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September 07, 2005

Health Care and Katrina

The good folks over at The Next Hurrah have been running a microanalysis of Katrina. The big problems -- food, water, sanitation, shelter, and so forth are being batted about amongst big minds and budgetary gatekeepers, but what of all the minor-yet-major disruptions that the drowning of a whole way of life brings about? TNH is giving them some thought, and DHinMI kindly asked me to participate in their impromptu think tank, so I'll chime in with the bit that's -- no surprise -- grabbed me: Health care.

Most Louisianans got their insurance through their workplaces, workplaces that're now charter members of Atlantis's Chamber of Commerce. Of those that can keep paying -- say, multinationals, large firms, and the like -- the displaced are going to be far out of tier and unsure how to use insurance policies that they'd never before had to access outside state borders. That is, of course, to say nothing of those who used government programs, no programs, local insurers, and all the rest. Many will still have some functioning form of coverage, but more won't, and almost all will be terrifically confused.

This is one spot the government could quickly, easily, and effectively step in. A public announcement that all those displaced could sign up for a special subsection of COBRA or Medicaid would squelch the confusion and assure families they could take their children to the doctor. It would, of course, be a transitional measure, an opt-in program that'd phase itself out as the city clambers back to its feet. But it'd nevertheless make a massive difference in sorting out what must be a massive source of anxiety, particularly as cholera's cousin and a host of other microbiotic gremlins begin winding their way across the flood's diaspora.

In that sense, this should be a priority of society at large. The last thing the previously-unaffected should want are for long-buried diseases to start spreading from the refugee population into the wider world. That could be disastrous. And if those seeking shelter and unsure about their coverage decide not to risk their bank accounts with a potentially-uninsured trip to the doctor, it's exactly what we'll get.

September 7, 2005 in Health Care | Permalink


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» Post-Katrina: Pointing Fingers And Proposing Policy from Beltway Blogroll
Two weeks after Hurricane Katrina made landfall, the policy tornadoes that she spawned continue to churn. In the background, bloggers are working hard to see that those twisters hit the right targets and that the demolished houses of government are... [Read More]

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» Post-Katrina: Pointing Fingers And Proposing Policy from Beltway Blogroll
Two weeks after Hurricane Katrina made landfall, the policy tornadoes that she spawned continue to churn. In the background, bloggers are working hard to see that those twisters hit the right targets and that the demolished houses of government are... [Read More]

Tracked on Sep 14, 2005 4:29:57 PM

» Post-Katrina: Pointing Fingers And Proposing Policy from Beltway Blogroll
Two weeks after Hurricane Katrina made landfall, the policy tornadoes that she spawned continue to churn. In the background, bloggers are working hard to see that those twisters hit the right targets and that the demolished houses of government are... [Read More]

Tracked on Sep 26, 2005 9:13:39 AM


The conditions of crowding of people together in shelters (like the Astrodome) are breeding grounds for contagious disease. Add in the likelihood that these lower income people have undiagnosed, untreated medical ailments - plus a huge probability of mental health problems due to displacement and loss of possessions. This combo is a time-bomb with the fuse lit.

COBRA doesn't seem like a solution here. The costs will be far too high for individuals to bear. COBRA also requires the employers to respond before granting coverage (if the person had employer provided health insurance previously) and the likelihood of N.O.-based companies being able to respond is zero.

Medicaid laws should be amended to grant special status and easy filing for those displaced by the storms and flooding. Especially worrying are the mental health needs, an area that is very weak in Medicaid and needs to be bolstered for these people. You can't get a job if you display serious sings of stress, disorientation or worse.

Posted by: JimPortlandOR | Sep 7, 2005 12:46:26 PM

Health care reform/issues have always had three components:


Separating them out is always difficult. In this case, quality's not the issue, and delivery will be on an ad hoc emergency basis, but with both medical records (no copies) and insurance records lost (the insurers have a copy), the extraordinary will have to happen short term (filling prescriptions in any willing pharmacy) while financing through a Medicaid-type system will need to happen longer term.

As noted at TNH by myself and others, the medical issues are likely to be the usual routine care writ large. Forget about typhoid, cholera, and Andromeda strain illnesses for now. It's diabetic and asthma meds, high blood pressure pills and heart medications needing to be refilled. Any problems that existed beforehand will be exacerbated by this, and there were plenty of problems here (in all three categories) before Katrina.

Posted by: DemFromCT | Sep 7, 2005 1:22:00 PM

I posted on Joe Paduda's Managed Care Matters that this chaos demonstrates why we ought to have single-payer financing. There's still the problem of medical records, but if the Federal government were in charge of the financing, some of the insurance issues would be less chaotic.

Posted by: Abby | Sep 7, 2005 1:47:04 PM

I agree in theory, but perhaps it might not be an "opt-in" situation, but rather one where everyone is presumed to be already in. One can "opt-out" as one's actual situation changes, or one's insurance delivery system comes back on line.

Posted by: SteveAudio | Sep 7, 2005 2:17:02 PM

Let see what this theory can do in future to resist more katrinas and hurricanes. We may expect them to blow in future.

Posted by: Jimy | Dec 8, 2005 6:44:21 AM

I think WHO setup a pre-plan of any natural disaster

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