KHN’s ‘What the Health?’: The autumn of Democrats’ discontent

Democrats in Congress and the White House are feverishly negotiating to pass as much of President Joe Biden's domestic agenda as they can agree on, even as Republicans who oppose much of the increased spending threaten to shut down the government and default on the nation's debt.

Meanwhile, confusion over so-called booster shots for covid-19 continues, and advocates on both sides of the abortion debate try to test Texas' novel abortion law that the Supreme Court allowed to take effect Sept. 1.

This week's panelists are Julie Rovner of KHN, Joanne Kenen of Politico, Mary Ellen McIntire of CQ Roll Call and Sarah Karlin-Smith of the Pink Sheet.

Among the takeaways from this week's episode:

• As Democratic lawmakers wrestle with efforts to please different factions of the party on the giant "human infrastructure" bill, the stakes are enormous. The bill encompasses dozens of massive policy changes, and each one alone could be the subject of major legislation that in past years would have taken months to negotiate. Failure to reach enough agreement to get the bill passed could cause severe ramifications for the party in the next round of elections and for the Biden administration.
• Among the key disagreements over health policy in that legislation is what Congress can do to hold down prescription drug prices. Negotiations are ongoing, but Sen. Ron Wyden (D-Ore.), who as head of the Finance Committee would have a strong hand in the final deal, is holding his cards close to his chest on what he will support.
• Despite the rhetoric around the drug-pricing issue, it appears the factions of the Democratic Party are not opposed to all curbs. The dispute is over how to restrict price increases and by how much.
• The drug industry is expecting to take a hit in the legislation, but it is using a broad advertising campaign to stress its need for funding to make medical innovations. However, the public seems inclined to want both: lower prices and better drug options. Plus, consumer advocates note that not all incentives in the current system are geared toward innovation and often reward only slight improvements in drugs.
• The current confusion about when and who should get an additional covid shot is confusing Americans. Officials at the Centers for Disease Control and Prevention seem to want a more cohesive strategy that doesn't single out specific vaccines, but the push by the White House earlier this month added to the pressure to get those shots moving.
• The U.S. promised more vaccine doses this week for underdeveloped countries since one of the biggest obstacles to getting people vaccinated in developing nations is a shortage of supply. But logistical problems loom large.

Also this week, Rovner interviews Dr. Scott Gottlieb, former commissioner of the Food and Drug Administration. He has a new book, titled "Uncontrolled Spread: Why COVID-19 Crushed Us and How We Can Defeat the Next Pandemic."

Plus, for extra credit, the panelists recommend their favorite health policy stories of the week they think you should read too:

Julie Rovner: The New York Times' "Their Baby Died in the Hospital. Then Came the $257,000 Bill," by Sarah Kliff

Joanne Kenen: The New Yorker's "The Struggle to Define Long Covid," by Dhruv Khullar

Mary Ellen McIntire: KHN's "Will 'Dr. Disinformation' Ever Face the Music?" by Victoria Knight

Sarah Karlin-Smith: The Washington Post's "The World's Tallest Populace Is Shrinking, and Scientists Want to Know Why," by Rachel Pannett