Issue #51

Last Update May 5, 2007

National Mothballing Hospitals by Gerry Krownstein February 12, 2007  Two trends are in conflict today. On the one hand, healthcare costs have ballooned beyond reason, and municipalities, states, federal agencies and health care corporations are all looking for ways to reduce inefficiencies and trim fat. On the other hand, municipal, state and federal disaster response agencies are concerned about having adequate resources to cope with a pandemic or bioterrorist attack. The point of conflict centers on underperforming and underutilized hospitals and health care centers. 

Closing or merging hospitals has always been a political minefield. Neighborhood people fear that the inconvenience of going to a facility further away and the additional time it takes to get there will reduce access and lead to unnecessary deaths. Staffs and unions fear loss of jobs. Those hospitals being closed, merged or downsized because of poor performance or inadequate experience to ensure favorable patient outcomes are upset at the slight to the reputations of staff and administration. Nevertheless, a number of mayors and governors have proposed such steps in order to stretch the limited health care funds available. Unfortunately, once a hospital is dismantled, it is almost impossible to resuscitate should the need arise. 

I propose a different approach, one that provides the needed cost reductions while at the same time preserving the facilities for emergency use: instead of closing a wing or a whole hospital, mothball it. Leave everything in place, including linens and pillows. Do daily vacuuming and cleaning to maintain the facility as an environment suitable for patients. Maintain a stock of current basic supplies. Maintain heating at a minimal level. Other than that,  lock it up, turn off the lights, and redistribute the staff.  

Obviously there are costs involved in mothballing. Planning costs are no worse than those for a complete shutdown, but maintenance costs (cleaning, resupply, heating, security, etc.) will be present, though far lower than for a functioning facility. These costs should be borne, not by the facility owner, but by a combination of municipal, county, state and federal preparedness agencies. These mothballed units would form a healthcare reserve that could be called into action by any event that stressed the capacity of active facilities. In addition to providing patient beds, reserve units could also provide temporary emergency housing following a natural disaster. In addition, should population shifts put demands on active facilities that can't be met, reserve units could be renovated and reactivated far quicker and at far lower cost than the construction of new facilities would entail.

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