Jun 14, 2021

Axios AM

Good Monday morning! Smart Brevity™ count: 1,188 words ... 4½ minutes. Edited by Zachary Basu.

Breaking: Novavax announced its COVID-19 vaccine was 90% effective in a large clinical trial, including against variants (AP).

1 big thing: Hospitals v. their patients

Illustration: Aïda Amer/Axios

Rising deductibles and out-of-pocket costs are increasingly leaving patients responsible for steep medical bills, Axios Vitals found in a joint investigation with Johns Hopkins University.

  • Stephen Swett, a 44-year old truck driver, went to the emergency room at Westchester Medical Center in New York in 2018, seeking help for withdrawal from Suboxone, which treats opioid addiction.
  • He says the hospital didn't do anything: He just sat on a gurney, then was discharged. But last June — 28 months later — the hospital filed a court summons in an effort to collect $2,539.43 it said he owed.

Among our findings:

  • Medical debt comprises 58% of all debt collections in the U.S. and has caused hundreds of thousands of Americans to file for bankruptcy.
  • Some hospitals turn to liens instead of lawsuits. Liens can allow hospitals to claim a portion of a personal-injury settlement — and can catch patients off-guard.
  • From 2018 to mid-2020, the period covered by our study, just 10 hospitals were responsible for 97% of court actions against patients. The two leaders were VCU Medical Center in Richmond and University Hospital in Charlottesville, Va., both of which stopped suing patients in 2020.
Expand chart
Data: Johns Hopkins University. Chart: Will Chase/Axios

Most top hospitals charge a more than 5x markup, Axios health care editor Tina Reed writes.

  • Some of the hospitals with the highest revenue also have some of the highest prices, charging an average of 10 times more than the actual cost of the care they deliver.
  • Of the top 100 largest hospitals in the U.S., 57 were charging more than five times the average cost of the care they provided.
  • Hospitals said few ever pay the actual price — it's a tactic to negotiate with insurers. But the prices can be used for uninsured patients. And a 2017 study showed that each additional dollar of list price results in 15–20 cents more revenue for the hospital, incentivizing higher markups.

Go deeper: Explore the project, including searchable data on the top 100 U.S. hospitals (Search by state, city or hospital).

2. Netanyahu ousted after 12 years
Israel's incoming prime minister, Naftali Bennett, reaches out to his predecessor, Benjamin Netanyahu, after yesterday's vote. Photo: Emmanuel Dunand/AFP via Getty Images

Israel has a new prime minister for the first time since 2009 after a power-sharing government led by Naftali Bennett survived a confidence vote yesterday, Axios from Tel Aviv author Barak Ravid reports.

  • Bennett was sworn in as prime minister after the final vote of 60-59 with one abstention — the smallest possible majority for the new government.

Netanyahu fought desperately to avert this outcome, vehemently denouncing Bennett and pressuring fellow conservatives to abandon him ahead of the vote. Tensions were so high that the head of the Shin Bet domestic security agency warned of potential political violence.

  • Shortly before the vote, Netanyahu was asked by reporters if he was committed to an orderly transfer of power and answered sarcastically: "No, there will be a revolution. What an idiotic question."

What's next: Netanyahu has promised to quickly bring down the government, which could be quite fragile given its narrow majority and deep ideological divisions.

  • Netanyahu has called Bennett's move the "fraud of the century."
  • During Knesset debate, Netanyahu promised: "We'll be back."

Share this story.

3. Companies face "great resignation"

Illustration: Annelise Capossela/Axios

🔮 Launching today ... Axios What's Next, our new weekday newsletter that'll be your guide to the waves of change in how we work, play and get around. Sign up here.

A sneak peek at the debut issue ... Companies that made it through the pandemic in one piece now have a major new problem: More than a quarter of their employees may leave, Axios' Erica Pandey writes.

  • Workers have had more than a year to reconsider work-life balance or career paths. As the world opens back up, many will give two weeks' notice and make those changes they’ve been dreaming about.
  • "The great resignation," economists are calling it.

Some are quitting because their bosses won't let them work from home post-pandemic. Others are leaving because they miss their offices, but their companies are now hybrid or all-remote.

4. Pics du jour: Bidens in Europe
Photo: Samir Hussein/WireImage via Getty Images

President Biden said after meeting Queen Elizabeth II, age 95, at Windsor Castle, her royal residence near London: "I don’t think she’ll be insulted, but she reminded me of my mother."

  • At Heathrow Airport, Biden told his traveling press corps that she asked him about Vladimir Putin and Xi Jinping, and that he had invited her to visit the White House.
Photo: Samir Hussein/WireImage via Getty Images

Amazing fact: Biden is the 13th U.S. president to meet the monarch. (AP)

Photo: Phil Noble/Reuters via Getty Images

Above: President Biden and France President Emmanuel Macron at yesterday's G7 plenary session in Carbis Bay, Cornwall, England.

The latest: Biden is in Brussels today, where he'll push European allies to counter provocations by China and Russia.

5. "Axios on HBO": U.N. ambassador on being the only woman in the room

Photo: "Axios on HBO"

U.S. Ambassador to the U.N. Linda Thomas-Greenfield told "Axios on HBO" that over her 39-year diplomatic career, she has always pushed for women to be part of negotiation teams.

  • "I notice ... when they're not in the room," she told me in the State Department Treaty Room. "Sometimes I'm the only one," she added with a laugh. "And I will call it out."

The ambassador, who rose from career foreign-service officer to President Biden's Cabinet, told me this story about walking into an overseas room with no other women:

  • "I raised that ... before the head of state came in. And the men laughed."
  • Then she had a word with the president — and it was different the next time.

"When I walked into the State Department in 1982, there were very few people who look like me," the ambassador added. "I would hope that young people who see me — who are Black, who are women, who are people of color — will see me as an example for what they could achieve."

6. U.S. Chamber CEO defends courting Ds

Photo: "Axios on HBO"

U.S. Chamber of Commerce president and CEO Suzanne Clark told me on "Axios on HBO" that the group was right to endorse vulnerable House Democrats last year, despite the flak that resulted from Republicans. I asked her how she'd describe the chamber's relationship with Democrats.

  • "Strong."

With Republicans?

  • "Strong."

I challenged that — a headline on the conservative website RedState last month said: "Republicans Tell the Chamber of Commerce to Pound Sand."

  • "You asked me how I felt about our relationships on the Hill, and I said 'strong,'" she replied. "I'm sticking with it. ... I'm not having the same conversations."

Watch a clip.

  • Go deeper: Suzanne Clark calls worker shortage "tragic."
7. Next big social network: Nextdoor

Illustration: Aïda Amer/Axios

Nextdoor, the neighborhood social network, has seen explosive growth as homebound users became more fixated on what was happening on a hyper-local level, Axios' Kim Hart writes in her Tech Agenda column.

  • Why it matters: What was once a niche social network is now so popular that it's grappling with some of the same thorny problems plaguing Facebook and Twitter, including content moderation.

Because users must join using their real names and verify their addresses, Nextdoor has generally managed to avoid harmful content.

  • Then the pandemic hit, followed by George Floyd's murder. Nextdoor neighborhoods became microcosms of national tensions.

Keep reading.

8. Brutal heat worsens drought in West
Data: U.S. Drought Monitor. Chart: Andrew Witherspoon/Axios

The West is experiencing its worst drought in 20 years, in both extent and severity, Andrew Freedman writes in Axios Generate.

  • Triple-digit temperatures are expected today in a half-dozen states.

🎲 What we're watching: The all-time high for Vegas (117°F) may topple, along with statewide records for Arizona (128°F) and Nevada (125°F).

9. Schools brace for kindergarten surge

Kindergarten students are separated by plexiglass during a math lesson at Milton Elementary School, in Rye, N.Y., last month. Photo: Mary Altaffer/AP

School districts across the United States are hiring additional teachers in anticipation of what will be one of the largest kindergarten classes ever as enrollment rebounds following the coronavirus pandemic, AP reports.

  • Educators are also bracing for many students to be less prepared than usual due to lower preschool attendance rates.
10. 1 pup thing

Photo: Timothy A. Clary/AFP via Getty Images

N.Y. Times has the weekend's best push-alert: "There are lots of good dogs, but this one is the best."

  • "Wasabi, a low-slung Pekingese named through bloodlines for a Michigan sushi restaurant, won Best in Show at the Westminster Kennel Club Dog Show." (Subscription)
Photo: Timothy A. Clary/AFP via Getty Images

Above: Attison, a Komondor (Hungarian sheepdog) runs with its handler.

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