While Ebola has faded from the headlines, cost of preparedness still weighs on hospitals
In today’s 24/7 media cycle, yesterday’s news quickly fades as the press moves on to the next story. But sometimes those forgotten stories leave behind important unresolved issues.
That’s certainly the case with Ebola, and for America’s hospitals, the unresolved issue is the lack of federal funding for the millions they’ve spent on Ebola preparedness.
Ebola dominated the headlines last fall, spreading fear and uncertainty across the nation. In New York, the Greater New York Hospital Association and the healthcare workers’ union 1199SEIU held an Ebola educational session in October at the Javits Center that was attended by officials from the Centers for Disease Control and Prevention and more than 5,000 healthcare workers and hospital executives.
During that anxious time, a Stanford University infectious-disease professor said that, “It is quite possible that every major city will see at least a handful of Ebola cases.” That didn’t happen, but two days after the Javits event, Doctors Without Borders volunteer Dr. Craig Spencer was rushed to Bellevue Hospital, where he tested positive for Ebola.
The outstanding treatment Spencer received at Bellevue taught us that caring for Ebola patients in real time is extremely costly and requires as many as 150 workers for a single patient. We also learned that even the best-prepared institutions can treat only a very small number of Ebola patients at any one time.
While the GNYHA and its members coordinated their Ebola-related activities with the New York City and New York State health departments, the federal government repeatedly urged hospitals to do everything possible to prepare for receiving a suspect or confirmed Ebola patient. Considering the federal government no less a partner than the city and state, New York’s hospitals—particularly the 11 institutions that stepped forward to become designated Ebola treatment centers— answered the call.
According to a GNYHA survey, New York’s Ebola treatment centers have already spent more than $42 million to stand ready, today and in the future, to treat Ebola and other infectious diseases. These expenses include creating the infrastructure to be a designated center, securing personal protective equipment and training large numbers of staff. They did these things because that is what hospitals do, but they were also responding to urgent appeals from the CDC, and with the implicit understanding that the federal government would help them cover their sizeable Ebolarelated expenditures.
In December, thanks largely to the leadership of Sen. Chuck Schumer (D-N.Y.), Congress appropriated $576 million to HHS’ Office of the Assistant Secretary for Preparedness and Response (ASPR) for Ebola response and preparedness activities. It was a promising development.
But of that total, New York’s Ebola treatment centers (excluding Bellevue) are slated to receive only $100,000 a year per center, an amount totally inadequate to maintain their ongoing readiness. Equally troubling, ASPR has yet to allocate $340 million of that $576 million. Meanwhile, the Ebola spending shortfall for New York’s Ebola centers to date is at least $36 million, and as much as $2 million annually for the ongoing readiness of some downstate centers.
This is not what Congress intended. The federal government has an obligation toward hospitals when there is a healthcare crisis. It’s an implicit partnership that carries an expectation that hospitals will receive funding for their no-questions-asked response to emergencies—especially when Washington has implored them to do so.
And make no mistake, the need for federal funding to help hospitals prepare for Ebola is far from a New York-only issue. Hospitals in every part of the country have actively prepared to receive a suspect Ebola patient. As Dallas can attest, an Ebola patient can show up anywhere.
When the next healthcare crisis arrives—and there’s always a next time—will the federal government be a genuine partner that will treat hospitals fairly?
By ensuring right now that designated Ebola centers—in New York and across the nation—have the necessary Ebola-preparedness resources, Washington will not only encourage the entire hospital community to maintain its readiness and rapidly respond to the next healthcare emergency, but also live up to its end of a deeply important partnership.
Kenneth Raske is president of the Greater New York Hospital Association.