“There are parts of the health care system that can be and should be lean but there are public health preparedness efforts that need to be ongoing.” said Crystal Watson, a senior scholar at the Johns Hopkins Center for Health Security.

What brought this on? The industry has gone through long-term consolidation that’s put a premium on shortening patient stays, moving care outside the hospital to cheaper settings and investing in high-tech diagnostic tools and big-ticket items like proton beam treatments for cancer. Infectious disease prevention, emergency preparedness and primary care made do with less.

But with some projections of millions of hospital admissions in a full-blown coronavirus pandemic, the industry is forced to consider pivoting back to a hospital-centric, all-hands-on-deck approach featuring sick patients who may stay for weeks, labor intensive staffing and anything but a check in-check out mentality.

The industry says it's up to the challenge and readying contingency plans. Some operators, for instance, are trying to boost telehealth capabilities in an effort to keep potentially infected people who aren't very sick away from the most vulnerable patients — and to keep beds open for those who need in-person treatment.

But the outbreak is reinforcing the idea that preparedness is an ongoing process.

Over the last decade, the federal government, the nation’s largest insurer, has rewarded hospitals that reduced the number of patients who walked through the doors. One of the only pieces of Obamacare with broad bipartisan support is the Center for Medicare and Medicaid Services' Innovation Center, which tries to provide better care at lower costs in part by pushing people into outpatient settings.

In 2015, scientists from HHS, CDC and the FDA warned that resources would be squeezed during a large scale public health emergency.