Imagine you are a hospital or other healthcare administrator and you are in the throes of a natural disaster. If the power goes out, you have to make a decision that is in the best interests of your patients, but you know your backup generators cannot provide enough power to both keep IVs pumping and machines monitoring, and also keep gallons of blood plasma and other lifesaving fluids refrigerated – what would you do?

An almost impossible choice, but that is the exact choice that hospitals had to make during the rolling blackouts that were initiated to try to halt the spread of the devastating California wildfires.

While everybody is focused on health insurance and who is going to pay for it, the problem faced by the healthcare facilities in California exposed a possible fatal flaw in the infrastructure of America’s healthcare system, which few if any government officials seem concerned about.

The United States health care system depends on electricity to function normally. It needs the power to run everything from ventilators to electronic health records, to ferry patients via elevator through hospitals, refrigerate medications, and countless other tasks. Therefore, of course, this is not a problem isolated to California. The number of weather-related power outages has been increasing nationwide, as extreme weather events become more common. As a result, it’s more critical than ever that healthcare facilities are prepared for a present and future where power isn’t a guarantee.

“We’re so used to having an uninterrupted supply of power,” says Grete Porteous, an anesthesiologist and emergency medicine specialist at Virginia Mason Medical Center in Seattle. “It really blows people’s minds to understand that all of this is very fragile.”

Federally Funded Hospitals Are Required to Have Backup Power

In order to receive federal funding from Medicare and Medicaid, hospitals that provide critical care are required to have generators that can power their essential functions. The Joint Commission, which accredits hospitals, calls them to have emergency plans in place and for generators to be tested regularly. However, despite precautions, generators can be vulnerable during disasters. At NYU Langone Medical Center, for example, key pieces of the backup system were in the basement, which flooded during Superstorm Sandy in 2012, knocking out all power to the hospital. “Just because you have generators doesn’t mean they’ll work, or work for long enough,” Porteous says.

Outpatient health clinics, which aren’t subject to the same regulations as hospitals, are working with even less of a safety net.

In 2017, during a power loss caused by Hurricane Irene, 12 elderly patients died in a Hollywood, Florida nursing home due to the sweltering heat with no air conditioning. The facility was closed, and the administrators charged with manslaughter.

A good part of the problem is that hospitals and healthcare systems in the US run on razor-thin financial margins, and convincing decision-makers to invest in emergency preparedness can be challenging.

Having power outages like those in California, in the news more and more regularly, helps make those in charge of healthcare more aware of the problem. When hospital power outages make national headlines, it’s an opportunity to show hospital administrators why they should be investing in emergency preparedness measures. They can ask themselves and their governing boards, “We saw something happen at a hospital over there in Sonoma County, now what would we do in that situation?”