October 10, 2020 Issue, Page 4 of 10

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Page 4 The Elk City News, Elk City, Oklahoma Saturday, October 10, 2020 The format of the next presidential Opinion Page “ElkCituNews debate is suddenly obvious Serving Western Oklahoma since 1901 New federal rule By John M. Crisp Tribune News Service 1987, knows that it has a problem. Within 12 hours it Everyone’s mic should be muted except for the speak- cated that you paid millions in income tax in 2016, while Before President Don- promised new measures to er’s during his prescribed a credible source says that threatens Americans ald Trump contracted CO- VID-19, a strong case could inject more order into the time. Then the speaker is cut you paid only $750. Can you debates. As yet, they are un- off, automatically and com- explain?” with brain disorders be made for modifying the format of the remaining de- specified. But in light of the presi- pletely. Interruptions and Then let the candidate talk cross-talk would be impos- for a prescribed time, center- By Linda Stalters bates from face-to-face to dent’s infection and the fact sible. screen, without interruption COVID-19 is taking a serious toll on chronically ill remote. Now it’s essential. that he may have been con- Do away with the split- or cross-talk, and see how he It may seem premature to tagious during the first de- screen that poses the debat- does. Americans, particularly those with severe neurological consider the format of fu- bate, the most obvious and ers side-by-side, thus elimi- Some may argue that the conditions. Bipolar disorder and schizophrenia-related ture debates before we know essential change is a move to nating the distracting smirks, candidates need to be sub- brain illnesses increase the risk of contracting and recover- the seriousness of the presi- a remote format. frowns, head-shaking and dent’s condition. But at pres- During Pandemic 2020, eye-rolls. Give each debater jected to the pressure of a ing from coronavirus. ent the nation should operate when all sorts of ordinarily his prescribed time at center- face-to-face confrontation. Unfortunately, a recently finalized rule from the federal under the assumption that face-to-face events are func- stage, during which he can Maybe. But we’ ve tried that. Centers for Medicare and Medicaid Services could make it the president is going to re- tioning adequately on Zoom, say anything he wants, with- In the current case, it was a cover and that the campaign there is no reason for the out interruptions. failure. even more difficult for these vulnerable Americans. will go on. presidential debaters to be in The idea of real-time fact May Mr. Trump recover The rule gives health insurers more flexibility in how The first debate was a di- the same room, or even the checkers is attractive, but in and may the debates go on. they calculate patients’ out-of-pocket expenses. If insurers saster. Only those with an same city. The debaters do practical terms fact-check- But if there is another de- appreciation for rhetorical not shake hands. No audi- ing is probably best done bate, the pandemic and good embrace the rule, patients will pay dramatically more for blood sport found anything ence is present. The debates’ after the debate. Instead, let order demand that it be in a their medicines. Many could be forced to choose between uplifting or informative in audiences see them through the campaigns agree before- remote format. The new for- skipping medications and skipping meals. the confrontation between television. hand on several non-partisan The debaters’ mat should have begun with Donald Trump and Joe physical locations are irrel- or bi-partisan moderators the vice presidential debate Most insurance companies require patients to pay a co- Biden. evant. whosesole job it is to clarify on Oct. 7. pay — either a flat fee or a percentage of a drug’s total price Superlatives abounded. Further, a remote debate particular threads of ques- It’s worth remembering — when filling prescriptions. Different drugs come with dif- Some called it “the worst could be inherently more or- tioning, which, under the that the presidential debates presidential debate in histo- derly. Some have suggested current system, tend to get belong to the people, not to ferent price tags, but the total a patient could ever spend is ry.” Columnist Frank Bruni cutting the mics of debaters steamrolled by the next in- the candidates. The debates’ capped at a plan’s “out-of-pocket” maximum. called it “the most chaotic, who interrupt, cross-talk or terruption or outburst. In format should suit what best These caps are high. Health plans offered through the counterproductive and out- exceed their time limits. But fact, let’s call these extra serves the people. Conduct- right offensive American Trump, an inveterate rule- moderators “clarifiers.” Affordable Care Act exchanges cap out-of-pocket costs at presidential debate” in his breaker, is unlikely to be They could ask follow- ing the debates remotely lifetime. CNN’s Dana Bash reined in by a dead mic as up questions such as: “Mr. would be safer, and it would $8,150 for an individual. So to help patients afford their prescription drugs, most called it a certain kind of long as Biden is within 20 Biden, you didn’t answer also be a way of reclaiming show, using an adjective that feet. Mr. Trump’s question about them from candidates who drug companies offer coupons. Patients apply online and your newspaper may not A remote debate could your willingness to ‘pack’ refuse to play by the rules. get a year’s at a time. At the pharmacy counter, patients print. solve this problem. Take the Supreme Court for ideo- John M. Crisp lives in The Commission on Presi- away from the moderator the logical balance. Will you an- Georgetown, Texas, and present these coupons just like they do at the supermarket. can be reached at jcrispcol- dential Debates, which has responsibility for controlling swer that question now?” Consider a 26-year-old battling schizophrenia. His anti- organized the debates since an unmanageable speaker. Or “Mr. Trump, you indi- [email protected]. psychotic medication might carry a copay of $500 -- but An anti-masker sticks to her guns he could fulfill that obligation by using a $400 coupon and paying the remainder in cash. Currently, insurance companies count the entire $500 -- the value of the manufacturer coupon plus the cash pay- ment -- toward each patient’s out-of-pocket maximum. despite Trump’s illness This makes perfect sense. It shouldn’t matter whether By Joe Nocera, Bloom- “This isn’t about flatten- ment to apply to passing en- ber would drop to 275,000. patients receive assistance from parents, a mental health berg Opinion ing the curve,” she told me counters in public spaces, That is an awful lot of lives. foundation, or a drug company. When I heard that Presi- a few weeks ago. “It is about not sustained interactions And just think about how dent Donald Trump had been control. The death rate isn’t within closed environments. many lives could have been Yet according to the new CMS tule, the source of assis- infected with the coronavi- . So why are we still We therefore strongly sup- saved - and how many peo- tance does matter. Starting next year, CMS will no longer rus, one of the first things I I ing like this?” port the calls of public health ple could have avoided be- require insurers to count manufacturer coupons. did was send a text to my sis- Her second reason is that agencies for all people to coming sick - if everyone ter-in-law. I wanted to know she doubts they make any wear masks when circum- For some, this seemingly minor bureaucratic change will if the news had changed her difference. Although Trump stances compel them to be had worn masks starting in prove life-threatening. mind about wearing masks. never articulates it precisely within 6 feet of others for March. Like all my _ in-laws this way, it also seems cen- sustained periods. Has my _ sister-in-law About 3.2 million Americans are battling schizophrenia. (though not my wife), she tral to his reasoning (along From where I’m sitting, changed her mind about There are numerous medications available, but treatment is is a fierce supporter of the with not wanting to look the number of studies sup- masks now that Trump him- hardly one-size-fits-all. Doctors work closely with patients president. In the most recent weak). As he put it in mid- porting the efficacy of mask- self has been infected? Alas, to determine the best regimen. pictures I've seen of her, she July during an interview wearing is utterly over- she has not. “If masks work, is wearing a blue T-shirt that with Chris Wallace: “I don’t whelming. My sister-in-law then why are the positive One treatment option is a medication the FDA approved says, “Trump 2020. Keep agree with the statement that finds none of them convinc- cases rising everywhere?” in 2015 called Vraylar. Because it is so new to the market, America Great.” She be- if everybody wears a mask, ing. And she’s not alone. A generic manufacturers are not allowed to produce copycat lieves that the Democrats everything disappears.” Or a Gallup poll in July showed she wrote to me in a text want to take away our free- month later, speaking from that 18% of Americans nev- Friday morning. “I stay six versions of it. doms and turn the U.S. into the White House: er or rarely wore a mask out- feet away from most people Vraylar is not cheap. Drug-maker Allergan’s “list price” a socialist country. “Maybe they’re great, and side their homes. in public, but most people for a 30-day supply of the oral capsules is $1,224. Allergan She sends me articles with maybe they’re just good. But now Trump has CO- I know don’t wear them in headlines such as “Soros- Maybe they’re not so good.” VID-19, as does his wife. their ‘circle’ at work or fam- has a “Patient Assistance Program” to make its medications linked Org Prepares for Since the pandemic began, My sister-in-law has con- ily.” She added, “Show me available for no or very low cost to qualifying patients. For Election Coup.” She re- my sister-in-law has seized sistently told me that she some science on masks and those with insurance, that would take the form of a coupon. cently texted me a list of upon articles and academic came to her view about I'd accept it and comply.” Trump’s accomplishments studies that debunk the ef- masks independently of At his age, and being as If an insurer requires 33-percent coinsurance for Vraylar, that included 125 separateficacy of masks. A number Trump. But I have my bullet points, everything of them quote reputable sci- doubts. Or rather, I should overweight as he is, Trump the coupon value could be as high as $5,000. from nominating conserva- entists who say that cloth say that I suspect if Trump is among the most vulner- If those manufacturer coupons no longer count, patients tive Supreme Court justices masks in particular are un- had been wearing a mask to able population. As much would be on the hook for an additional $5,000 out-of-pock- to “requiring airports to pro- likely to be effective in set an example for the coun- as I dislike him, I do hope et. vide spaces for breast-feed- blocking aerosol particles try - and if he had backed up he recovers. And what then? Unfortunately, we know all too well what happens when ing moms.” that may contain the virus. his government scientists in Will he finally acknowledge Needless to say, my sister- Other articles claim that N9S stressing the importance of that he - and everyone else patients face excessively high out-of-pocket costs: they in-law has been opposed to masks cause headaches and masks - she wouldn’t have in the White House - should stop taking medications. For those with schizophrenia, the wearing masks almost since other health problems. felt the need to seek out ar- have worn masks? And that the start of the pandemic. She sent me an article ticles debunking them. In results can be devastating. Too often, they end up in emer- masks save lives? In text and email exchanges from the New England Jour- all likelihood, Trump sup- gency rooms, homeless, in jail cells or tragically dead. over the last month or so, she nal of Medicine that includ- porters like her would have Knowing him, he probably laid out two primary reasons. won't, But it scarcely mat- Hopefully, insurers will realize it’s in their own best in- ed this sentence: “We know accepted the need for masks The first is that a mask that wearing a mask outside in the same way they accept ters. The damage has already terest to continue counting manufacturer coupons towards been done. mandate, in her words, “is health care facilities offers the need for seat belts or hel- out-of-pocket caps. After all, it’s much cheaper to adhere to the biggest violation of my little, if any, protection from mets when riding a bike. The Joe Nocera is a Bloom- medicines and stay healthy, rather than let them deteriorate civil liberties.” She add- infection.” issue would never have be- berg Opinion columnist and pay for expensive hospitalizations. ed, “I’m not going to be a But then I found a follow- come politicized. covering business. He has sheep.” She wears a mask up letter to the journal’s edi- The Institute for Health written business. He has In these trying times, it’s more important than ever to only when she has no other tor a few months later by the Metrics and Evaluation at written business columns protect Americans’ health. So it makes no sense that the choice - when she is shop- same authors: the University of Washing- for Esquire, GQ and the ping for groceries, for in- ‘We did state in the article ton in Seattle estimates that federal government is actively making healthcare less af- New York Times, and is the stance - and even then for as that “wearing a mask out- the U.S. is on track to reg- fordable. brief a time as possible. She side health care facilities of- ister almost 372,000 deaths former editorial director of links forced mask wearing fers little, if any, protection from COVID-19 by the end Fortune. His latest project Linda Stalters is Founder and Chief Executive Officer - and quarantines, for that from infection,” but as the of the year. But if 95% of is the Bloomberg-Wondery of the Schizophrenia And Related Disorders Alliance of matter - with an agenda by rest of the paragraph makes the population wore masks, podcast “The Shrink Next America. unseen forces to control us. clear, we intended this state- THME estimates that num- Door.”