Hospitals' ability to withstand natural disasters while keeping their patients safe came under scrutiny by the House Ways and Means Committee Wednesday.
But lawmakers mostly avoided talking about new hospital regulations as they convened the panel's first hearing on climate change in 12 years.
When the issue came up, Rep. Terri Sewell (D-Ala.) immediately signaled concern about where the money should come from, as she doesn't want the government to add costs to rural hospitals. She asked whether the federal government should start funding hospital preparations.
"I'm worried about the resources to get them prepared," the congresswoman said after the hearing. "I think that we need to think of some carrots and sticks that will help them to get there, but I also know so many of them right now, my rural hospitals, because we did not expand Medicaid in Alabama, are quite concerned about just keeping the doors open, the lights on, and being able to have medical professionals to do the work."
Dr. Ashish Jha of the Harvard Global Health Institute focused his testimony almost entirely on the public health threat of climate change, the costs to the healthcare system, and where the healthcare industry needs to do better. He urged lawmakers to think about more federal regulations, saying accreditation agencies should require hospitals and clinics to meet certain resiliency standards before approving their accreditation.
When Sewell raised the question of funding to the panel, Jha said that rural hospital finances pose a challenge. But they still need to be ready for disasters and he believes the federal government should take the lead on funding.
"Ultimately these hospitals are safety nets for the communities they serve," he said, noting that they not only have to be able to withstand storms, but they have to be better at predicting what they'll need and staying staffed up through a natural disaster.
The House hearing on the health and economic factors of climate change coincided with the Senate's near-agreement over disaster relief for the states most recently hit by fires and floods.
Hospitals and nursing homes often find themselves in the limelight in the wake of disasters, depending on how they've been able to respond and how they've treated patients.
Last fall, Democrats of the Senate Finance Committee urged the CMS to tighten regulations on nursing homes after they investigated a dozen patient deaths by heatstroke in a Florida home post Hurricane Irma. The investigation also probed Texas nursing homes, including a residence where staff decided not to evacuate their elderly patients despite flood warnings.
As severe weather hits, so do the bills. One study that Jha cited said six weather events related to climate change brought $740 million in healthcare costs — about 9,000 hospitalizations, more than 21,000 emergency visits and 734,000 outpatient visits.
The healthcare industry also came under criticism for its role in climate change and related costs. Those companies are responsible for about one-tenth of the nation's greenhouse gas emissions, Jha told lawmakers.
Kaiser Permanente, the Oakland, Calif.-based system that plans to be carbon-neutral next year, and Gundersen Health System in Wisconsin, which froze investments in fossil fuels were suggested as examples other health systems should follow.
But all the major players need to do more, Jha argued.
"The production of pharmaceuticals is very energy intensive and there's very little evidence [manufacturers] have taken it seriously," he told lawmakers.