Hospital administrators say worker shortages are their biggest concern. Congress is listening.

But there’s a debate about whether the problems are the result of an aging workforce and deficiencies in training programs exacerbated by the Covid-19 pandemic or simple greed.

A new survey of close to 300 hospital CEOs by the American College of Healthcare Executives asked the top executives to rank 11 challenges by how “pressing” they are. On average, the CEOs said workforce issues like staffing shortages were the most urgent.

Digging deeper: Ninety percent of the CEOs surveyed flagged nursing shortages as a problem. They also mentioned shortages of lower-level staff like technicians (83 percent) and burnout among nonphysician staff (80 percent).

About two-thirds of the executives also pointed to physician specialist and primary care physician shortages.

Washington, D.C., reacts: The Senate Health, Education, Labor and Pensions Committee held a hearing last week and Chair Bernie Sanders (I-Vt.) called for legislation. He didn’t delve into details but suggested expanding the Teaching Health Center program — which permits residents to work in community health centers and primary care offices — and forgiving more student debt for health care workers.

Ranking member Bill Cassidy (R-La.) floated reducing administrative burdens for doctors and facilitating workplace education to help workers advance in their careers.

A hearing witness, Dartmouth economics professor Douglas Staiger, noted that there were about 5 percent more nurses in 2022 than in 2019 but added that nurses are moving from hospitals to other settings like outpatient clinics and schools.

Why that’s happening, Staiger said, isn’t as clear.

Gathering storm: The American Hospital Association argued in a statement for the committee that “long building structural changes” in the workforce along with the pandemic have left hospitals in a “national staffing emergency.”

The association points to an aging workforce and nursing schools that were forced to turn away more than 90,000 qualified applicants in 2021 because of insufficient faculty and training infrastructure.

The group called for international recruiting, nursing training programs, job flexibility and the reauthorization of workforce development programs. It also called for federal protections for workers from violence and intimidation.

“Hospitals and health systems can’t do this alone,” Mary Naylor, senior director of federal relations at AHA, told Ben.

Nurses respond: Michelle Mahon, assistant director of nursing practice at National Nurses United, a labor union, argued that a sufficient number of nurses are available, but hospitals don’t hire enough because they want to keep their profits up.

“It’s really interesting that CEOs are very worried about this,” Mahon told Ben. “The solutions are really in their control.”

Federal mandates on nurse-to-patient ratios are needed, Mahon said, as are stronger worker safety standards for Covid and infectious diseases and violence prevention.

The AHA has pushed back against a Labor Department rule that would extend and potentially expand Covid safety measures enacted earlier in the pandemic, saying they would be unnecessary as protections are already in place.

Employers should rely on CDC guidance, which can change depending on the conditions, as opposed to the lengthy rulemaking process, Nancy Foster, AHA’s vice president for quality and patient safety, previously told POLITICO.

“It's extremely disingenuous for them to say that they want to make sure that the workplace is safe because, for three years, they have really done nothing unless it was mandated that they do it," Deborah Burger, the president of the National Nurses United, previously told POLITICO.

This is where we explore the ideas and innovators shaping health care.

Some help may be on the horizon for people who can’t stop drinking once they start. A recent study found that naltrexone, a pill used for decades to treat alcohol dependence, also helps people cut down on binge drinking.

Share any thoughts, news, tips and feedback with Ben Leonard at [email protected], Ruth Reader at [email protected], Carmen Paun at [email protected] or Erin Schumaker at [email protected].

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Today on our Pulse Check podcast, host Katherine Ellen Foley talks with Krista Mahr about America’s nursing homes, which have been at the epicenter of the Covid pandemic, and what's behind their low rates of Covid-19 booster shots among residents and staff.

Medicare coverage of rapid, over-the-counter Covid tests will end if President Joe Biden proceeds with his plan to wind down the public health emergency on May 11.

That will make it more expensive for older Americans most vulnerable to severe disease to get tested and, if needed, receive early treatment.

Concern in Congress: House Energy and Commerce Health Subcommittee ranking member Anna Eshoo (D-Calif.) and other Democrats are pressuring the Centers for Medicare and Medicaid Services to continue to pay for the tests.

“I’m urging the administration to continue this smart policy because it’s practical, low cost and effective,” Eshoo told POLITICO on Wednesday.

Thirty-two House Democrats, led by Rep. Bill Pascrell (D-N.J.) and Scott Peters (D-Calif.), wrote to CMS last week calling on Medicare to continue covering the tests, saying they can help prevent the virus’ spread among vulnerable older adults.

Democratic lawmakers across the ideological spectrum — including Reps. Josh Gottheimer (D-N.J.) and Sheila Jackson Lee (D-Texas) — have argued that, without Medicare reimbursement of rapid tests, older Americans could struggle to pay for the tests out of pocket.

The administration responds: The Department of Health and Human Services said it needs Congress to pass legislation because Medicare isn’t otherwise authorized to cover OTC products.

Even so: The Biden administration has indicated it may continue to give out free tests from the Strategic National Stockpile depending on supply and resources via states, the Postal Service and community partners, according to HHS. But it’s not clear whether those efforts are adequate to address future demand.

The tests currently run about $20 for a pack of two.

No cure is yet available for food allergies, which can be life-threatening and afflict about 32 million Americans, including close to 1 in 10 kids.

Treatments like immunotherapy — ingesting small amounts of an allergen over time — can be risky and time-consuming.

Researchers from Indiana University’s School of Medicine think they’ve found a method to stop anaphylaxis, a life-threatening allergic reaction, for peanut allergies. The researchers crafted inhibitors specific to peanuts that blocked anaphylaxis in mice for more than two weeks.

The researchers are doing more animal testing to determine its effectiveness before conducting clinical trials in people.

Race for cures: The researchers aren’t alone in their efforts to tackle food allergies.

Alladapt Immunotherapeutics is developing a drug to help avert severe reactions and received nearly $120 million in venture funding last year. Allergenis has developed a blood test to help patients determine how much of an allergen they can tolerate.

And Ukko got tens of millions of dollars from investors to engineer food to so it doesn’t cause allergies in the first place.