The view from inside major medical centers
PEACOCK: Can I put a million dollars in the context for the disaster world? We put in decontamination showers last year. We decontaminated about 300 people an hour we are guessing. That costs a million dollars, showers; that is no beds.
KELLY: Yeah, please.
SALEM: The fact of the matter is that even though it is an unfair burden on the public-private issue, that is the way it is. And we just heard from Secretary Leavitt and that is where people are going to show up.
So the question is, as part of this, whether it – $4 billion initiative for the federal government, where are the true partnerships with local medical centers and at the local level? I mean, a lot people say those words, but the question is as part of – you heard the difficulties in terms of even distributing Tamiflu around the country. But the issue is can we tackle these particular larger issues, partner with the federal government, and make these changes that are necessary in order to be prepared?
KELLY: Yeah, Ron.
KAHN: Yeah, I would just like to make a comment in relationship to this, as I did to Secretary Leavitt, which is I think that one party that is missing a bit from this discussion are the health insurance companies. And most medical institutions depend on funding from the federal government, from patients themselves, but of course a large part of this comes through health insurance. And while it's true that in an acute medical disaster, maybe for those first few days that people will waive a lot of considerations about health coverage as something protracted takes place, we look to has insurance, who doesn't – does the insurance cover this or does it not?
And it seems to me that they should be at this table too, not necessarily at this table at this second, but at the table as we discuss this issue because they have responsibility here which I think they need to recognize is partly theirs. It has to do with both health information, that they are accessible to that frequently hospitals don't have when patients come from out of state or out of town or from another area. It comes to the resources, the financial resources to provide for care. And I think that we need to engage them in a serious way part – have part ownership for this initiative because we won't be able to do it with any one piece alone, the federal government, the hospitals; we need them to participate as well.
KELLY: Tom, maybe if I can ask you to extend that a little bit. Who should pay in this instance?
BURKE: Well, I think the – if you looked at the entire price tag, I don't think anybody is capable of paying the full price tag, and that is kind of the issue that we are dealing with. And I think the comment of being practical is the most realistic approach we can take. We invest part of our resources like the others at the table do to provide first-response kind of activities. We have also taken the tack of trying to build on our strength. We are a cancer center. We are used to dealing immune-compromised people. We feel like we bring special expertise to our community should there be a nuclear event or some other kind of event that leaves people neutropenic or immune compromised. And so we have sort of taken that role in our community to kind of work from an area of strength.
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