got individual hospitals and practices saying we're willing to take mandatory standards but don't tell anybody else. We're one major breach away from draconian efforts. So let's do it ahead of time rather than react. With Covid-19 spreading fast in China, do you see any national security implications? The real security implications will be not only potential spread of the virus or a new strain but the economic issues if China has to go into a massive shutdown again. It appears that you have a government that's gone from no tolerance to basically no reporting and saying we're going to let everyone get sick. You sit on the Senate Finance Health Subcommittee. What's on the agenda? What I want to look at is cost containment. It's all been about coverage. Remember all the promises of savings for the accountable care organizations? I'd color me skeptical in terms of thinking that we've really wrestled with the cost issues. Access to drugs used to treat opioid disorder and mental illness could suffer if the Drug Enforcement Administration doesn't extend pandemic rules allowing prescribing by telehealth. What should be done?  We all want to make sure that we have appropriate restrictions on opioids. Through Covid, they have worked through appropriate safeguards, maybe not perfectly but generally speaking. I hope the DEA gets the rulemaking done as quickly as possible. If there's a gap, I would generally be supportive of maintaining the eased rules. I've not seen gross amounts of negligence here.   STEP INSIDE THE WEST WING: What's really happening in West Wing offices? Find out who's up, who's down, and who really has the president's ear in our West Wing Playbook newsletter, the insider's guide to the Biden White House and Cabinet. For buzzy nuggets and details that you won't find anywhere else, subscribe today.     WELCOME TO FUTURE PULSE The London Eye, London | Ben Leonard This is where we explore the ideas and innovators shaping health care.  Attention snake oil salesmen. The Lown Institute, a health care policy think tank, has announced the winners of its sixth annual "Shkreli Awards," named after "pharma bro" Martin Shkreli, who was convicted of defrauding investors in 2017. The awards highlight what the institute thinks are 2022's worst examples of profiteering and dysfunction in health care. Top prize went to insurers in the Medicare Advantage program that Lown says have overbilled the government. Share any other thoughts, news, tips and feedback with Ben Leonard at bleonard@politico.com, Ruth Reader at rreader@politico.com, Carmen Paun at cpaun@politico.com or Erin Schumaker at eschumaker@politico.com. Send tips securely through SecureDrop, Signal, Telegram or WhatsApp. Today on our Pulse Check podcast, Lauren Gardner talks with Helen Collis about soaring Covid and seasonal infections like Strep A and RSV in the U.K. and how they've compounded the National Health Service's long-term problems, such as immense waiting lists and a chronically understaffed and burnt-out workforce. Listen to today's Pulse Check podcast WORLD VIEW China says it's already reached the top of its first Covid wave, but some disease modelers are skeptical. | Getty Images Just over a month since China ditched its yearslong "zero-Covid" policy, its officials say the first wave of infection in many of the country's most populous provinces is easing. That would mean hundreds of millions of people caught Covid-19 in just five weeks. Disease modelers are skeptical. They note that, after absorbing Chinese government messages about the virus' deadliness while also living through draconian lockdowns and quarantines, many Chinese people continue to take precautions like avoiding crowded indoor spaces and wearing masks. Case in point: Chinese officials claimed last week that nearly 90 percent of the residents of Henan province, home to 100 million people in western China, have already caught Covid. "The infection numbers and timing of that wave seems unlikely as they indicate this first wave would have begun in early October," said Louise Blair, head of vaccines and epidemiology at Airfinity, a U.K.-based health analytics company. "This means that we would have seen the increased hospitalization and peak deaths nationwide earlier in November instead of January, as our model indicates," she said, adding that the number of deaths, hospital demand and anecdotal evidence suggest the Chinese claims are incorrect. Still, Airfinity believes that 12 Chinese regions have seen a peak in infections, including the capital Beijing, the southwestern Guangdong and the central Sichuan provinces. "However, this means that cases are still rising in 20 other regions and provinces," she said. The spread so far comes before the Lunar New Year, celebrated on Jan. 22, during which many Chinese people travel to see family. "We believe the peak in infections in China will be after the Lunar New Year celebrations, sometime in late February or mid-March," added Ali Mokdad, health metrics sciences professor at the University of Washington's Institute of Health Metrics and Evaluation, which has accurately forecasted many previous infection waves in the U.S. and Europe. China releases some data: After calls from the World Health Organization and others for more data on its current wave of infections, Chinese authorities said Saturday that nearly 60,000 people with Covid have died since early December. The WHO said it received more information from China on hospitalizations, patients requiring emergency care and hospital deaths related to Covid-19. "The reported data indicate a decline in case numbers, hospitalizations, and those requiring critical care," the WHO said, adding that it requested a more detailed breakdown by province over time.   LISTEN TO POLITICO'S ENERGY PODCAST: Check out our daily five-minute brief on the latest energy and environmental politics and policy news. Don't miss out on the must-know stories, candid insights, and analysis from POLITICO's energy team. Listen today.     DANGER ZONE Marijuana use has risen as states have moved to legalize it. | AP Photo/Alex Brandon New pre-proof research in the journal Preventive Medicine says the legalization of cannabis for recreational use could be contributing to an increase in asthma among teens. The researchers found that between 2011 and 2019, teenagers in states that legalized recreational cannabis saw a "slight" uptick in asthma rates in kids ages 12 to 17 compared with states in which cannabis remained illegal. The team, from the City University of New York, Columbia, the University of California, San Diego, and others, also found an increase in asthma among children in some racial and ethnic groups. "Our findings suggest that state-level cannabis policy could have downstream impacts on children's respiratory health," said Renee Goodwin, an adjunct associate professor at Columbia's Mailman School of Public Health, in a statement. With more adults using cannabis, Goodwin said, kids could be exposed to more secondhand smoke, which she called "a key risk factor for asthma." The research adds to other recent reports of the ill health consequences of increased marijuana use. Those include: — The health effects on the lungs of smoking marijuana are as harmful as — or worse than — using tobacco. — People getting high and drunk at the same time increased between 2008 and 2019. — Canadian kids are accidentally ingesting cannabis edibles more often since the Canadian government allowed their sale in 2020.   Follow us on Twitter Ben Leonard @_BenLeonard_ Ruth Reader @RuthReader Carmen Paun @carmenpaun Erin Schumaker @erinlschumaker   Follow us

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