The last 4 years have been difficult for science and medicine. The relentless attack by members of the executive and legislative branches of government on science and federal agencies that conduct science has shaken the fundamental pillars of great US institutions such as the Centers for Disease Control and Prevention, Food and Drug Administration, Environmental Protection Agency, and in some regards the National Institutes of Health (NIH). Although the 2020 NIH budget increased to almost $42 billion, more individuals are uninsured, and although health care costs have not increased substantially over the past 4 years, the financial health of most states is in shambles because of the Great Pandemic of 2020, threatening the commitment to Medicaid, which consumes almost 30% of many state budgets. In addition to Medicaid costs, states are responsible for the health care costs of their employees, and in some states many of their retirees. Moreover, the morbidity, mortality, and ubiquitous nature of COVID-19 have created unprecedented challenges for clinicians, health care systems, and public health, while some political leaders have erroneously minimized the extent, severity, and seriousness of the pandemic.
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CME Disclosure Statement: Unless noted, all individuals in control of content reported no relevant financial relationships. If applicable, all relevant financial relationships have been mitigated.
Corresponding Author: Howard Bauchner, MD, JAMA (Howard.Bauchner@jamanetwork.org).
Published Online: December 23, 2020. doi:10.1001/jama.2020.23346
Conflict of Interest Disclosures: None reported.
Credit Designation Statement: The American Medical Association designates this Journal-based CME activity activity for a maximum of 1.00 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to:
It is the CME activity provider's responsibility to submit participant completion information to ACCME for the purpose of granting MOC credit.
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