White House approach to COVID-19 funding allocations forces some hospitals into survival mode

By Mona Austin

(The Slice): Press Sec. Kayleigh McEnany announced  in her first formal press briefing the provisions from the $12 billion Provider Relief Fund will support select hospitals impacted by COVID-19. In revealing how the funds would be divided, she also revealed an emergent issue for the healthcare sector.  Funding will not be available to all medical facilities.

"Ten billion of the twelve billion will go towards hospitals treating 100 or more COVID-19 admissions," she said. 

Leaving no doubt that the funds are being allocated to areas that have the most cases, the press secretary explained, "HHS is distributing an additional $2 billion to these 395 hospitals in proportion to the amount of care they provide to low-income and uninsured patients."

McEnany  indirectly confirmed that thousands of medical facilities -- unless they have a reserve of funds to cushion their budgetary plummet -- could go into debt over the economic freeze related to Coronavirus closures. 

"This is consistent with our effort to ensure that Americans who need federal government assistance the most receive it." 

 

While the needy have been prioritized in this allocation plan, it is the initial expectation of the medical sctor getting national across-theboard assistance was not met. THe plan may have lacked the precience to cover facilities outside of inner cities. 

All hospitals need funds to maintain an adequate supply of PPE (Presonal Protection Equipment).  The basic supplies of masks, gloves and sanitizer in addition to equipment like respirators are necessary.  Funds would be used to acquire supplies like the coveted N95 mask that is used when treating critically ill patients. Without these items, doctors and nurses working on the fronlines  have expressed they do not feel equipped to combat the Coronavirus. They worry about shortages.

There are 6, 146 hospitals in the United States according to the American Hospital Association. Dentists, Optometry and other providers of outpatient health services were not included in the number McKenany disclosed. The federal government's efforts to respond to medical facilities that tested and triaged patients during the outbreak at a higher rate may have been inadvertently shortsighted -- overlooking staff cuts at hospitals with fewer patients nationwide. Their budgets too have been stricken. Offering support to only 395 out of thousands of medical facilities that potentially need help may prove to be insufficient.

To his credit, Pres. Donald Trump converted ships into hospitals and demanded the production of ventilators be amped up. But in its eager efforts to stop the economic bleed around the nation, the Trump Administration is apparently not giving enough attention to the growing unemployment among healthcare personnel or the massive amounts of revenue that has stopped flowing in the medical community triggered by stay-in-place orders.

Trump also  approved the Coronavirus bill which ordered free coronavirus testingthat in reality was not available in many areas of the country. (H.R.7255 - Coronavirus Health Care Worker Wellness Act of 2020 would be introduced to address the direct needs of healcare workers, but has seen little action in the House of Representatives.)  The current response to the outbreak of the deadly virus is not giving  hospitals confidence in remaining afloat.  

An Emrgency Room doctor at a Northern Virginia hospital  said they furloughed a large portion of their staff. The need for urgent care was replaced with them conducting Coronavirus tests and calling patients with results. Still, they were barely using the tent that had been set up outside the emergency room door for Coronavirus testing.  When asked if staff cuts were mainly hitting  larger cities our source said they were across-the-board, emphasizing that the patient volume has decreased significantly in hospitals across the country and the medical industry as a whole. They said many people are afraid to come to hospitals, anxious about being exposed to the disease and are opting for tele-health appointments.

Adding to the loss of business, in the initial guidance from the White House medical facilities were advised to stop elective surgeries and minimize non-emergency appointments. Scaling back business in this manner left extra empty rooms and reduced the need for full time staffs. Hospitals are seeing the loss of life and money. 

The desperate need for funds may have led to a questionable survival strategy for some hospitals.
Minnesotta law maker Scott Jensen, claimed hospitals with COVD-19 patients would be getting larger payouts from the government. On April 8 Jensen, a family physician, told Fox News host Laura Ingraham  the number of COVID-19 deaths may be inflated, insinuating hospital administrators may have been gaming the system. He later said he was not trying to say hospitals were intentionally taking advantge of the government.

With a society in survival mode, everyone is looking to the government for relief, especially those who have direct access to the president.

Trump has been meeting with Republican governors from states where he has vested interests and getting reports directly from them.  The scenario below is exemplary of this.

On Thursday (April 30) at the White House he met with Gov. Murphy of New Jersey. Murphy reported that his state has been hit hard as it is located close to New York the epicenter of the Coronavirus pandemic, but said he will be opening certain sites over the coming weekend in spite of tremendous loss. It appears that the administration is placing a greater weight on the economy and capitalism than lives and that Trump is showing more favor to states where he needs political gains or has strong business ties. He has had  dubious exchanges about the distribution of the funds. Those who have face time with him are liklier to get the support they need as the following excerpt about the impact of the Coronavirus on New Jersey's hospital system indicates:

"We’ve been crushed as a state. As you know, it’s a state you know very well. We have 6,770 fatalities. But the curves, thank God, are beginning to show promise. And we’re beginning to take some baby steps on that road to reopen. In fact, we’ve announced that, as of this weekend, our state and county parks, golf, under certain protocols, as of Saturday morning will be able to be open again." Trump replied: "Good."

THE PRESIDENT: Thank you very much. And we have been helping on the hospitals. And your hospitals have been really under stress, to put it mildly, right? 

GOVERNOR MURPHY: Amen. 

THE PRESIDENT: You know, you have some hospitals where you don’t have such a big COVID problem, and they -- they do what they do. In fact, they really could do a lot more because they weren’t allowed to use the elective.

GOVERNOR MURPHY: Correct.

THE PRESIDENT: And by not having the elective, all of a sudden they had such a different situation from you -- 

GOVERNOR MURPHY: No question. 

THE PRESIDENT: -- because you had to use it for COVID, and it was a tremendous strain. 

GOVERNOR MURPHY: You bet. 

THE PRESIDENT: So we’re going to work with you on that. We have been, but we’re going to be working with you on that. 

GOVERNOR MURPHY: Thank you. 

The death rate in New Jersey accounts for roughly 10 percent of the national death rate. Ofcourse, hospitals and frontline workers there need relief aid too. However, other health workers are being sidelined by loss of work and need to take advantage of the support the governement is offering. Governors lacking a direct connection to the White House appear to be at a disadvantage, causing the neglect of struggling workers in those areas.

 

Published on 6/3/20