Baton Rouge   The headline caught my eye. Sheri Fink, author of what has to be the definitive case study of a hospital in crisis post-Katrina, the award-winning Five Days at Memorial: Life and Death in a Storm-Ravaged Hospital, had written an op-ed piece in the Times entitled, “Can Hospitals Afford to Be Ready for Disaster.” You can probably already see my head scratching. I had written a book about Katrina myself, The Battle for the Ninth Ward: ACORN, Rebuilding New Orleans, and the Lessons for Disaster. The one lesson I felt confident of was that we finally had a national, and certainly a community, consensus that we had to be ready for disaster, so for me the question was really, “Can Hospitals Afford NOT to be Ready for Disaster?”

The issue was an important one that is now lost in the bureaucratic maze. The Bush Administration started the wheels turning in 2007 post-Katrina and the Obama Administration proposed a draft for public comment in 2013. The language is stuck now in legal review at the Office of Management and Budget (OMB) on an extension of a 90-day legal review. The whole rule though is on a 3-year timetable, so if not finalized, we’re left with nothing.

You might say, “…but that can’t happen here.” We’ve had Katrina, Sandy Hook, Ebola, and now Zika all highlighting the need for disaster preparedness and, worse, proving over and over again how few health care facilities are ready and able. Please remember the Katrina situation involved nursing homes so unprepared for evacuation that many elderly were trapped and drowned. Memorial Hospital, the old Baptist facility, was in such a crisis mode as Fink has documented that “two desperate doctors later said that they hastened the death of patients who had waited days in the heat for rescue.” Reading the book, there was little doubt that many of these patients would have had years left to live had there been a different set of responses.

The rule would change much of those worries. It would affect 68,000 providers across the whole range of the health care industry and not just hospitals and nursing homes but kidney dialysis centers, mental health facilities, home health and the whole shebang.

So, this is a no-brainer, right? Well, it should be but you’ve already probably guessed that it would be if we had a public health system, but with a private dominated healthcare system if administrators can avoid spending the money, then emergency preparedness is at the bottom of the list. Fink even noted that there are 250 California hospitals that have still not been “retrofitted, replaced, or removed from service” 45 years after the Sylmar earthquake killed dozens at California hospitals. A professor in Maryland noted that an administrator was probably calculating that if they had to spend a couple of hundred thousand and they never had a disaster, then they lost revenue. This is topsy-turvy of course. You spend to prepare, while hoping you never have to meet a disaster. The same prof though noted that if the facility spent the money and faced a disaster and were ready, they would make a killing, but “how do you do a budget analysis on that?” Wow! The warped priorities here just takes your breath away, and where is Senator Charles Grassley from Iowa when we need him reminding so many of these facilities that they are tax exempt so why is “making a killing” a priority anyway!

We need this rule and probably a lot more. Time to Boy Scout up and get in touch with your Senators and Congressmen to reach out to the OMB and the Department of Health and Human Services and remind them that “Be Prepared” is not just a slogan, but a lifesaver!