Current Hospital System Ill-Suited for Bioterrorism
As lawmakers and public health officials debate how much funding the nation's health system needs to prepare for a large-scale bioterrorist attack, the New York Times reports that this effort will require more than money -- "it will also [necessitate] a sea change in the way hospitals
do business." For more than a decade, Medicare and managed care organizations have "pressed hospitals to squeeze the extras out of their budgets," leading hospitals to reduce the number of beds and eliminate positions such as laboratory technicians and pharmacists. Instead of stockpiling drugs, they buy them "each day as needed." These cutbacks have "eliminated what is known as surge capacity," something that hospitals would need if a bioterrorist attack sent hundreds or thousands of people to emergency rooms. "Back in civil defense days, there were regional hospital planning committees that had some type of a game plan," Amy Smithson, a bioterrorism expert at the Henry L. Stimson Center, said, adding, "Privatization of the hospital industry has meant that if physicians, nurses and hospital administrators could not charge their time to a health insurer or Uncle Sam, then it was difficult for them to do this type of thing." Hospital executives say the current system where facilities are reimbursed "only for patient care" does not provide enough money to increase bioterrorism readiness. Dr. Tara O'Toole, director of the Center for Civilian Biodefense Studies at Johns Hopkins University, said, "We have spent, in the last three years, one dollar per year per American on bioterrorism preparedness. We are basically getting what we paid for."
Still, lawmakers remain divided on how much money hospitals should get for bioterrorism. The American Hospital Association, which estimates that each urban hospital would have to care for 1,000 patients in a large-scale attack, last week requested $11.3 billion from Congress to increase hospitals' preparedness. But the "leading legislation" in Congress, proposed by Sens. Bill Frist (R-Tenn.) and Edward Kennedy (D-Mass.), calls for only $3 billion for "all aspects of preparedness," with only $400 million allocated. Frist, a former heart surgeon, said that he was hesitant to provide more funding to hospitals until they have developed adequate bioterrorism plans. Frist said, "Only one out of five hospitals even has a bioterrorism plan. If you gave them a billion dollars, they don't have a plan to spend it on" (Stolberg, New York Times, 11/5).This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.