Rural Massachusetts hospital group and others rely on PPE 'gray market', sometimes competing with the government

A story from Massachusetts illustrates the difficulties many rural health-care providers face in getting medical supplies to fight the coronavirus.

President Trump has boasted that his administration has ensured the distribution of personal protective equipment and ventilators, but rural providers are often at the end of supply chains and have a much harder time getting such supplies. That has led many to buy from third-party vendors in the "chaotic, cutthroat gray market," often paying inflated prices they can ill afford, Doug Bock Clark reports for The New York Times.

Baystate Health, which serves rural western Massachusetts, "had been forced to turn to unproven entrepreneurs like this after the corporate distributor it had once depended on ran out of N95s, when national and international supply chains collapsed at the beginning of the pandemic," Clark reports. "Their predicament wasn’t unique. Many hospitals, states and even federal agencies were also desperate, transforming the normally staid market for health care commodities into a Darwinian competition of all against all."

A Bay State executive "had to wonder: How had the U.S. medical system devolved to this? The Baystate Health team was just at the beginning of a months-long battle to secure PPE from an out-of-control market that the Trump administration would avoid closely managing — despite bipartisan calls to do so from mayors, governors, congressional representatives and the leaders of some of America’s largest health care workers’ unions and industry associations," Clark reports. "Indeed, during the initial outbreak, the federal government would sometimes be the most feared player in that market, acting not in an oversight capacity but as its most powerful buyer and disruptive agent. Though the Trump administration would subsequently take action to improve the PPE supply, the result of its efforts was a characteristically American, ongoing experiment in whether local governments and health-care systems can fend for themselves during a deadly pandemic — an experiment that may have left the country unprepared to deal with a record-shattering 'third wave' of infections this winter."

The Trump administration’s "attempts to deal with the PPE crisis reportedly emanated from a team of unpaid consultants, many in their 20s with little to no experience in health care, assembled by Jared Kushner, the president’s son-in-law," Clark reports. "After distributing the dregs of the Strategic National Stockpile, the federal government focused on procuring whatever supplies it could from corporate medical distributors and the gray market, distributing them through FEMA. An analysis by The Associated Press suggested that rural states with less serious outbreaks were awarded more PPE per confirmed case than states with significantly more dangerous outbreaks. This raised accusations of political favoritism in a life-or-death situation — though the administration has strongly denied this." The same AP story noted that many rural health-care facilities still lacked access to PPE.