Primary care doctors are key to overcoming doubts about COVID vaccines: Slavitt Says

Primary care doctors can play a key role in persuading Americans who haven’t yet been vaccinated against COVID-19 to do so, according to Andy Slavitt, MBA, senior advisor to the COVID-19 response coordinator in the Biden administration.

Slavitt spoke as part of a panel presentation “The First (and Next) 100 Days: What’s in Store for Health Care in Washington?” at the American College of Physicians Internal Medicine Meeting 2021. He noted that many of the non-vaccinated are not necessarily opposed to vaccinations but have questions or concerns they want addressed before agreeing to get one.

“You [primary care doctors] are well positioned to answer these questions, and we believe that if people get straight answers the vast majority will choose to get vaccinated, because it’s a darned good product,” he said.

Because they are seen as trusted sources of information, Slavitt added, primary care doctors can dispel misinformation about the vaccines circulating on social media platforms. “Your job as physicians is to get to your patients before they get information from Facebook,” he said.

Slavitt praised the administration’s COVID-19 vaccination results thus far, noting that about 100 million Americans now are fully vaccinated. He said the administration has focused on racial and economic equity in vaccine distribution, with the result that 90% of the country’s population now lives within five miles of a vaccination site.

“Many of us had learned the lesson that if you do nothing different then everything you do will be inequitable, because the world is a tilted playing field,” Slavitt said. “Without childcare or access to transportation, or if you face implicit barriers because of the color of your skin or anything else, then you’re not getting as good care.”

Panelist Cynthia Cox, MPH, vice president at the Kaiser Family Foundation and director for the program on the Affordable Care Act (ACA,) described the Biden administration’s efforts to make fulfill the president’s campaign pledge to extend health care coverage to more Americans.

One of the first steps in this direction, she said, was to include funds in the American Rescue Plan (also called the COVID-19 stimulus package) to make 3.5 million more people eligible for insurance subsidies. “It’s a relatively small group of people, but it’s a group who’d been completely left out of the ACA’s initial coverage expansion,” she said.

Stimulus funds are also making it possible for people getting unemployment insurance or those earning less than 150% of the federal poverty level to get health plans with no or very low deductibles premiums. The stimulus package also includes incentives to persuade the 12 states that haven’t expanded Medicaid coverage under the ACA to do so. “But it’s up to the states and so far we aren’t sure if any of them will take advantage of it,” Cox said.

And while financial assistance does not cover undocumented immigrants, she said, “Among American citizens the vast majority of uninsured citizens are now eligible for significant assistance either through Medicaid or the ACA’s exchange marketplace,” with half the uninsured population eligible for a free plan, many with no or low deductibles.

The caveat to all the expansion initiatives, Cox said, is that they are funded only for two years, although she expressed cautious optimism that Congress will eventually make them permanent.

Robert Doherty, MA, the ACP’s senior vice president for government affairs and public policy, reviewed the “Vision for a Better US Health Care System for All” that the ACP published early in 2020. It took the form of papers examining coverage and affordability, payment and delivery systems and ways to reduce barriers to care and address social factors impacting patients’ health. It outlined the ACP’s vision for a health care system that:

• Ensures affordable and universal coverage,
• reduces administrative spending and tasks,
• supports physician-led primary and comprehensive care,
• eliminates non-financial barriers to care, and
• prioritizes science and public health

Summarizing the project’s findings, Doherty said U.S. health care costs too much, leaves too many without affordable coverage, creates incentives that are misaligned with patients’ interests, undervalues primary care and public health, and fosters barriers to care for and discrimination against vulnerable individuals. “We said that in January 2020, and it’s even more true in April 2021.”