Healthcare system’s basic infrastructure left it unprepared for COVID-19
In 2005 President George Bush stated: “A pandemic is a lot like a forest fire: if caught early, it might be extinguished with limited damage ... if we wait for a pandemic to appear, it will be too late to prepare, and one day many lives could be needlessly lost because we failed to act today.” On Dec. 19, 2006 the “Pandemic and All-Hazards Preparedness Act” became law.
Unfortunately, the pandemic infrastructure which was created has been largely dismantled. The United States is now facing the pandemic of the century caused by an extremely infectious adversary, making herd immunity without a vaccine almost impossible to achieve. Through much of January, we took China at their word that there was no person-to-person spread. The narrative quickly changed with the emergence of YouTube videos showing quarantine enforcement personnel in spacesuits.
Our healthcare system was unprepared, on a quest for higher profits with an emphasis on lean staffing and supplies rather than maintaining necessary reserves. Dr. Steven Stack, Kentucky’s public health commissioner, at a recent COVID-19 briefing stated: “…a lot of these hospitals worked on 3 to 7 day just in time supply chains…. They didn’t keep lots of inventory on hand…”
According to The Center for Public Integrity, because of reduced personal protective equipment reserves, usage requirements have been downgraded and supported by The American Hospital Association. So far, these lax requirements have resulted in over 9,000 healthcare workers across the nation developing COVID-19. Ironically, large non-healthcare corporations appeared to have larger stockpiles of N-95 masks than most of the hospital systems in the United States. Apple has donated to healthcare facilities over 9 million masks from their reserves and Intel has donated over 1 million.
One has to ask why doesn’t our healthcare industry also have a robust supply of masks in reserve? Despite being willing to risk their lives, healthcare workers also risk being laid off. Multiple Kentucky healthcare systems have announced such layoffs, which almost seemed like a coordinated attack on our Governor.
While the CEO of YUM, the Kentucky Fried Chicken corporation, took a full cut in salary to support employees, some healthcare facilities have not largely followed suit. Baptist Healthcare System’s President & CEO took a 20 percent pay cut. According to 2017 tax returns his salary was $1.9 million and the corporation had over $1.6 billion in “net assets or fund balances.” Baptist Healthcare system has announced employee furloughs.
However, many frontline hospitals, such as the University of Louisville whose “Net Assets or Fund Balances” in 2018 were negative $596,493, serve desperate populations and are not as economically stable. This compares to Norton Hospital, Inc., which has almost $2.4 billion dollars’ worth of “net assets or fund balances,” with the President & CEO’s salary of over $2 million, according to their 2018 tax returns.
Hospitals are receiving massive bailouts based upon their Medicare billings. However, this will primarily shunt money to large healthcare systems as opposed to frontline hospitals. Similar, to everyday citizens’ stimulus checks, hospital bailouts should be based upon need. Non-profits with high net assets should not receive as much funds as frontline hospitals with negative assets. If for-profit facilities or private equity firms receive a bailout, it should be paid back with interest or the Government should acquire an equity position in the company. And all of this should be predicated on not furloughing workers.
We are confronting this epidemic with the healthcare system that we have, not the one we needed. Large “net assets” could be leveraged to prevent layoffs and even build industrial plants to produce our own personal protective equipment to be used in both the healthcare and private sectors. Let’s strategically support, not reward, those who have profited from the lean system which has placed us all at risk, and whose infrastructure must be rebuilt before we can fully reopen our economy.
Kevin T. Kavanagh is a retired physician and board chairman of Health Watch USA.