Plus, an update on action on Capitol Hill Wednesday, including a historic #MeToo bill passed and the Respect for Marriage Act passing a key test vote. And, the direction of the Ukraine war as it enters its 267th day.
Guests: Arielle Dreher of Axios and Neil Hauer, freelance journalist. Credits: Axios Today is produced by Niala Boodhoo, Sara Kehaulani Goo, Alexandra Botti, Amy Pedulla, Fonda Mwangi and Alex Sugiura. The music is composed by Evan Viola. You can contact us at [email protected]. You can send questions, comments and story ideas to Niala as a text or voice memo at 202-918-4893. Go deeper: Copy NIALA: Good morning! Welcome to Axios Today! It’s Thursday, November 17th. I’m Niala Boodhoo. Here’s what we’re covering today: the current trajectory of the war in Ukraine. Additionally, a groundbreaking #MeToo bill is being passed in Congress. But first, hospitals struggle to house patients – with deadly consequences. This is today’s One Big Thing. NIALA: Hospitals are keeping patients longer than needed as shortages of healthcare workers make it difficult to provide long-term care to some patients. Now, health care facilities are looking to Congress for help to pay for patients who can’t be discharged. Meanwhile, ERs have overflowed in some parts of the country and a lack of beds has led some to die in emergency waiting rooms. Axios Healthcare reporter Arielle Dreher covers this story. Hi Arielle. ARIELLE DREHER: Hi. NIALA: Ariel. Why can’t hospitals discharge patients? What problems are they facing there? ARIELLE: It’s what I’d call a perfect storm, right? We have staff shortages at almost every level of the health care system right now, including, and especially in, the long-term care system. So skilled nursing facilities and long-term care facilities, family homes, those types of facilities were really hit hard by Covid. And then it’s hit hard by staff shortages, so when there’s not enough staff in those facilities, there’s not as much capacity and room for hospitals to discharge patients. NIALA: A letter was sent to President Biden that was striking in that it talked about the literal consequences of this life. It was scary to read about nurses calling 911 because their ERs are overflowing, or ER doctors talking about patients dying in the waiting room because of it. What exactly do hospitals want Congress to do? ARIELLE: The American Hospital Association is essentially asking Congress for a per diem payment for each of these patients staying there to help ease their financial stress when it comes to the backlog. Hospitals in general are facing a lot of financial pressure right now when it comes to losing some of the pandemic funding they’ve been getting from Congress and treating patients that are frankly higher acuity than they’ve seen in a long time, which means they’re seeing patients sicker than they might see right now in 2019. I’ve talked to a few clinicians and a few analysts about this. We believe part of this is because people delayed care during the pandemic. So people are coming to hospitals in emergency rooms sicker than they would have this time in 2018 or 2019 because they might not have had that screening in 2020 or even 2021. NIALA: Arielle, in your report, you found that skilled nursing facilities are still turning away patient referrals from hospitals at higher rates than before the pandemic. Why; ARIELLE: So it goes back to this personnel issue, right? And I talked to some consumers, the voice of consumers, who are advocates for these long-term care patients. And in some cases, a facility turning away a patient is actually a good thing, right? If a patient can’t be safely admitted to a facility, we don’t want to take them on. And so it’s kind of a push right now where you don’t want a facility to be overwhelmed and have too many patients per staff member. But on the other hand, in the hospital, these patients kind of wait and wait and wait. I spoke to a hospital administrator and she had patients over 100 days at a time, and I think it’s very difficult when the whole system is as stressed as it is. Covid is no longer the reason these patients cannot enter the facility. Outbreaks used to be why transferring patients or referring patients was difficult, but now it’s just a matter of capacity and staffing. NIALA: Arielle Dreher covers health care for Axios. Thanks. ARIELLE: Thank you very much. An update on action on Capitol Hill NIALA: A few more updates from Capitol Hill. Senate Minority Leader Mitch McConnell was re-elected to his leadership post yesterday after facing a challenger for the first time in 15 years. He beat Florida Sen. Rick Scott, 37 to 10. And in a press conference, he addressed the GOP’s losses in the midterms. MITCH MCCONNELL: We underperformed among voters who didn’t like President Biden’s performance, among independents and moderate Republicans who looked at us and concluded too much chaos, too much negativity, and we turned off a lot of those centrist voters. That’s why I never predicted a red wave to begin with. In a major victory for the #MeToo movement, the House yesterday passed a bill – with bipartisan support – that would limit the use of non-disclosure agreements in sexual harassment cases. The Speak Out Act now goes to President Biden’s desk to be signed. And a bill that would codify same-sex marriage protections passed a major test vote yesterday in the Senate. A procedural motion passed with enough support to show that the Respect for Marriage Act can pass the entire chamber. Earlier this week – the law received an official statement of support from the Mormon church. In a moment, an update on the direction of the war in Ukraine. [AD SPOT] The direction of Ukraine’s war as it enters its 267th day NIALA: Welcome back to Axios Today! I’m Niala Boodhoo. An update on a story we’re following. Yesterday at a meeting in Brussels, Poland and the NATO alliance said a Russian-made missile that fell in Poland was probably a stray fired by Ukrainian air defenses and not Russia – avoiding the risk of NATO escalating the conflict. But – NATO Secretary General Jens Stoltenberg said the missile was not Ukraine’s fault and that Russia bears ultimate responsibility for its war against Ukraine. There have been around 66 Ukrainian civilian deaths in just the past two weeks – this according to the Office of the UN High Commissioner for Human Rights. That’s why we wanted to get an update on the trajectory of the war, which has just entered its 267th day. I spoke last night with Neil Hauer, a freelance journalist based in Armenia who is in Ukraine right now covering the war. Hi Neil. NEIL HAUER: Hi. Thanks for having me. NIALA: Well, we don’t want to overlook where the war is right now. You recently returned from Kherson, the Ukrainian city where the Russian forces recently withdrew. Can you explain what the city looked like after it was liberated by Ukrainian troops and what this means for Russia? Correctly. NEIL: You know, one of the most impressive things about the city was that it was in remarkably good condition in terms of destruction, preservation, because, you know, there was no protracted battle for it when the Russians took it. early March at the start of the invasion. And then the Ukrainians were able to force the Russians to withdraw without extensive civil fighting for the city. So it is physically in much better shape than many other cities in Ukraine that were on the front line here. it was really, surreal to be honest, to see the people out there on the streets, against the background of these risqué Russian propaganda still hanging around the city on billboards. The people waving the Ukrainian flag and the absolute burst of emotion there. In the last couple of months, as Russia has increasingly lost its military advantage, when it has experienced a loss on the battlefield, they have tended to respond with these kinds of strikes on civilian infrastructure. And I think it was Zelensky’s visit in particular, which was also on Monday, this week, a day later, they launched, by some accounts, the largest cruise missile attack of the war with over a hundred hitting Ukraine in just one day. NIALA: What does the withdrawal of Russian forces from Kherson mean for Russian military strategy at this point? NEIL: It’s a move they were going to have to make sooner or later. The city of Kherson and the surrounding area is located on the other side of the Dnipro River, along which there were only two bridges that Russia had to use to supply its forces there, and these were badly damaged, hardly usable. So Russia was just going to lose more and more men in material sitting there on that side, and they would have been militarily forced to withdraw at some point. NIALA: We talked about the missiles. Ukrainian power plants shut down automatically as a result of these strikes, leaving urban centers without power. What do you hear about Kyiv specifically, or big cities and electricity, how do they handle that? NEIL: That was the focus of the Russian strikes that the Russians are focusing their efforts on Kyiv. It has caused a lot of strain on the grid. There are rolling blackouts here and some areas are without power for hours at a time. But Russia’s stockpile of guided munitions is dwindling over time. NIALA: What is daily life like in Kyiv right…
