Skip to content
  • About
  • Contact
  • Contribute
  • Book
  • Careers
  • Podcast
  • Recommended
  • Speaking
  • All
  • Physician
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • Video
    • All
    • Physician
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • Video
    • About
    • Contact
    • Contribute
    • Book
    • Careers
    • Podcast
    • Recommended
    • Speaking

The bipartisan infrastructure deal is now law, but here’s what it forgets

Charles Sanky, MD, MPH
Policy
December 16, 2021
1 Shares
Share
Tweet
Share

In June 2021, the Biden administration announced bipartisan support for federal legislation to rebuild our nation’s crumbling infrastructure. The Infrastructure Investment and Jobs Act seeks to revive highway, transit, rail, and public work systems, as well as improve broadband internet access, mitigate the supply chain crisis and combat climate change.

Like most Americans, I am grateful that we are finally addressing our deficits in infrastructure. Nevertheless, this recently signed law forgets one blatantly obvious thing — our deficits in health care infrastructure, as demonstrated vividly by the COVID-19 pandemic.

The past almost two years of the COVID-19 pandemic halted our economy and our daily lives, more importantly resulting in 5.2 million deaths.

Emergency legislation such as the CARES Act and HEROES Act supported already thinly-stretched hospitals but only reflected a fraction of their lost revenue. Despite the best intentions, these band aid-solution approaches resulted in minimal improvement of health care capacity to meet the new demands of the COVID-19 pandemic.

Efforts to “flatten the curve” were necessary simply because the American health care delivery system was already broken and unable to support the growing number of COVID-19 cases. Many U.S. hospitals faced bankruptcy and were shut down, particularly in rural areas where access to care and resources were already limited. Others had to make tough decisions regarding how they would allocate ventilators, space, staff, and other scarce resources. To this day, health care and government leadership still have not conducted the post-mortem analysis to understand fundamentally how and why our health care and public health systems have been so devastatingly incapable of preventing and responding to this threat.

Over the past several years, the number of natural and man-made disasters in the United States and globally has increased, ranging from terrorism and cyber-attacks to shootings and contagious infectious diseases. These disasters have severely impacted health care delivery and population health in the United States.

Even climate change has taken a toll; Hurricanes Sandy, Harvey, and Katrina disabled the operating capacity of entire hospitals and resulted in the loss of lives, both inside and outside of hospitals. Hurricane Maria’s impact in Puerto Rico resulted in critical shortages of saline across the United States. Candidly, such threats become disasters when the new demands placed on our society exceed the supplies, staff, space, and systems able to respond.

These demands often fall entirely upon our health systems, yet U.S hospitals and public health systems lack the infrastructure to rise to the occasion. As a practicing physician who has seen hospital ceilings collapse and flooding during mere thunderstorms, I see how our health care infrastructure is crumbling every day.

High-consequence events demonstrate one truth that biosecurity and emergency management experts have been screaming for decades: Unless we seriously invest in public health and health care delivery, we will be unable to meet the demands of emerging threats, resulting in profound economic and societal loss as well as the loss of lives.

However, the Infrastructure Investment and Jobs Act lacks explicit funding for health system preparedness and infrastructure. Have we learned nothing from the COVID-19 pandemic?

This infrastructure law adopts a broad definition of infrastructure, mindful that the physical plants, spaces, and policies we create in service of the public ultimately impact the well-being of a nation and its people. The law’s noble efforts to address the detrimental impacts of climate change and replace lead pipes in our water systems have notable societal consequences and implications for improving population health.

Still, investing in our health care delivery and public health systems has historically been deficient and continues to elude the current conversation, likely because disaster preparedness and health care resilience are not revenue-generating in the short term.

The last large-scale investment in health care infrastructure was accomplished through the Hill-Burton Act (1946), which attempted to construct and repair hospitals across the United States. It resulted in inequitable, segregated allocation of funding, but proved that infrastructure investment could launch an era of health care transformation.

Nevertheless, the mere fact that government funding for already-outdated hospital systems has not happened in 75 years is alarming. Thoughtful investment in health care delivery with an eye toward disaster preparedness and health equity would improve population health for generations to come.

As politics continue to be divisive, perhaps the lessons we have yet to learn from this pandemic could be common ground. Recognizing public health as an essential element of America’s national security would make public health an attractive business value proposition.

Our nation’s health and our national security are intertwined, and our health care financing should reflect this. A thoughtful approach through infrastructure development could support and sustain a range of physical plant, supply chain, and other improvements in public health and health care systems. It would create large numbers of well-paying health sector jobs, improve health care access and equity, and lead to sustainable economic growth.

Upstream interventions have been desperately required for some time. We should be repairing and replacing our bridges, tunnels, internet, power grid, and the entire American infrastructure – and these efforts will certainly improve population health. However, these interventions are too little, too late, and they represent only an infinitesimal portion of what is required to repair many years of neglect.

The COVID-19 pandemic taught us what happens in times of disaster, and it makes sense to start with rebuilding our society and economy. But now, almost two years into a global pandemic with an embarrassingly uncoordinated, underwhelming response, we urgently need to start with health care. Our safety net has been, and will continue to be, our health systems.

Health care infrastructure demands our immediate attention, not just another emergency act of Congress the next time we are in trouble. With the emergence of ever-new COVID-19 variants, our future depends on reviving our health care infrastructure. Now, at this moment, health care delivery and public health should be our highest priority, greatest return on investment, and most pressing infrastructure allocation.

Charles Sanky is an emergency medicine resident.

Image credit: Shutterstock.com

Prev

Changes in the Public Service Loan Forgiveness waiver and its impact on physicians [PODCAST]

December 15, 2021 Kevin 0
…
Next

The Kyle Rittenhouse acquittal: a contrasting physician opinion

December 16, 2021 Kevin 5
…

Tagged as: Public Health & Policy

Post navigation

< Previous Post
Changes in the Public Service Loan Forgiveness waiver and its impact on physicians [PODCAST]
Next Post >
The Kyle Rittenhouse acquittal: a contrasting physician opinion

Related Posts

  • We need a mental health infrastructure bill

    Jennifer Reid, MD
  • Why health care delivery is an exceptionally different industry: health system infrastructure and health system operations and execution

    Joe Mandato and Ryan Van Wert, MD
  • The vision forward for health care should be bipartisan

    Suhas Gondi and Vishal Khetpal
  • Does federal law violate our right to health care?

    Matthew Dyer
  • Are negative news cycles and social media injurious to our health?

    Rabia Jalal, MD
  • How social media can help or hurt your health care career

    Health eCareers

More in Policy

  • Unveiling the intricate link between housing costs and health care

    Harvey Castro, MD, MBA
  • Uncovering the truth about racial health inequities in America: a book review

    John Paul Mikhaiel, MD
  • Why affirmative action is crucial for health equity and social justice in medicine

    Katrina Gipson, MD, MPH
  • The untold story of Hispanic/Latino health: Why subgroup data matters

    Matthew B. Alonso
  • Unmasking the brutal reality of gun violence in America: a call to action for unity and meaningful change

    Osmund Agbo, MD
  • Family physicians unite at the U.S. Capitol, seeking congressional support for Medicare reform and health care transformation

    Tochi Iroku-Malize, MD, MPH, MBA, Sterling N. Ransone, Jr., MD, and Steven P. Furr, MD
  • Most Popular

  • Past Week

    • How chronic illness and disability are portrayed in media and the importance of daily choices for improved quality of life

      Juliet Morgan and Meghan Jobson | Physician
    • The hidden factor in physician burnout: How the climate crisis is contributing to the erosion of well-being

      Elizabeth Cerceo, MD | Physician
    • Why affirmative action is crucial for health equity and social justice in medicine

      Katrina Gipson, MD, MPH | Policy
    • The power of coaching for physicians: transforming thoughts, changing lives

      Kim Downey, PT | Conditions
    • A patient’s perspective on the diminishing relationship between doctors and patients

      Michele Luckenbaugh | Conditions
    • Emulating Michael Jordan’s winning mindset: a path to success for health care professionals and entrepreneurs

      Harvey Castro, MD, MBA | Physician
  • Past 6 Months

    • The growing threat to transgender health care: implications for patients, providers, and trainees

      Carson Hartlage | Policy
    • It’s time to replace the 0 to 10 pain intensity scale with a better measure

      Mark Sullivan, MD and Jane Ballantyne, MD | Conditions
    • “Is your surgeon really skilled? The hidden threat to public safety in medicine.

      Gene Uzawa Dorio, MD | Physician
    • Breaking point: the 5 reasons American doctors are dreaming of walking away from medicine

      Amol Shrikhande, MD | Physician
    • Breaking the cycle of racism in health care: a call for anti-racist action

      Tomi Mitchell, MD | Policy
    • Revolutionize your practice: the value-based care model that reduces physician burnout

      Chandravadan Patel, MD | Physician
  • Recent Posts

    • The pros and cons of taking a gap year during medical school

      Med School Insiders | Education, Sponsored
    • A family physician’s journey on the OIG list and the struggle to return to practice [PODCAST]

      The Podcast by KevinMD | Podcast
    • Heartwarming stories of cancer patients teaching us about life and the human spirit

      Johnathan Yao, MD, MPH | Physician
    • We need a new Hippocratic Oath that puts patient autonomy first

      Jeffrey A. Singer, MD | Physician
    • The meaning of death in medicine: the role of compassionate care in end-of-life patient care

      Ton La, Jr., MD, JD | Physician
    • From skydiving to saving lives: a surgeon’s journey on adversity, passion, and perseverance [PODCAST]

      The Podcast by KevinMD | Podcast

Subscribe to KevinMD and never miss a story!

Get free updates delivered free to your inbox.


Find jobs at
Careers by KevinMD.com

Search thousands of physician, PA, NP, and CRNA jobs now.

Learn more

Leave a Comment

Founded in 2004 by Kevin Pho, MD, KevinMD.com is the web’s leading platform where physicians, advanced practitioners, nurses, medical students, and patients share their insight and tell their stories.

Social

  • Like on Facebook
  • Follow on Twitter
  • Connect on Linkedin
  • Subscribe on Youtube
  • Instagram

CME Spotlights

From MedPage Today

Latest News

  • Bariatric Surgery in Kids With Obesity Becoming More Common
  • NT-proBNP for All; Risky Weekend HF Admits; Ticagrelor for Infective Endocarditis?
  • Clinical Challenges: Test Your Knowledge of Dry Eye Disease
  • Clinical Challenges: Meibomian Gland Dysfunction Underdiagnosed and Undertreated
  • Best Exercise Time; FDA's Diabetes Guidance; Weight Discrimination Illegal in N.Y.C.

Meeting Coverage

  • New Model Aims to Study Intestinal Fibrosis in Crohn's Disease
  • Hypertension Tied to Worse Survival After Surgery for Upper Tract Urothelial Cancers
  • The Role of Amyloid PET in the Management of Alzheimer's Disease
  • New Inflammation Inhibitor Proves Effective and Safe for Dry Eye Disease
  • No Access to Routine Healthcare Biggest Barrier to HPV Vaccination
  • Most Popular

  • Past Week

    • How chronic illness and disability are portrayed in media and the importance of daily choices for improved quality of life

      Juliet Morgan and Meghan Jobson | Physician
    • The hidden factor in physician burnout: How the climate crisis is contributing to the erosion of well-being

      Elizabeth Cerceo, MD | Physician
    • Why affirmative action is crucial for health equity and social justice in medicine

      Katrina Gipson, MD, MPH | Policy
    • The power of coaching for physicians: transforming thoughts, changing lives

      Kim Downey, PT | Conditions
    • A patient’s perspective on the diminishing relationship between doctors and patients

      Michele Luckenbaugh | Conditions
    • Emulating Michael Jordan’s winning mindset: a path to success for health care professionals and entrepreneurs

      Harvey Castro, MD, MBA | Physician
  • Past 6 Months

    • The growing threat to transgender health care: implications for patients, providers, and trainees

      Carson Hartlage | Policy
    • It’s time to replace the 0 to 10 pain intensity scale with a better measure

      Mark Sullivan, MD and Jane Ballantyne, MD | Conditions
    • “Is your surgeon really skilled? The hidden threat to public safety in medicine.

      Gene Uzawa Dorio, MD | Physician
    • Breaking point: the 5 reasons American doctors are dreaming of walking away from medicine

      Amol Shrikhande, MD | Physician
    • Breaking the cycle of racism in health care: a call for anti-racist action

      Tomi Mitchell, MD | Policy
    • Revolutionize your practice: the value-based care model that reduces physician burnout

      Chandravadan Patel, MD | Physician
  • Recent Posts

    • The pros and cons of taking a gap year during medical school

      Med School Insiders | Education, Sponsored
    • A family physician’s journey on the OIG list and the struggle to return to practice [PODCAST]

      The Podcast by KevinMD | Podcast
    • Heartwarming stories of cancer patients teaching us about life and the human spirit

      Johnathan Yao, MD, MPH | Physician
    • We need a new Hippocratic Oath that puts patient autonomy first

      Jeffrey A. Singer, MD | Physician
    • The meaning of death in medicine: the role of compassionate care in end-of-life patient care

      Ton La, Jr., MD, JD | Physician
    • From skydiving to saving lives: a surgeon’s journey on adversity, passion, and perseverance [PODCAST]

      The Podcast by KevinMD | Podcast

MedPage Today Professional

An Everyday Health Property Medpage Today
  • Terms of Use | Disclaimer
  • Privacy Policy
  • DMCA Policy
All Content © KevinMD, LLC
Site by Outthink Group

Leave a Comment

Comments are moderated before they are published. Please read the comment policy.

Loading Comments...