Washington, DC – As the United States re-emerges and recovers from COVID-19, members of the Bipartisan Policy Center’s Future of Health Care Initiative call on the White House and Congress to revitalize, incentivize, and strengthen the nation’s public health system to prepare for the next pandemic. In a new report publicly released today, the task force offers recommendations that would create clarity and accountability in federal leadership during a pandemic and establish a new National Board on Pandemic Preparedness to provide oversight, develop a 21st-century, interoperable public health data and technology infrastructure that includes supporting a vaccine credential system, and ensure the United States invests more and consistent public health funding of at least $7.6 billion annually at the federal, state, and local level.
BPC’s report, Positioning America’s Pubic Health System for the Next Pandemic, was developed by 12 of the nation’s leading health care and public health officials including former Senate Majority Leaders Tom Daschle and Bill Frist, M.D.; Gail Wilensky, former administrator of the Health Care Financing Administration (now CMS); Sheila Burke, fellow, BPC, and strategic advisor, Baker Donelson; Jim Capretta, resident fellow and Milton Friedman chair, American Enterprise Institute; Dan Crippen, Ph.D., former director, Congressional Budget Office; Margaret Hamburg, M.D., former commissioner, Food and Drug Administration, and former NYC health commissioner; Chris Jennings, former senior health policy advisor, Obama and Clinton administrations; Risa Lavizzo-Mourey, M.D., former president and CEO, Robert Wood Johnson Foundation; William Roper, M.D., former director, Centers for Disease Control and Prevention; Mark Smith, M.D., former founding president and CEO, California Health Care Foundation; and Leana Wen, M.D., former Baltimore health commissioner.
“Our recommendations represent a common-sense, bipartisan path toward the goal of preventing a repeat of the economic, social, and health disruptions over the past year,” said Capretta. “While Congress and the administration have provided significant resources and implementation efforts to combat COVID-19, our recommendations are the next step to building on the lessons learned from the pandemic and positioning the country to respond more effectively to the next crisis and support the long-term health of its citizens.”
“For decades, the nation’s public health system has been underfunded, understaffed, and relied on an antiquated data system that is not interoperable between public health, clinical, and other entities to track and stop infectious diseases from spreading,” said Hamburg. “We must better equip our public health system with the tools and resources needed to do its job, both for routine protection of our citizens and to withstand the next pandemic or any number of public health emergencies in the future.”
To improve the nation’s federal response to public health disasters, BPC’s health leaders propose the president appoint a White House Deputy National Security Advisor for Pandemic and Biothreats Preparedness to provide federal leadership and conduct comprehensive pandemic planning. They also recommend Congress create an independent National Board on Pandemic Preparedness, supported by career staff, to provide oversight, establish a set of metrics and benchmarks for evaluating the federal and state pandemic capacity and capability, and provide an annual report to Congress.
“Currently, there is no congressionally chartered oversight mechanism for evaluating the state of America’s pandemic preparedness system as it relates to the capacity, capabilities, and coordination of federal, state, and local public health agencies,” said Jennings. “Strengthening a resilient pandemic response requires a modern public health system with intergovernmental coordination and sustained federal financial support, oversight, and accountability.”
“States and localities also play a critical role in preparing and executing an effective pandemic response,” said Crippen. “We recommend Congress and the executive branch create incentives that encourage states to participate in a coordinated national response.”
The report points out that to improve early detection of public health threats and guide effective policies, the country’s public health agencies and departments need a stronger, more modern, and integrated data and technology infrastructure. BPC’s task force recommends the CDC establish an integrated and interoperable infectious disease surveillance system modeled after the existing influenza system and be expanded to detect other novel pathogens.
“Establishing an integrated infectious disease surveillance system to detect emerging disease threats is imperative,” said Roper. “The United States uses multiple early warning systems across different federal agencies which leads to data entry duplication and puts an additional burden on providers. These recommendations would provide a more comprehensive and streamlined approach.”
Another recommendation is for the Office of the National Coordinator for Health Information Technology (ONC) to define a “core public health dataset” that includes demographic information, electronic labs, travel health, genomic sequencing, and electronic vital records.
“A core public health dataset would help ensure adequate data collection and reporting, especially in the Black, Latino, and Indigenous communities who have been hit the hardest by COVID-19,” said Smith. “COVID-19 has highlighted the long-standing disparities in national health outcomes from chronic disease and other illnesses across racial, ethnic, and income groups.”
BPC’s health leaders also recommend the federal government build on that data collection by supporting the development of a digital vaccine credential system that’s secure, private, and synchronized. Currently, there is not a reliable system to identify who has been fully vaccinated.
“A vaccine credential system would be a valuable tool as we all try to return to a normal life,” said Wen. “This is not a ‘vaccine passport’—a kind of mandatory federal identification system—but rather a voluntary mechanism to empower employers, businesses, and consumers to verify vaccination status and testing results to increase worker and customer safety. The platforms would be developed by private companies, but the federal government has a role to ensure quality, authenticity, interoperability, and security.”
Additionally, the task force calls on HHS to build on the technology it currently uses to collect states’ COVID-19 immunization tracking data and improve interoperability between states by enhancing the collection of demographic data.
Even prior to the pandemic, America’s 50 state health departments, 2,794 local governments, 565 federally recognized tribal agencies, and five U.S. territories faced decades of inadequate funding. The report emphasizes that public health capacity and emergency preparedness need to be adequately and consistently funded for the long term. BPC’s task force calls for gradually allocating $4.5 billion annually for a new public health infrastructure account to support state, local, tribal, and territorial public health capabilities, and $4 billion annually for the Prevention and Public Health Fund to bolster public health programs and local needs. This funding would be paid for by a public health excise tax on products that have an adverse effect on health such as alcohol, tobacco, nicotine in vaping, and sugar-sweetened beverages. This type of tax can lead to direct and indirect savings through discouraging behavior that may cause disease.