Thoughts from Ken Kaufman

Pandemic Redux?

2 minute
Covid vaccine and stethoscope

A lack of pandemic preparedness, of course, is no run-of-the-mill social and public health problem. When the nation is unprepared for catastrophic public health emergencies, the consequences are as real as they can get. As we saw with COVID-19, many people died while the country’s public health apparatus struggled to catch up.

The current situation is quite likely even worse than as described in two recent high-profile op-eds—one by Ezekiel Emanuel and other members of President Biden’s advisory board on COVID-19 and another by leading health researcher Eric Topol.

During the COVID-19 pandemic we experienced an almost complete “fail” of America’s public healthcare system. Our public health organizations had been underfunded for years, so when the COVID-19 pandemic arrived America’s public health agencies did not have any of the resources, financial or otherwise, to cope with a true public health emergency.

So what happened? America’s hospitals stepped into the public health breach. Hospitals took care of the very sick COVID-19 patients and over time learned and communicated best practice care procedures. In addition, hospitals assisted with case tracking and in many locations provided the tip of the spear for highly organized vaccination programs. All of this extra public health effort was funded by CARES Act money and hospital balance sheets that had been carefully accumulated over many years.

But that was then and now is now. America’s hospitals are suffering through their worst financial results since the 2008 financial crisis. A Kaufman Hall report prepared for the American Hospital Association predicts that 55% of all hospitals will lose money from operations in 2022. In fact, hospital margins have decreased by 31% when compared to pre-pandemic levels. Further, because of COVID and related inflationary pressures, total hospital expenses increased in 2022 by 8% while overall inpatient revenue increased not at all. Finally the hospital labor market is seriously distressed. Many hospitals cannot find the nursing and technical help needed to keep critical services open and operating at pre-pandemic levels. In fact, from 2020 to 2022 hospitals experienced a 63% increase in the number of open and available positions, based on an analysis of Bureau of Labor Statistics data.

So it is the triple whammy for our society. The country is clearly unprepared for the next pathogen—the next pandemic. Our public health agencies are no better ready to help than they were in 2020. And America’s hospitals, which jumped into the breach during COVID-19, are now financially and clinically challenged, particularly in the face of any potential unexpected public health crisis.

The last pandemic did major damage to our day to day economy, causing dramatic damage to many businesses large and small, dramatic employment dislocation, and a surprising and debilitating uptick in inflation. It should go without saying that preparation for any future public health emergency should be a matter of concern for governments, corporations, and healthcare provider organizations throughout the country.

This article is adapted from “A Pressing Topic for the Corporate Social Voice” by Michael W. Peregrine and Kenneth Kaufman, which appeared on January 20, 2023, in The CLS Blue Sky Blog of Columbia Law School. Used with permission.

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