US election: Biden announces covid-19 task force, promising “compassion, empathy, and concern”
BMJ 2020; 371 doi: https://doi.org/10.1136/bmj.m4327 (Published 09 November 2020) Cite this as: BMJ 2020;371:m4327Read our latest coverage of the coronavirus outbreak
In his victory speech on Saturday night the US president elect, Joe Biden, said he felt called on to “marshal the forces of science and the forces of hope in the great battles of our time,” and he specifically mentioned the climate emergency, healthcare, and covid-19.
“Our work begins with getting covid under control,” he said, promising a plan “constructed out of compassion, empathy, and concern.” On 9 November, with President Donald Trump continuing to challenge the election results, Biden announced the formation of a covid-19 task force.
Trump, who is challenging the election results with court actions, has underplayed the impact of covid-19 since its start. During the campaign he made fun of Biden for wearing a mask and has for the most part left interventions up to individual states. By the end of last week the US had nearly 10 million total confirmed cases and nearly 238 000 deaths, shows Johns Hopkins University’s tracker.1
Cooperation needed
Meanwhile the Trump administration remains in power until 20 January and is still active. The day after the election, Trump’s Department of Health and Human Services announced a plan to require its agencies, including the Food and Drug Administration, to review regulations that have been on the books for more than 10 years or the regulations would be dropped.2 If the rule is finalised it would be a huge distraction for the FDA, which is currently occupied with dealing with covid-19 drugs and vaccines.
Although Biden can act on his own on some of his initiatives—removing the global gag rule on abortion, for example, and re-instituting some environmental regulations—he would have to get cooperation from Congress on many of his other plans. And that could be a problem.
Already, some liberal Democrats are complaining that Biden’s healthcare initiatives (box 1) don’t go far enough. And Republicans may or may not have control of the Senate: run-off elections on 5 January will determine that. A Republican Senate could keep Biden from filling his Cabinet with his top choices, as the Senate confirms Cabinet positions.
Other health and science plans expected from Biden
Climate emergency and the environment
Less than five months after he took office President Donald Trump announced his plan to take the US out of the international Paris climate accord.3 The removal became official on 4 November, the day after the election. Since early in his candidacy Biden has been promising to undo the action.4 Trump used his position to issue executive orders that rolled back 100 public health and environmental rules, and the Washington Post reports that Biden will use the same process to re-institute those rules.5 Biden has also promised to make the energy industry carbon free by 2035.6
World Health Organisation
On 7 July, following through on a threat, Trump formally started the process of withdrawing the US from WHO,7 which he said had mismanaged the coronavirus response and was too close to China. That same day Biden tweeted a promise to rejoin WHO on his first day as president.8
Healthcare insurance
Biden would like to reduce the age of eligibility for Medicare, the health insurance plan for older people subsidised by the government, from 65 to 60, and provide more financial help for people buying “Obamacare” health insurance, and he has vowed to create a government run insurance programme.9 He’ll need Senate support for all that, which could be a problem if it turns out to have a Republican majority. Meanwhile this week the Supreme Court will consider a legal challenge to Obamacare that could strike it down. The challenge is not likely to succeed, but if it does there could be a major scramble to find a replacement.
International family planning
Since 1984 Republican administrations have instituted an anti-abortion policy known as the “Mexico City policy” or global gag rule, preventing US foreign aid money for abortion services. Democratic administrations, in turn, have eliminated it. Trump’s version was the harshest yet, forbidding money not just for abortion services offered by international groups but any money at all to groups that offer abortions. Biden is expected to eliminate the policy as his Democratic predecessors have.
Drug pricing
Trump promised to lower drug costs, promoted a plan to set prices for elderly people at rates similar to those in countries that have price controls, and promised $200 coupons to senior citizens. None of those plans came through. In his healthcare plan Biden promises to force drug companies to offer lower prices to seniors, reduce the high price of new drugs, limit price increases for currently available drugs, and allow consumers to import lower priced prescription drugs.9
If the Republicans do hold on to the Senate the new chairperson of the committee that deals with health issues would either be a Senator who has received campaign funds from the tobacco and healthcare industries or another who has repeatedly argued with the federal covid expert Anthony Fauci, says the journalism website Politico.10
Trump himself is another wild card. It’s customary for outgoing presidents to issue executive orders, and Trump’s orders for the most part have been antiscience. Whether he will go out with a bang remains to be seen.
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