Health strategy seen as needed, costly

A national plan announced Thursday is 'well thought out and reasonable, but incredibly expensive.'

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An emergency-preparedness plan one local health official considers "well thought out and reasonable, but incredibly expensive" was announced Thursday by the federal government.

The National Health Security Strategy is America's first comprehensive plan focused on protecting people's health during a large-scale emergency, according to Kathleen Sebelius, secretary of the U.S. Department of Health and Human Services. The strategy sets priorities for government and non-government activities over the next four years.

"As we've learned in the response to the 2009 H1N1 pandemic, responsibility for improving our nation's ability to address existing and emerging health threats must be broadly shared by everyone -- governments, communities, families, and individuals," Sebelius said in a press release. "The National Health Security Strategy is a call to action for each of us so that every community becomes fully prepared and ready to recover quickly after an emergency."

The concept of standardized, nationwide emergency health planning is overdue, believes Harvey Crowder, administrator for Walla Walla County Public Health Department. "Ideally it should be done. If you look at the response to pandemic influenza, given the disease we had, for the most part the health care system did a pretty good job," he said Thursday. "But a more severe disease we would have been hard pressed to handle."

According to the federal government, national health security means the nation and its people are prepared for, protected from and resilient in the face of health threats or incidents like bioterrorism and natural disasters. The proposed strategy provides a framework for actions that will build community resilience, strengthen and sustain health emergency response systems and fill current gaps in services, Sebelius said.

"Events which threaten the health of the people of this nation could very easily compromise our national security. Whether it's a pandemic or a premeditated chemical attack, our public health system must be prepared to respond to protect the interests of the American people," she said. "In order to be prepared to both respond to an incident and to recover, we need a strong national health system with individuals and families ready to handle the health effects of a disaster."

Along with 10 implementation objectives, the National Health Security Strategy also highlights specific actions that the nation -- including individuals, communities, non-government organizations and government agencies -- should take to prevent, protect against, respond to, and recover from health threats.

The government will conduct a review to improve the system for developing and delivering countermeasures for health emergencies such as medications, vaccines, supplies and equipment. Plans also call for a coordination of government and community officials to identify and prioritize the capabilities, research, and investments needed to achieve national health security; and evaluating the impact of these investments.

All those measures, Crowder said, are going to cost manpower and money. While the work for this season's H1N1 pandemic flu has been handled with existing staff, creating a much broader picture of pandemic readiness is not sustainable at a local level. Especially given that "emergency preparedness funding has been dwindling for some time."

The national strategy would provide a great margin of safety in medical emergencies," he added, "but cost and effort will be significant. Without Congress funding it, it's just not going to happen."

In Walla Walla and in most places, health departments have not been able to add to staff to address emergency health preparedness. If funding for more hiring does become available, training for the strategic plan is one component. Finding people to hire, however, is a much larger and immediate issue that circles back to health-care reform, Crowder explained.

"Public health care has an aging workforce, and that means getting enough people into health care and making sure they have available opportunities to remain so." With increasingly low Medicaid and Medicare reimbursement to providers, it's difficult to convince medical students to go into family- and primary-care medicine -- to do so is to commit to working much harder than a specialist in order to have enough money to pay back school loans. And because of that problem, the current health care system "has very little expandability," Crowder said. "These are real expensive issues that have long-term implications."

The newly-announced National Health Security Strategy was carefully crafted with input from local, tribal, state and federal experts in six regional workshops and is "a great plan," he added. "But the real issue is, how can we afford to pay for it and how long will it take us to get to that point?"

To obtain a copy of the strategy and implementation guide, visit www.hhs.gov/disasters.

Sheila Hagar can be reached at sheilahagar@wwub.com or 526-8322. Check out her blog at blogs.ublabs.org/fromthestorageroom.

Plan highlights

The National Health Security Strategy proposed by the federal government is designed to protect the nation's health during emergencies. The plan's creators developed 10 objectives to achieve health security, which include:

Foster informed, empowered individuals and communities.

Develop and maintain the workforce needed for national health security.

Ensure awareness of situations, including timely and effective communication, so responders are aware of changes.

Develop integrated, health care delivery systems that can respond to a disaster of any size.

Work with cross-border and global partners to enhance national, continental, and global health security.

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