Flu outbreak highlights broken US health system

A rapidly spreading flu outbreak may quickly overload a U.S. health system already straining from hospital closures, cuts in public health funding, a nursing shortage and too many uninsured patients, health experts said on Friday. They said the threat of a flu pandemic caused by an unusual new strain of the H1N1 influenza virus has shone a bright light on what may see as a broken U.S. health system. "I don't think we are anywhere near ready" for a pandemic, said Deborah Burger of the California Nurses Association in a telephone interview. "We've already been behind the eight-ball. Patients have been delaying their care and treatment because of the economy," Burger said. "They've had major losses of healthcare benefits and job losses, so they are not being able to afford the medicines they would normally be taking, let alone being able to have access to any of the kind of healthcare for this possible pandemic." The country's most severe recession in a generation has cost more than 5 million jobs since it began in late 2007, and an estimated 46 million Americans already lacked health insurance. Burger said she is worried about "massive slashes" in public health care funding, including $870 million slated for flu preparedness that was removed from the economic stimulus bill. This week President Barack Obama asked Congress for another $1.5 billion for pandemic preparedness. Such spending often benefits the public health infrastructure and several studies show where it may be needed. A recent survey by the Association of State and Territorial Health Officials found at least 40 percent of state health departments expect to lose staff through layoffs or attrition this year. "What we're concerned about is the public health clinics," Bruger said. "The most likely people to be affected by this (flu) are low wage earner workers that have to depend on the public health system to get their care," she added. "We're also concerned about the emergency room aspect because of the capacity." A survey this week by the American Hospital Association found that six out of 10 hospitals have more patients without insurance coming through their emergency departments. Yet nearly half of hospitals reported they have cut staff. "There is no question it comes at a bad time," Dr. Lynn Massingale, executive chairman of TeamHealth, which supplies emergency department physicians to some 300 U.S. hospitals, said in a telephone interview. "Hospital emergency department visits have grown at a rate of 2 or 3 percent a year for the last 15 or 20 years," he said. "Almost all ERs are busy. They are strained financially." He said many hospitals have been forced to close certain floors because there are not enough nurses to keep them open. But the biggest threat in a pandemic would be health care workers who get sick or have to stay home to take care of family members. "That to us is the train wreck scenario," Massingale said. Massingale said so far, emergency room doctors have not seen any evidence of the system failing. "But we are seeing some of those volumes starting to crank up and we'll know a lot more over the next two or three days."