By Brandon Moseley
Alabama Political Reporter
Wednesday, April 29, the Senate Health Committee held a public hearing on SB 295, sponsored by Senator Paul Bussman (R-Cullman).
Sen. Bussman is a dentist. He said that SB295 simply says that if a health insurer develops a quality rating system for dentists, the cost of services would not be a factor.
Sen. Bussman said that Dentists are paid a certain fee for a service, but that does not mean the same service is equal. “I can order crowns from India for a very reduced fee or I can buy a crown in the United States that is of much better quality at a higher cost.”
Phillip Kennedy, representing the Alabama Dental Association, spoke in favor of the bill. Kennedy says that this issue has not impacted Alabama yet, but is an emerging issue around the country.
The cost of those services should not be a part of any rating system. “The bill does not say that insurers cannot do a rating system.”
Robin Stone, the Executive Director of Governmental Affairs for Blue Cross Blue Shield (BCBS) of Alabama, spoke against the legislation. Stone said, “We agree that cost should not be the only factor in a rating system, but it should be a component in a rating system if an insurance company should choose to do that.”
Stone said, “More people have dental insurance now than ever in the history of the State. We have over 1 million dental customers. Dental care is more accessible now than ever. This bill would prohibit BCBS from using cost in a rating system. Our concerns are that cost impacts our customers in a big way. This takes cost off the table. Our customers are always looking at the cost and quality of care. Cost is critically important to our company and to our customers. They are very concerned about their premiums, copays and deductibles going up. People are looking for greater value. People are Searching for economy. This has never been passed as a stand alone bill anywhere in the country.”
Stone said that when the time comes for the insurers to develop a rating plan for dentists, insurers should make that decision. “We don’t have one and don’t plan to put one in…Allow the insurance community to work with our providers…We are always happy to work with the dentists like we are with other providers.”
Sen. Bussman said, “First you said you had no plan then you said when the time comes you are contradicting yourself.”
Stone said, “We do not have a current plan or idea to do this.”
Bussman asked, “Does your company pay the same across the State?”
Stone said “I think it is the same.”
Sen. Bussman asked, “Would you favor the bill if cost were only part of it?”
Stone said, “I don’t know that I would support it, but it would be a step in the right direction.”
Sen. Linda Coleman (D-Birmingham) said that she believes in capitalism and private enterprise and worried about too much regulation.
Stone said that BCBS has 2.1 million customers in Alabama and over a million dental customers. “Our customers and companies are constantly asking us how to reduce cost particularly in small groups.”
Sen. Coleman said, “I don’t think the legislature should be dictating to companies about cost. This seems to be more of an internal industry thing and I don’t know that this is something that the legislature should be involved in. I am not necessarily for us always having to pass something so that we have to regulate something. Maybe we should find another way rather than using a cannon to kill a gnat.
Business Council of Alabama President Billy Canary also spoke against the bill. Canary said that BCA opposes this bill philosophically. “We believe very strongly that possible mandate bills reduce the choice that companies have. Cost is a factor in dental care.”
Canary praised legislators as well intentioned individuals. Canary said that he wants to create a dialogue for an easier way to remedy these concerns. “We have a very active healthcare committee within the BCA structure that would be happy to work with this committee.”
Sen. Bussman amended the bill so that cost would not be the only factor in a rating system.
Sen. Billy Beasley (D) a pharmacist said that he is afraid the quality of healthcare is not well reported by ratings systems. “We have star ratings in pharmacy. If I don’t do what they want me to do, I lose a star. If do what they want me to do, I gain a star. It has nothing to do with the practice of pharmacy.”
Sen. Bussman said all dentists do things differently. “The cleanliness of my office, the equipment I use, that I schedule patients so they don’t have to wait all provide value to my patients. 10:00 means 10:00 not like the legislature and they start at 10:15. Other people will stack people in a waiting room and will get to them as they get to them just to make sure there are bodies in the chair. There is a value for that. I use the best materials. This does not affect the insurer and it does not affect the business community in one shape or another.”
Sen. Harri Anne Smith (D) said, I would like to commend you for bringing this piece of legislation. To Canary, Smith said “It would be great to have more dialogue with you. I have not heard from you in 8 years.”
Senators Blackwell, Reed, Coleman, Wagner, Whatley, and Dial all voted against the bill.
Senators Melson, Stutts, Smith, Mcclendon, Ward, Busman, and Beasley voted for the bill.
SB295 received a favorable report from the committee 7 to 6.
Bussman also sponsored SB 296 which said that insurers can not set a fee for a service they don’t cover. Bussman said this does not cost the insurer, it does not affect the business community in any way. SB296 received a favorable report 7 to 2.
Alabama state health officer: COVID numbers are “mind-boggling”
“Unfortunately, we have very difficult times ahead,” said Alabama State Health Officer Dr. Scott Harris.
For the third straight day, Alabama’s new daily COVID-19 case count was at a record high on Friday, and the number of hospitalized coronavirus patients reached a record high for the fourth time in four days. Elective medical procedures have begun to be postponed in Huntsville and in Birmingham as hospitals in both cities are seeing record numbers of COVID-19 patients.
“Unfortunately, we have very difficult times ahead,” said Alabama State Health Officer Dr. Scott Harris, speaking during a briefing Friday. Harris noted that public health officials were concerned in April when there were 500 hospitalized coronavirus patients statewide, and said for the last couple of days, more than 1,800 have been hospitalized.
“The numbers are just mind-boggling sometimes,” Harris said.
The Alabama Department of Public Health reported 3,840 new cases Friday, the third straight day the state has confirmed more than 3,000 cases. For the first time, the state averaged more than 3,000 cases per day over the past seven days. The seven-day average of 3,046 is a 44 percent increase from two weeks ago.
Alabama hospitals were caring for 1,875 COVID-19 patients on Friday, a 41 percent increase from two weeks ago. The medical staff at UAB is strained, said Dr. Sarah Nafziger, co-chair of UAB’s Emergency Management Committee and professor of medicine in the school’s Department of Emergency Medicine, speaking during a separate press briefing Friday.
“Our patient volumes of COVID-19 positive patients have more than doubled over the course of the last month,” Nafziger said.
A little more than a week ago many celebrated Thanksgiving by gathering with others, Nafziger said. Those gatherings have been a concern among the medical community for fear of outbreaks.
“We haven’t even begun to see those patients yet,” Nafziger said.
Huntsville Hospital Systems has begun delaying elective procedures due to so many COVID-19 patients needing care, and Nafziger said UAB has also begun delaying some of those procedures, many of which are serious to a person’s quality of life, such as hip replacements to ease pain.
“It absolutely breaks my heart. It breaks the heart of our clinicians, our hospital administration. All of our staff is absolutely brokenhearted about it because the last thing we want to do is delay care for people who need us,” Nafziger said.
Cases among UAB employees have begun to rise significantly, Nafziger said, and most of those workers contracted the disease in their own communities, and not at work, where they wear personal protective gear that’s proven to provide strong protection.
“They are emotionally drained. They’re physically tired,” Nafziger said of UAB staff. “But at the same time, while I see that in their eyes, hear it in their voices, they also voice their resolve that they’re not going to quit.”
Testing statewide remains low. The average percentage of tests positive over the last week was 34 percent. Public health experts say it should be below 5 percent to ensure adequate testing is being done to prevent cases from going undetected. The state averaged 8,517 tests each day over the last two weeks, down from the two week average of 9,407 recorded on Nov. 26.
ADPH reported 55 COVID-19 deaths on Friday. Over the last two weeks, the department has confirmed 380 deaths were due to coronavirus. At least 3,831 people have died from the disease in Alabama since the pandemic began.
Sen. Doug Jones, D-Alabama, pleaded with the public Friday to wear masks, practice social distancing and to stay at home as much as possible to help slow the spread.
“Don’t just think about those people who have had minor symptoms. Think about those who had an empty chair at Thanksgiving, because a loved one was lost,” Jones said.
Harris, during the briefing hosted by Jones, said that the state is seeing numbers “much higher than we’ve seen anytime during the pandemic” and warned that the rapidly rising number of cases and hospitalizations “is not sustainable.”
“We cannot continue to go down this road,” he said,
Despite new treatments and the pending vaccines, the only tools public health has to prevent the spread of the disease are the same we’ve had since the start, Harris explained. Face masks, social distancing, hand hygiene and staying at home as much as possible help prevent illnesses and save lives, he said.
Harris discussed the state’s plans to distribute vaccines, of which the first could arrive within the next couple of weeks, but said there are “a lot of moving parts and a lot of logistical complications that we are working to deal with” and it will be some time before the wider public has access to vaccines.
If approved by the U.S. food and Drug Administration on Dec. 10, the state expects to receive in a short time the first shipment of 40,950 doses of the Pfizer vaccine, Harris said. The Pfizer vaccine requires two shots, one shot to be given 21 days after the first.
A vaccine produced by the drug maker Moderna is expected to be approved the following week, although Harris said he’s unsure how much Alabama will get initially.
The early shipments of the vaccines will be in short supply and will have to be prioritized to protect the most vulnerable, according to the Alabama Department of Public Health’s plan. ADPH is working to determine levels of risk among various medical workers, Harris said.
“It’s a real mixed blessing. We’re thrilled to have a vaccine. We know it’s going to save lives … but at the same time, we’ve got a long way to go before we have enough to cover everyone,” Harris said.
Nursing home residents will begin receiving vaccines the week following the initial shipment, Harris said. By then, there should be both the Pfizer and the Moderna vaccines in the state, so access should grow as those vulnerable people receive immunizations.
In early 2021, possibly in late spring, there would be as many as six different vaccines circulating in Alabama, but each will likely be appropriate for certain people, Harris explained. Some may better protect the elderly, while others better protect younger people.
The Pfizer vaccine will at first be shipped to eight larger medical facilities with the capability to store the drug at ultracold temperatures, as required, Harris said, and be able to administer the minimum shipment of 975 doses. Some smaller medical facilities in rural areas may have ultracold storage but wouldn’t be able to administer so many doses in time, he said.
“So that’s clearly a disadvantage for smaller and more rural places,” Harris said.
To help with that, Harris said those hospitals selected to receive the first shipments have been asked to administer vaccines to the at-risk medical workers in surrounding areas.
“So they’re going to set aside a certain portion of their vaccine, probably somewhere around maybe 40 percent of the allotment,” Harris said. “It’ll be used for their own health care workers in their facility, but the remaining amount is going to be allocated to other health care workers in their area.”
“The real solution, ultimately, for our more rural place is going to be the use of the Moderna vaccine, Harris said, which can be stored in a regular freezer and won’t have to be shipped in such large quantities.
Alabama has around 300,000 health care workers and between 25,000 and 30,000 residents in skilled nursing facilities, and around the same number of staff in those facilities, Harris said. It will take “a few weeks” to immunize those persons, he said.
Both Jones and Harris were asked by a reporter whether they’d take a vaccine, once one is available to them, and both said yes.
“I absolutely will take the vaccine, as soon as it’s approved by the FDA, and we have guidance from the ACIP, which should happen in next few days,” Harris said, referring to the Advisory Committee on Immunization Practices, an independent body of physicians and medical researchers tasked with developing recommendations on the use of vaccines.
Harris said he’s completely confident in the process, and said the only reason it’s gone so quickly is that the federal government allowed these companies to begin manufacturing the vaccines as they simultaneously sought approval.
“That’s really been the biggest timesaver,” Harris said. “They have not shortcut the safety process. They have not shortcut the review process in any other way.”
Birmingham Mayor Randall Woodfin in a separate press briefing on Friday asked business owners to enforce state law regarding masks being worn inside their businesses.
“If you are a small business owner in the city of Birmingham, if you are a manager of some form of a public store, I expect you to enforce the state’s facial covering [mandate],” Woodfin said. “You need to make sure if a person walks into your establishment that they are abiding by the state’s law.”
Dr. David Hicks, Jefferson County Department of Health deputy health officer, said the county has had more than 500 deaths and is averaging 326 new cases daily.
“That’s unacceptable … this season we need to spread joy. We do not need to spread COVID-19,” Hicks said.
Woodfin implored city employees and the public to wear masks and practice social distancing.
“We all know someone who has an underlying condition or pre-existing condition … remember that as you go about interacting with other human beings,” Woodfin said. “We believe in science. We believe in data, and we believe in those who are the experts, and we should listen to them.”
Aderholt tests positive for the coronavirus but is showing no symptoms
Aderholt tested positive while isolating because his wife had tested positive for the virus.
Congressman Robert Aderholt, R-Alabama, announced that he has tested positive for the coronavirus. Aderholt released the following statement after learning he had tested positive for the virus.
“As I had previously mentioned last week, my wife Caroline found out she was positive for COVID-19. (She has since recovered.) So, I have been isolating again,” Aderholt said. “As part of the isolation process, I received a COVID test Thursday to see if I could end my quarantine under the new, shortened CDC guidelines, and resume voting on the House floor. I fully expected to receive a negative test, because I have felt, and continue to feel fine, and have no symptoms. Unfortunately, I received word Friday morning that my test came back positive. After speaking with the Attending Physician for Congress, I will continue to isolate.”
Aderholt is one of the latest Alabamians to test positive for the coronavirus. At least 264,199 people in Alabama have already tested positive since March, and 3,831 have died including Alabama Republican Party Chief of Staff Harold Sachs and Vietnam War Medal of Honor winner Bennie Adkins.
Alabama remains under a “safer-at-home” order, which includes a mask mandate. All citizens are urged to practice caution: don’t leave home except when necessary, avoid crowded venues, avoid unnecessary travel, don’t shake hands or hug anyone not in your household, wash your hands frequently, use hand sanitizer, and maintain at least six feet from people not living in your household at all times.
Aderholt was recently overwhelmingly re-elected to his 13th term representing Alabama’s 4th Congressional District.
Merrill defends social media comments, questions motives of Black Lives Matter movement
During the interview, he blamed most of the uproar on “liberal, white women” who have “attacked” him on social media.
Alabama Secretary of State John Merrill regrets some of his recent controversial comments on social media but he refused to acknowledge that he should be held to a higher standard as an elected official and made no apologies for “defending” himself.
Merrill took part in a lengthy, wide-ranging interview on the Alabama Politics This Week podcast. The sometimes contentious back-and-forth conversation covered an array of topics, from Merrill’s comments — in which he encouraged one man to get a sex change — to his views on race, religion and election fraud claims.
Merrill has come under fire over the last few weeks for his interactions on social media, and a number of civil rights groups have called for him to either apologize or resign. During the APTW interview, he blamed most of the uproar on “liberal, white women” who have “attacked” him on social media and said he wasn’t going to allow someone “to hit me over the head and not fight back.”
“You expect me, as an elected official, if someone comes up and knocks me in the head, I’m supposed to just take it? That’s your expectation?” Merrill asked.
Host David Person responded: “My expectation is that you, as a public servant, would have a level of deportment that would be different than the average person.”
Merrill acknowledged that he probably went too far in his responses and has since started ignoring or blocking people who attempt to antagonize him.
Later in the interview, when asked about his retweet of a video and a “war on whites” comment, Merrill said he has since deleted his retweet and that it didn’t reflect his true feelings. But when asked about his thoughts on the Black Lives Matter movement, Merrill responded that “all lives matter.” He then launched into a biblical explanation of his feelings.
When Person explained the history and meaning of the BLM movement — and that it doesn’t seek to elevate Black lives above anyone, but instead merely wants to see equal value — Merrill responded by stating the BLM movement has been “co-opted.”
“I’m afraid to tell you this, but I think there’s a number of people across the nation who have co-opted what your intent was — if that was your intent — and they’ve changed the narrative … and tried to make it something else … which is that Black lives are superior and if you can’t agree that Black lives are superior then you have no place in the conversation,” Merrill said.
That is patently false, and the leaders of the BLM movement have taken great care to make equality and acceptance the primary goals of the movement. The false narrative introduced by Merrill — that the BLM movement is somehow racist — is a popular one on right-wing websites and TV shows, but it has been credibly debunked numerous times by numerous reputable sources.
Merrill also addressed his controversial comments about election fraud, defended claims he made that appear to be false and talked his way around questions about Alabama’s voter ID law.
You can listen to the full interview at the APTW website or you can search for and subscribe to the podcast wherever you get your podcasts.
Ivey says no new restrictions on day Alabama broke COVID case, hospitalization records
“We know what to do, what works. I have no plans to shut down any businesses. No plans to shut down businesses,” Ivey said.
Alabama Gov. Kay Ivey told reporters Thursday she has no plans for new restrictions on businesses despite the state recording record high new COVID-19 cases and hospitalizations Thursday.
“We’ve been dealing with this thing for quite some time,” Ivey said, according to AL.com. “Several months. We know what to do, what works. I have no plans to shut down any businesses. No plans to shut down businesses. They’re doing a good job of protecting their patrons. We need to keep our folks working and earning a living.”
Ivey was speaking to reporters after a ceremony at the National Guard headquarters in Montgomery, according to the news outlet.
“So yes, the numbers are rising. We know what to do. We know that the masks and social distancing and personal hygiene works. Folks, just keep it up. We’ll get through this. The vaccine’s coming,” Ivey said.
The Alabama Department of Public Health reported a record high 3,531 new cases Thursday, and the state has averaged 2,461 cases each day for the last two weeks, a 28 percent increase over the previous two weeks.
The number of people in Alabama hospitals with COVID-19 on Thursday reached a record high 1,827. That’s nearly 40 percent higher than two weeks ago. Huntsville Hospital had a record-high 338 COVID-19 patients on Thursday, after a string of record-setting daily hospitalizations. UAB Hospital was caring for a record 127 COVID-19 patients Wednesday and 125 on Thursday.
Ivey issued a statewide mask order in July, when the state was experiencing a surge in coronavirus and hospitals were beginning to be stressed with an influx of COVID-19 patients. She extended that order several times, but it’s set to expire Dec. 11, if she doesn’t extend it again.
After a peak of new daily deaths on July 31, which was nearly two weeks after Ivey’s mask order, the number of Alabamians dying each day from COVID-19 began dropping significantly, according to data from the Alabama Department of Public Health.
In April, Ivey decided to extend her “stay at home” order, which included closures of non-essential businesses, and told reporters that “all of our decisions that I’m going to make are based on data. Not a desired date.”
Ivey on Nov. 5 relaxed restrictions on businesses, including capacity limits inside retailers, entertainment venues and gyms, and eased social distancing requirements in restaurants, barbershops, salons and gyms, with restrictions.
“Simply put, this should be welcome news as we get ready for the upcoming holiday season, which is often the bread and butter for retail, and especially for locally-owned small businesses,” Ivey said at the time.
Asked by a reporter on Nov. 5 how Ivey came to decide to loosen restrictions for business amid growing COVID-19 cases, Ivey said: “Well, we’re just gonna have to encourage people to wear their masks, social distancing and practicing precautionary protocols to stay safe.”
Public health experts say it takes around two weeks after a change, such as a mask order, to begin noticing differences in new cases, hospitalizations and deaths. Deaths are an indicator that lags even further behind new cases and hospitalizations, however.
During the two weeks leading up to Ivey relaxing those restrictions on businesses on Nov. 5, Alabama added 22,094 cases. In the two weeks following her decision, the state added 26,752 cases. During the next two weeks, the time frame during which public health experts believe results of such changes can become evident, Alabama added 34,449 cases, a nearly 60 percent growth in cases from the two weeks prior to Ivey relaxing restrictions.
“It must be made clear that if you are over 65 or have significant health conditions, you should not enter any indoor public spaces where anyone is unmasked due to the immediate risk to your health,” a report from the White House Coronavirus Task Force on Sunday reads. “You should have groceries and medications delivered.”
Dr. Jeanne Marrazzo, director of UAB’s Division of Infectious Diseases, told reporters Tuesday that there is a possibility that hospitals will have to set up mobile hospitals to care for the rush of patients, and that she worries hospitals may not have enough staff to care for “what might be a tidal wave of patients in the next month.”
Centers for Disease Control and Prevention Director Robert Redfield made a dire prediction Wednesday.
“The reality is December and January and February are going to be rough times. I actually believe they’re going to be the most difficult time in the public health history of this nation,” Redfield said.