Expect a ‘Rolling Reopening’ of Economy, Not a ‘Light Switch’


This week on “Problematic Women,” we talk with health care economist and National Coronavirus Recovery Commission member Gail Wilensky about how we can save both American lives and livelihoods during the novel coronavirus pandemic. 

Plus, Heritage Foundation legal fellow Elizabeth Slattery joins us to discuss religious liberty, as some churches are still trying to meet in creative ways during COVID-19. And Olympic pistol shooter Lexi Lagan tells us how the postponement of the Summer 2020 Games until next year is affecting her training. 

Finally, as always, we’ll be crowning our problematic woman of the week.

Virginia Allen: On April 6, The Heritage Foundation launched the National Coronavirus Recovery Commission, a commission created to strengthen the American economy and help Americans get back to work after the coronavirus.

The aim of the 17 commissioners is to save not only lives, but also livelihoods. Kay C. James, Heritage Foundation president, is the chair of the commission that is composed of leaders and experts in the fields of government, public health, disaster response and relief, academia and education, business, and the faith community.

Now, [there are] five steps that the commission has put forth in order to get America back to normal … and here to tell us more about those five steps and the commission as a whole is Dr. Gail Wilensky, an economist and senior fellow at Project Hope.

Dr. Wilensky, thank you so much for being here today. We really appreciate it.

Gail Wilensky: My pleasure to join you.

Allen: Now, you are a health care economist, and you have worked with the World Health Organization in the past. You’ve served in the White House as a senior health and welfare adviser to President George H. W. Bush, and you’re an elected member of the Institute of Medicine.

We could go on and on with all of your qualifications and your impressive resume, but can you begin just by telling us what exactly a health care economist does?

Wilensky: It’s a good question. It’s not a term many people are familiar with. As a health care economist, it means that I am trained first and foremost as an economist. I have a doctoral-level degree from the University of Michigan.

I’m a health economist because, since the early to mid-1970s, I have worked in the area of health care and health economics as a policy researcher, as an academic at the University of Michigan and George Washington University; in government, running Medicare and Medicaid in the first Bush administration, and also being an adviser to Bush 41, and also on a number of commissions.

Since then, including the initial four years of the Medicare Payment Advisory Commission, known as MedPAC, I’m a member of defense-related commissions, either congressionally mandated or from the White House and continue on the Board of Regents of the Uniformed Services University of the Health Sciences.

So, it’s an unusual mix of government experience, survey research experience, policy research, and a keen observer of what is going on in the economy.

Lauren Evans: Dr. Wilensky, you’ve been working with Project Hope since 1993. What sort of work does Project Hope do, and what do you do for Project Hope?

Wilensky: Two very different questions. Project Hope is primarily focused on medical education in low- and middle-income countries throughout the world and also does some work in the United States, as well as elsewhere, on disaster relief.

In the early 1980s, Project Hope set up a domestic side, a policy research group, which I had initially headed and a policy journal called Health Affairs, which is now available both in print and online to supplement the very practical-oriented work it had been doing primarily internationally.

Allen: Interesting. We love hearing a little bit about your background and experience, but we do want to jump in and talk just a little bit about the commission and, really, what you all are doing.

So, you’re one of the 17 members on the National Coronavirus Recovery Commission. Can you explain the mission of the commission and what your role is?

Wilensky: The commission’s focus is on helping the country understand something about the spread of the disease, the testing and reporting and tracing of the disease, and what it would look like if we were to return to a more normal level of business activity, what it means to be able to continue building on the science, and what it means to have continuing U.S. leadership as part of the economic recovery.

And, obviously, all of us in the United States and around the world would like to reduce the likelihood of future pandemics.

Evans: So, with this pandemic, we’re stuck between a bit of a rock and a hard place because we want to keep the American people safe, but we also need to reopen our economy.

Can you explain how these two objectives are so dependent upon one another?

Wilensky: People sometimes forget that people’s health and well-being doesn’t just depend on their physical health. It also depends on their economic well-being.

I spent three and a half years on a World Health Organization commission on the social determinants of health, and what that was all about was recognizing that people’s health depends on the access to medical care at particular points in their life when they need access to medical care, but equally important depends on work opportunities, on the conditions where they live, on the circumstances in which they work and they spend most of their lives. And the themes are very much integrated.

If you want to improve health—not necessarily maximize health, but health is one element of our lifestyle, but improve and have good health—you can’t ignore these other aspects, these social determinants of how we live and work and spend our lives.

Allen: Now, you all on the commission, you’ve laid out five steps … to where we can really kind of get America back to a place of strength and strength in the American economy. Could you just walk us through what those five steps are?

Wilensky: Yes. What I think is the first step is that we need to slow the spread of the virus while we are expanding testing and reporting.

That really is the first line of business to calming fears and also providing some assurances to the American public that there is an understanding about how important stopping the spread of the virus is.

But we also understand that we have an absolute need to return to a more normal level of business activity and that we need to do so at a regional and local level and by using the best scientific data that is available.

And not all places in the country are getting hit at the same rate and at the same time, and not all places in the country are likely to recover at the same rate and at the same time. And what might make sense for low-density states like North and South Dakota or Wyoming might be inappropriate for the middle of Manhattan.

We are a big country with a lot of diversity at every level, and that’s going to impact how we have a sensible recovery. This is definitely not a one-size-fits-all solution.

In addition to returning to a more normal level of business economy, we want to make sure that we continue with the science.

We’re learning a lot about the kind of diagnostic tests that are needed, and we need to be able to make sure that proven therapeutics—emphasis on “proven”—are adopted and expanded as quickly as possible.

We want to make sure that we maintain our position as the leader in both the economy and the free world, and we want to make sure that we put in place monitoring mechanisms that will make it less likely that these kinds of pandemics hit us in the future—although saying they won’t hit us again, I think, would be a bit foolhardy.

Allen: So, let’s touch a little bit more on that fifth step within the commission’s plan, which is to reduce the risk of future pandemics.

I mean, how do we really do that, and how much control do we have when we’re looking at a virus that came from China and … spread from other countries? … How much are we able to manipulate, controlling that this won’t ever happen again?

Wilensky: I don’t think we should promise that this won’t ever happen again because I think it’s outside our ability to keep such promises, and I don’t like to make promises I don’t think I can keep.

What we can do is try to have a quicker ability to respond to the threat of future pandemics in terms of having ongoing surveillance and reconsidering where we place the monitoring of the pandemic.

There has been a history, actually, since the Clinton administration, so this is not anything new, about whether or not to have a pandemic office in the White House. It is now in [the Department of Health and Human Services], which is somewhat downstream.

It was in the White House, it was canceled. … It was reestablished by an assistant secretary who was very well-suited to the job, but having it in HHS, rather than the White House, does put it at the same level as other threats to national security.

I think it may be time when this pandemic is part of our past to reconsider, is it best to have it up at the level of national security,or should it be part of HHS?

There are some arguments either way, but as somebody who has both worked running an independent agency in HHS and then an adviser to the president in the White House, there’s no question that when something is lodged in the White House, it has a power that is not comparable if it is compared to when it is in one of the departments or agencies outside of the White House.

So I think it might be time to reconsider that as it’s been reconsidered on and off for the last 20-plus years.

Evans: Dr. Wilensky, America will get over coronavirus eventually. What is society going to look like, and what will be our “new normal” in America?

Wilensky: I don’t want to make it sound like I think it is going to be months and months until we get over this. I expect the economy to start reopening in the next six to eight weeks on a staged basis.

I think people ought not to think about it as being a light switch, and there will be a magic date on which all of the country opens on the same point. That makes no sense.

The incidence and frequency of the disease is not the same everywhere, and the recovery will not be the same.

We will gradually have a rolling reopening of economies in accordance with the desires of not only the federal government, but importantly, of the state and local governments as to what their communities are ready to do.

But just as not everything returned to the way it was after 9/11, my guess is, not everything will return to the way it was before the beginning of this pandemic.

If nothing else, we will have learned that telehealth has a lot of value and uses, and presumably there will be changes in rules and regulations and perhaps legislation to the extent needed that will allow for greater use of telehealth, and we will also have an increased use of other electronic communications between individuals.

But in-person contact is very important for many reasons, and I expect that we will continue to see the bulk of our business transactions going on in a person-to-person basis. Again, unrolling, as it appears to be safe and prudent in various places across the country.

Allen: Well, we are certainly thankful for all the work that you’re doing on the commission and those that are working with you are doing. How can we follow your work and kind of see the progress as you all are moving along?

Can you maybe point us in the right direction of a way that we can watch and kind of see the new things that you all are coming out of?

Wilensky: This is a very fast-tracking activity. We want to have this done in the next couple of months. We will be posting online, on Facebook, the individual members of the group will be posting through their own organizations, as well as online.

So, we hope to share the views of this group. All of us are volunteering our time, of course, to try to come out with what we hope will be actionable, sensible recommendations, and any way you can help spread the message would be most appreciated.

Allen: That’s great, and we certainly encourage all of our listeners to follow the National Coronavirus Recovery Commission on Twitter, @covid19recovery.

Dr. Wilensky, we really appreciate your time today. Thank you so much.

Wilensky: My pleasure to join you. I hope your listeners will do as you have suggested.





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