Ebola vs. PPACA: 3 effects

During the House hearing today, for example, Dr. Nicole Lurie, assistant secretary for preparedness and response HHS, testified about the billions of dollars Congress has already appropriated for medical countermeasures to chemical, biological, radiological or nuclear (CBRN) threats, including efforts to fund more than 80 countermeasure candidate products. Lurie said HHS hopes to include many of those countermeasure products in the Strategic National Stockpile.

Another witness, John Roth, inspector general at the Department of Homeland Security (DHS), noted that, in the past, that DHS has not done a great job at planning or acquiring pandemic preparedness supplies. The department spent $9.5 million on protective equipment in 2006 without doing much to analyze protective equipment needs, Roth said.

DHS has not kept good records on preparedness equipment purchases and is not sure what it has in stock, Roth said.

Meanwhile, hospitals that might have been thinking about investing in care coordination systems are shopping for Hazmat suits that cover the neck and wrists. 

2. The people who get things done will be even more scattered and harder to reach.

Due to time pressure, money problems and the complexity of the federal hiring process, the organizational chart of the Center for Consumer Information and Insurance Oversight (CCIIO) — the arm of HHS in charge of PPACA provisions and programs that affect commercial health insurance — shows many vacancies in important leadership positions.

CCIIO shows acting directors in other key posts, such as the director positions at the exchange policy and operations group and the insurance programs group.

The Ebola news has reportedly led HHS to transfer some of its people to Ebola jobs. 

Lurie noted today at the House hearing that HHS Secretary Sylvia Mathews Burwell has statutory authority to let states reassign federally funded personnel to declared public health emergency efforts. Dr. Karen DeSalvo, for example, is moving from a post as national coordinator for Health Information Technology to a post on the Ebola team.

That might be good for the Ebola response team but hard for efforts to get doctors and hospitals to move to the ICD-10 diagnostic coding system, or to get the health care system to converge on the use of electronic health reform systems that work better together.

Similarly, insurance companies may find that they have to devote more of the time of creative, resourceful executives to their own pandemic preparedness efforts. 

3. You, your clients and home-office workers will be even busier with non-core activities.

You, employer clients and many of your more affluent or more prominent individual clients already get asked to donate to this and volunteer for that — all while trying to figure out how to count employees for PPACA compliance efforts and understand exactly how to format a PPACA Summary of Benefits and Coverage notice.

Those projects were already taking time your clients could have been using to generate more personal income or company revenue, and it’s been taking time away from your core efforts to help people get covered and keep them covered.

Now, you may all have to spend more precious time wiping door knobs, thinking about pandemic preparedness plans and, possibly, volunteering for preparedness drills. Many of those efforts may be necessary efforts, but they may cost more of that spare time you don’t actually have to spare.