The Sept. 11 attacks dramatically exposed the nation's lack of concentration on terrorism.
Now that airliner missiles and anthrax mail have grabbed our attention, we are beginning to fathom the possible inadequacies of our public health networks. For instance, a survey conducted in 2000 and released at last week's meeting of the American College of Emergency Physicians in Chicago found that 30 hospitals in four states and our nation's capital were ill-equipped to handle a widespread biological disaster. According to researchers, administrators at just one of the hospitals said they had stockpiled medicines for a bioterrorism attack, and 26 hospitals reported they could handle only 10 to 15 victims at once. Some 22 hospitals said they were not prepared to handle a chemical weapons or nuclear attack.
Government officials are trying to bolster the public health system, however belatedly. Two leading congressional lawmakers on healthcare issues, Sens. Edward Kennedy (D-Mass.) and William Frist (R-Tenn.) have proposed funneling $295 million to aid in hospital response to bioterrorism. In addition, Sens. John Edwards (D-N.C.) and Chuck Hagel (R-Neb.) have introduced legislation to provide $100 million in block grants to state and local governments for hospital preparedness for chemical and biological attacks. Another $100 million would be earmarked for federal programs to strengthen hospital emergency, trauma and intensive-care units.
If we expect our hospitals to deal with terrorism, government should give them the money needed to fulfill that mission. The U.S. now wants hospitals to treat anyone who comes through their doors, but this wealthy nation can't muster the resources to guarantee that everyone has insurance coverage.
On the other hand, lawmakers need to ensure that disaster aid programs don't degenerate into pork-barrel projects. Before Sept. 11, some hospital lobbyists had been grasping for a reason Congress, even in a time of tax reduction and tight budgets, should give hospitals more Medicare money. They seized on labor shortages as the rationale du jour.
Public funds targeted for disaster preparedness should not be used as a back-door funding mechanism to compensate for systemic shortcomings. Money should be spent on developing major regional centers or networks and not to give every struggling seven-bed facility a decontamination unit and some extra cash. Let the hospital industry concentrate on the very pressing problem at hand and work on reform of overall healthcare funding as a separate issue.