A lively new article says that the United States is "woefully unprepared" for bioterrorism, and adds that "long-tolerated weaknesses in the U.S. health care system have become serious national security vulnerabilities."
Subsitute "long-tolerated" with "hard-won," and you're onto something I've been saying since Reagan took office. A huge amount of these "weaknesses" are the result of conscious decisions made by people in government, people to whom the words of Grover Norquist are thunder-loud and honey-sweet. Most of these weaknesses were never viewed as problems, but as the ecstatic realization of a dream too long denied.
Most people know that the big pharmaceutical companies are simply unwilling to manufacture stockpiles of drugs against epidemics and bioterror attacks. As this article puts it,
Big firms are accustomed to huge profits on their drugs for arthritis, ulcers, impotence and the like, and foresee returns a fraction of that size for biodefense work.
That's so patently unpatriotic, vicious, and stupid that it doesn't bear going into here. What I'd rather discuss is "the challenge of redirecting cash-starved hospitals and local health agencies into the unfamiliar field of mass casualty response." For example:
Local and state health officials say their underfunded agencies, which focus mostly on caring for the poor, have received inadequate federal funds and guidance on what the states should address in their bioterrorism master plans.
Most U.S. hospitals also lack the "surge capacity" to respond to a bioattack -- the ability to rapidly bring in hundreds of trained medical professionals to care for a huge influx of very sick people. Expanding staffs runs counter to the decades-long trend of hospitals reducing staff sizes because of budget pressures.
The reasons for this are all pretty simple, but here's one of the simplest: Without national healthcare, the poor are compelled to go to emergency rooms for routine problems. Emergency room treatment is much, much more expensive than a visit to a doctor, and the poor can't pay for it. Thus, general hospitals cost states and municipalities a great deal of money. Staffing is cut; doctors and nurses are overworked and highly stressed. They make mistakes, in triage or treatment. There are investigations, and perhaps lawsuits. That costs more money. Staffing is cut, and so are supplies. More hospitals close, and thus the burden on nearby hospitals increases, exacerbating the same problems.
It would be irrational to expect a public-health system in this condition to be able to respond to an epidemic. The surprise is not that it can't, but that anyone would believe it could.
As I've said before, national healthcare and homeland security are quite simply synonymous. But we're expected to believe that in making our willfully broken healthcare system safe and sane, we'd succumb to that primal evil known as "collectivism." I'm not impressed with that line of argument, not least because if a country is anything at all, it's a collective. In our case, the word "united" - whether it's used in our country's name, or intoned piously by some political hack - is supposed to denote a particularly high-minded adherence to the concept of shared destiny. Well, there are few more "collective" experiences than being caught in the middle of a smallpox or influenza epidemic. In our vulnerability to anthrax spores, at least, our nation is admirably indivisible.
That said, let's lighten up a bit, and take a look at the punchline of this article:
Some believe that Bush should publicly declare the seriousness of the government's bioterrorism concerns, name a bioterrorism "czar" to focus public attention, and initiate vastly expanded research into new drugs. Administration officials said that such steps are unnecessary and that the current arrangement works fine.