By Rich Lowry
Tuesday, April 28, 2020
We had to destroy the hospitals to save them.
You could be forgiven for thinking that’s the upshot of
the coronavirus lockdowns that have suspended elective surgeries and generally
discouraged people from going to hospitals.
Many hospitals are getting pushed near, or over, the
financial edge. At a time when we feared that hospitals would get overwhelmed
by a surge of patients, they have instead been emptied out. At a time when we
thought medical personnel would be at a premium, they are instead being idled
all over the country.
We are experiencing an epidemic that bizarrely — and in
part because of the choices of policymakers — has created a surfeit of hospital
beds and an excess of doctors and nurses.
Not everywhere, of course. Hospitals in New York City and
parts of New Jersey have been tested to their limits. But throughout much of
the country, hospitals are drastically underutilized, both because states have
banned elective procedures and people have been too afraid to show up.
One reason that we didn’t want hospitals to get overrun
by COVID-19 patients is that we didn’t want to crowd out everyone else needing
care. But, as a deliberate choice, we’ve ended up crowding out many people needing
care — even where COVID-19 surges haven’t happened and probably never will.
Drastic measures were called for when the coronavirus hit
our shores and began to spread out of control, especially in urban areas
particularly susceptible to the pandemic. It is understandable that we wanted
hospitals to prepare for the worst, and to preserve and muster equipment
necessary to safely care for infected people. Hospitals themselves can become a
vector for spread of COVID-19, so keeping away people who didn’t absolutely
need to show up was a reasonable impulse.
But this is a case where the cure may be really worse
than the disease — or at least has created its own crisis.
Elective surgeries are a major source of revenue for
hospitals, which have taken an enormous hit as they have disappeared, often in
response to state orders.
West Tennessee Healthcare, based in Jackson, lost $18
million in March after the state prohibited elective surgeries, and furloughed
1,100 out of a 7,000-person staff, according to Becker’s Hospital Review.
Summit Healthcare in Arizona expects as much as a 50 percent drop in revenue
after the state’s ban on elective surgeries. Philadelphia-based Tower Health,
also dealing with a 50 percent drop in revenue, furloughed 1,000 employees out
of 14,000.
The examples go on and on and on. Even hospitals in New
York State, a center for the virus, are feeling the pinch. Catholic Health and
Kaleida Health in Buffalo are furloughing workers. So is Mohawk Valley Health
System in Utica, Cayuga Medical Center in Ithaca, and Columbia Memorial
Hospital in Hudson.
Elective surgeries aren’t necessarily what you think. As
a piece in The Atlantic pointed out, they aren’t just knee replacements.
They include procedures for serious illnesses such as cancer. A recent New
York Times story was headline, “The Pandemic’s Hidden Victims: Sick or
Dying, but Not from the Virus.” It led with the story of a Rutgers University
professor who couldn’t get treatment for the recurrence of his blood cancer.
As with the lockdowns in general, it’s not clear how much
of the reduced traffic in the hospitals has been the result of people changing
their behavior on their own based on fear of the virus, and how much has been
the result of state edicts. But it’s certainly true that the prohibitions on
elective surgeries — more than 30 governors had issued some version of them as
of late April — were too clumsy and sweeping, and not geographically selective
enough.
Governors in some states are now loosening them up, and
it’s time for other governors around the country to follow suit, except in true
hot spots. In retrospect, the bans fail the cardinal rule of health care:
First, do no harm.
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