WASHINGTON — The hottest birthday spot in town: A Hispanic senior center in northwest DC
That’s where Health and Human Services Secretary Xavier Becerra heralded his 65th birthday Thursday morning, with songs sung by the center’s choir, speeches about Covid-19 vaccines, and a giant replica of a Medicare card to signify his new eligibility for the federal program he oversees . Cake was absent – too many seniors with diabetes.
Speaking in a mix of Spanish and English to the roughly two-dozen seniors assembled, several of whom received Covid-19 boosters and shingles shots at the event, Becerra highlighted the Biden administration’s moves to cap insulin costs, make shingles shots free after the Inflation Reduction Act, and supply coronavirus vaccines to Americans.
Between songs and presents, STAT spoke briefly with the secretary, Medicare Director Meena Seshamani, and Alison Barkoff, Administration for Community Living acting administrator and assistant secretary for aging. The interview has been edited for length and clarity.
The first question everyone has: traditional Medicare, or Medicare Advantage?
Becerra: I am, right now, still covered through the federal health benefits program. So I’m applying for Medicare Part A, but that’s only [because] I’m still getting covered through my employee benefits.
In terms of Covid shots, where are we on turning those into an annual event, especially for seniors?
Seshamani: This is something that our colleagues at [the Food and Drug Administration] and [the Centers for Disease Control and Prevention] are working through, in terms of making sure that people have the ability to get their vaccinations, not just Covid, but others on a regular basis. We, through the Medicare program, can support that … thanks to the new drug law, now having recommended vaccines at no out-of-pocket cost for shingles and whooping cough. That’s a huge difference for people’s lives, to enable them to access these vaccines.
Becerra: Everything has followed apace, as we see the evidence grow on not only effectiveness, but safety. Once we get those levels of comfort, then we take those next steps. What we’re hoping of course is that we can tell people, “Once a year is all you’ll have to worry about,” but we want to make sure. And so the scientists continue to wait as we collect more and more evidence.
I mean, the fact that we are able to say that bivalent is better for you today than the earlier versions, that’s all very important. We’re evolving to that point where we’re going to say, “Once a year.”
Besides the safety and effectiveness data, are there milestones in case rates or hospitalization rates where you would say, we can now go to an annual schedule?
Becerra: Covid has been a moving target from the beginning. Before, we gauged most of our actions on the number of cases, because it used to follow that the number of cases would essentially give you a sense of the number of hospitalizations, and the number of hospitalizations gives you a sense of the number of deaths . That’s changing. The vaccines have really helped change the dynamic.
You may still see a large number of cases, but the number of hospitalizations, which was relatively steep, is now far fewer, and deaths even fewer. What we’re learning is that we are able to tackle this in different ways. It’s a moving target and we try to move with it.
The head of the choir here just said that they started up during the pandemic because of social isolation. What are you doing on mental health and seniors, in particular, and what other senior health issues are top of mind for you?
Barkoff: Our senior centers are very focused on everything from health prevention to social isolation, and with Covid pivoted in lots of different ways. We were able to help older adults learn how to use technology and connect in so many different ways.
Screening people for Alzheimer’s is really key, and bringing in medical professionals [to where seniors are]like we saw today with vaccines, to help get where we need to go.
Seshamani: We are absolutely leveraging the Medicare program to address our nation’s behavioral health crisis. The policies we’re doing to mobilize the behavioral health workforce to enable better access to behavioral health providers make that care more effective by encouraging more team-based integrated approaches to care, and address our national substance use disorder crisis. For example, paying for mobile vans to do opioid treatment services so that you’re meeting people where they are.
Becerra: I’m gonna go right back to vaccinates, because there is no way for a crowd of seniors this age to gather unless they were vaccinated and have the confidence to do that. And if they couldn’t, then they would definitely be socially isolated.
But I will say that Covid exposed what’s always been right below the surface, and that is this pain that people feel, mental pain, and it’s coming out. Thank God President Biden wants to take it to the next level, [to] bring mental health parity to regular health.