No Jab, No Medicare?

Joseph Hippolito, How far are they ready to go?

The federal government has become so desperate to get Americans vaccinated against COVID-19 that it plans to hold Medicare and Medicaid payments hostage.

On Wednesday, Joe Biden, the virtual president, announced that nursing homes will receive federal money for Medicare and Medicaid expenses only if their employees are vaccinated.

The “Delta variant”, it appears, justified the step.

“I’m using the power of the federal government as a payer of healthcare costs to ensure we reduce those risks to our most vulnerable seniors,” Biden said. The Department of Human Services will issue the mandate, which will take effect in September, in conjunction with the Centers for Medicare and Medicaid Services (CMS) and the Centers for Disease Control and Prevention (CDC).

Biden made his announcement less than two weeks after a left-wing think tank made a wider-ranging proposal along similar lines. On Aug. 6, three members of the Center for American Progress proposed linking Medicare and Medicaid reimbursement for all health-care providers to staff vaccinations. The three made their argument on the center’s website.

“Making COVID-19 vaccination mandatory for providers participating in Medicare and Medicaid would protect vulnerable patients, set a positive example for other employers, and contribute to the national effort to contain the virus,” wrote Jill Rosenthal, Emily Gee and Maura Calsyn. Rosenthal is the center’s director of public health policy, Gee is its senior economist on the subject, and Calsyn is the center’s vice president and coordinator for health policy.

The think tank was created by John Podesta, President Bill Clinton’s former chief of staff and the former chairman of Hillary Clinton’s presidential campaign.

While the authors made no mention of making individual benefits dependent upon vaccination, their proposal raises that frightening possibility. Since the federal government adopted part of that recommendation, what would prevent those who need Medicare and Medicaid from eventually being targeted?

Rosenthal, Gee and Calsyn justified their position by citing one example of how Medicare demanded social change. In 1966, Medicare’s first year, hospitals had to end racial segregation to receive reimbursement. That mandate led “more than 1,000 hospitals to integrate their medical staffs and hospital floors in less than four months,” the authors wrote.

But the authors make a substantial mistake in logic by equating mandatory vaccination with mandatory desegregation. Integration remedied long-standing violations of Constitutional rights. Mandatory vaccination, however, violates employees’ rights not to receive shots that remain experimental. Most importantly, the authors ignore the concerns of many health-care workers about the vaccines’ safety.

Last month, the CDC reported that 74 percent of new COVID-19 cases in Massachusetts came from vaccinated patients. Cases also rose dramatically in Israel, where 85 percent of the population received at least one shot and 58 percent are fully vaccinated. The health ministry reported 3,843 new cases Aug. 5.

At Jerusalem’s Herzog Hospital, which specializes in caring for the elderly, vaccinated Israelis represented 85 percent to 90 percent of new admissions, said Dr. Kobi Haviv, the medical director. Haviv also said that 95 percent of patients with “severe” COVID-19 cases took the vaccine.

“We are going to be right in the same spot that we were exactly one year ago,” said Dr. Eitan Wertheim, director general of the Rabin Medical Center near Tel Aviv. “We are on the same route.”

On Aug. 9, the Journal of Infection, the British Infection Association’s monthly, published a peer-reviewed study that disputes the narrative. The study showed that the spike proteins in mRNA vaccines increase the chances of being infected with the Delta variant. It also recommended that manufacturers fix their COVID-19 vaccines to eliminate that risk.

The Food and Drug Administration lists “vaccine-enhanced disease” as one of the possible side effects. Others include severe inflammation of the brain and spinal cord, stroke and severe heart attack. A slide listing those effects appeared during an FDA video presentation — for less than a second.

But Rosenthal, Gee and Calsyn argue that the CMS can force health-care employees to be vaccinated, even without public input and discussion. The CMS can make the demand by including it in the center’s Conditions of Participation and Conditions for Coverage, which establish the health and safety criteria that doctors, hospitals and nursing homes must meet to receive federal reimbursement.

“The Medicare and Medicaid Conditions of Participation and Conditions for Coverage are untapped levers the federal government can use to support this effort,” wrote the authors, who added that those mandates “are national in scope, making them a powerful tool to effectuate change when there is local or regional reluctance.”

Normally, any change in those mandates must follow public input and discussion. But the CMS can waive that requirement when “impracticable, unnecessary, or contrary to the public interest.” CMS did so last August by imposing contact tracing in hospitals, in May by mandating education about the vaccines in nursing homes and this week with its announcement.

“CMS strongly encourages nursing home residents and staff members to get vaccinated as the Agency undergoes the necessary steps in the rule-making process over the course of the next several weeks,” a release stated. “CMS expects nursing home operators to act in the best interest of residents and their staff by complying with these new rules, which the Agency expects to issue in September.”

But what if vaccination rates keep failing to meet projected targets? How far would the federal government go?

On Aug. 12, Biden suggested vaccine passports for interstate travel. Three days earlier, French President Emmanuel Macron already issued a similar order. Other mandates elsewhere demand vaccination for university students to use campus Wi-Fi, or for residents of a large city in the Philippines to buy food.

Since Rosenthal, Gee and Calsyn support linking reimbursement to vaccination, what would prevent tying entitlement benefits to it? Would state governments adopt the idea for their own entitlement programs?

All those questions reflect one that is more fundamental and baffling.

Why are authorities promoting a vaccine that appears to be making things worse?