When Health Care is not a Public Good, why would hospitals agree to take Ebola patients?/ WaPo

The WaPo explores which hospitals will be approved by CDC to treat Ebola patients, and whether hospitals will lose or gain from such a designation. Treating an Ebola patient scares other patients away, puts
staff at risk, and demands extraordinary levels of intensive care that exceed
what can be reimbursed by insurers, and sometimes what can feasibly be provided. Excerpts follow:

U.S. officials trying to set up a
network of hospitals in this country to care for Ebola patients are running
into reluctance from facilities worried about steep costs, unwanted attention
and the possibility of scaring away other patients.

“They’re saying, ‘Look, we might
be willing to do this, but we don’t want to be called an Ebola hospital. We
don’t want people to be cancelling appointments left and right,’ ” said Michael
Bell, director of laboratory safety at the Centers for Disease Control and

Just a few facilities in the
United States have special bio-containment units, which are ideal for treating
Ebola, and they can handle only two or three patients at a time. And the case
of Thomas Eric Duncan, the Liberian man who was initially misdiagnosed at a
Dallas hospital and died, shows how easily a community hospital can stumble.

Of the 5,000 hospitals in the
United States, dozens have volunteered to treat Ebola patients. As of
mid-November, CDC infection-control experts had visited 41 facilities in 12
states and the District of Columbia, according to agency Director Thomas

But it is not clear how many
medical centers will pass muster and whether the number will be enough for the
administration to meet its goal of establishing an adequate network of
Ebola-ready facilities.

The handful of U.S. hospitals that
have treated Ebola patients have discovered that doing so can be costly,
requiring around-the-clock care involving scores of nurses and other health
workers. That would be a big challenge for many hospitals, where staffing is
often stretched thin.

Adding to the burden is the
widespread media attention that accompanies treating an Ebola patient and the
potential loss of revenue if other patients steer clear of the facility. There
is also the constant worry that a mistake could result in employees’ becoming

Most of the 10 Ebola cases in the
United States were treated at three hospitals with biocontainment units —
Nebraska Medical Center, Emory University Hospital and the clinical center at
the National Institutes of Health in Maryland.

Those hospitals would be
“overwhelmed by even a modest surge of 10 to 20 patients,” Bryce Gartland, vice
president of operations for Emory University Hospital, said in a Nov. 7 letter
to Congress in support of more federal funds…

From today’s Hartford Courant:

A spokesman for Day Kimball Hospital in Putnam said that, although the hospital is capable of safely identifying, isolating and providing initial care for an Ebola patient, dealing with an Ebola patient in the long term would shut down the hospital because of the costs involved.

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