spreading the disease – Liberal Street Fighter
Looking at sick care in this country is overwhelming, but a couple of interesting reports all came out this week, imposing themselves on us, making it hard not to look a little closer at the mess that is our “health care” system. The one that made the biggest splash, American exceptionalism being the easily-wounded delusion that it is, was this report from across the pond:
Americans 55 and over are much sicker than their British counterparts even though the United States spends more than twice as much per person on health care as Britain, researchers said Tuesday.
Writing in The Journal of the American Medical Association, researchers from University College London also seemed to confirm stereotypes tossed across the Atlantic, concluding that Americans are prone to obesity while Britons drink too much.
The conclusions followed an inquiry that used data from American and British health surveys to compare the relative health of people ages 55 to 64 and how their health varies as a result of social and economic status.
The researchers wrote that “health insurance cannot be the central reason for the better health outcomes in England” because the richest Americans have nearly universal access to care but their outcomes are often worse than those in England.
It’s easy, or tempting, to want to explain these things away with surface explanations, about the costs or bureaucracies or diet or too much television. Like so many of these studies, it really doesn’t explain much of anything. A bit of trivia for the talking heads to blather about, instead of dealing with our real problems with public health in this country. In fact, that’s the problem … we HAVE no commitment to public health in this country. Of all the things to privatize, this has been one of the stupidest and most dangerous areas ruined by our worship of the so-called free market.
Here’s the REALLY interesting and scary report to come out this week:
A flu pandemic would cause massive disruptions lasting for months, and cities, states and businesses must make plans now to keep functioning — and not count on a federal rescue, the Bush administration said Wednesday.
“Our nation will face this global threat united in purpose and united in action in order to best protect our families, our communities, our nation and our world from the threat of pandemic influenza,” President Bush said in a letter to Americans noting the release of an updated national pandemic response strategy.
Yup, you read that right. In typical Bush Administration fashion, they’re simultaneously announcing that we’re “united in purpose” in a report that bluntly states that we’re pretty much all on our own, pretty scary in a world facing several possible sources of worldwide pandemic. There’s some pretty unintentionally funny stuff in here, ranking right up there with plastic sheeting and duct tape as survival strategies:
A flu pandemic would roll through the country, likely causing six to eight weeks of active infection per community.
“Local communities will have to address the medical and non-medical impacts of the pandemic with available resources,” the report warns, because the federal government won’t be able to offer the kind of aid expected after hurricanes or other one-time, one-location natural disasters.
The report assumes a worst-case scenario of up to 2 million U.S. deaths. But Townsend sought to downplay the perception that chaos will consume the nation.
“The whole purpose of planning … is to take the fear out of it, so there’s no chaos,” she said.
Within a year, federal health officials should approve states’ individual pandemic plans, it says.
For businesses, the report encourages setting clear, non-punitive sick-leave policies to limit the possibly infected from staying at work, and using alternate offices, work-at-home and “snow days” to minimize employee contact. Also, it advises regularly cleaning offices — flu can live on hard surfaces for 48 hours — as well as not shaking hands and keeping co-workers at least 3 feet apart.
But the yard’s-distance advice assumes that flu only spreads in the large droplets of coughs and sneezes; tiny droplets that stay suspended in the air for long periods can spread it, too.
“We depend on everyone outside of the government to take this as seriously as we do,” Townsend said.
The incremental plan already was drawing complaints that despite months of dire talk about the threat of a pandemic, the administration hasn’t accomplished enough.
“Other nations have been implementing their plans for years, but we’re reading ours for the first time now. These needless delays have put Americans at risk,” said Sen. Edward Kennedy, D-Mass.
I wonder if Townsend said that with a straight face? TAKE IT SERIOUSLY?!? As for Teddy, well, we’ll get back to his worthless ass in a second.
There was a time when governments planned for these sorts of things. Yes, REALLY planned. Lets jump into the Wayback Machine and take a look at another pandemic in this country, the “Spanish Flu” Pandemic in 1918.
Emergency hospital during influenza epidemic, Camp Funston, Kansas.
Well, some of the government was prepared. Actually, much of the best work was done at the state level, especially in Wisconsin, a state run for several years by strong progressives with a passionate belief in an activist government. (you can read a full account of the Wisconsin experience with the pandemic also here – warning pdf).
In 1918, the State Health Officer was Dr. Cornelius A. Harper. Appointed in 1902 by his friend Governor Robert M. La Follette, Sr., Harper was steeped in the Progressive tradition of activist state government. When the highly contagious, airborne epidemic arrived in Wisconsin, Harper was prepared to use the extraordinary powers of his office to blunt its impact.
One such power was the age-old practice of quarantining goods, animals, or people believed to be carrying contagious diseases. With no medical treatment yet available for influenza, identifying and isolating infected people was one of the few effective public health measures. Wisconsin Health officials posted signs like the one at left on buildings occupied by quarantined influenza victims in 1918.
Amid rising infection rates and death tolls, Dr. Harper took the unprecedented step on October 10, 1918 of ordering all public institutions in Wisconsin closed. This included all schools, theaters, saloons, churches, and places of public amusement statewide – virtually every public venue other than factories, offices, and workplaces. In no other state was such a comprehensive order issued, and it stayed in effect until the epidemic burned itself out in late December.
Harper’s order was facilitated by a statewide system of local health officers. In 1883, the legislature had required every Wisconsin village, city and town to appoint a local public health officer and board of health, to inform the State Board and carry out its orders locally. In 1918, there were 1,685 local boards in place to implement Harper’s orders. In Milwaukee, the state’s largest and most crowded city, several decades of committed work by reformers and socialist politicians had created an enviable public health system supported by the public and business interests alike.
Governments can work when they are run by people who BELIEVE in government. As Katrina demonstrated so graphically, that certainly doesn’t describe those in power in this country now, in EITHER political party. Government now is purely a money laundering scheme for delivering patronage dollars and beefy government contracts. As the Shepherd-Express continues the story:
Milwaukee also had created a viable public health infrastructure. The Socialists had been swept into City Hall in 1910 partly on the promise of free medical care for all. Mayor Emil Seidel was savvy enough to enlist the support of the business, civic and medical communities to help implement his ideas for health reform in small, popular steps. This ensured continuation and expansion of such important services as neighborhood health clinics, even after Seidel was ousted two years later. Socialist Daniel Hoan became mayor in 1916 and worked with these same groups to expand the scope of the city’s health department even further.
Such a well-funded, nonpartisan approach to public health would result in Milwaukee often being named “America’s Healthiest City” over the next two decades. It also meant that the public was becoming familiar with government tackling issues of water cleanliness, school vaccination programs, food sanitation, pest eradication and, of course, epidemics.
Yes, Socialists worked with local business for the good of all. A commitment was made to the shared health of the community, and the basic building blocks of a healthy community are healthy citizens. This was before the right completely demonized socialism, tying it to Stalin’s Soviet Union, to “godless communism” and red scares and blacklists. This is a progressive tradition that this country desperately needs to revive. Don’t, however, espect the ever-drifting-rightward, money-loving Democratic Party to step up and fight for a real progressive tradition. They, after all, helped Richard Nixon create this mess, along with some hard work by the AFL-CIO. They helped hand over our health care system to the HMOs:
Unions Embraced HMOs
The AFL-CIO helped create this mess. It did so by endorsing the concept of the “health maintenance organization” when it was first proposed by Richard Nixon in 1971, and, over the ensuing decades, by repeatedly endorsing the diagnosis of the health care crisis promoted by HMO advocates (namely, that doctors order too many services and someone has to do the dirty work of telling doctors and patients no).
The Nixon administration concocted the phrase “health maintenance organization” in February 1970. In March 1970, the administration announced that this new-fangled form of insurance would be the centerpiece of Nixon’s health policy. With the critical support of the AFL-CIO, Nixon’s proposal, known as the HMO Act, became law in 1973. This is the law that created the planet’s first HMO industry. The HMO Act subsidized the formation of HMOs and required employers with more than 24 employees to offer an HMO to their employees if an HMO existed in their area.
The definition of an HMO in the 1973 law was extraordinarily vague. Informally, experts said then, and say now, that an HMO is an insurance company which uses managed care tools – financial incentives to get doctors to deny care and second-guessing of doctors if the financial incentives don’t work – and which imposes restrictions on choice of doctor. HMOs limit choice of doctor because that enhances the power of managed-care tools (doctors with higher proportions of their patients insured by an HMO are more likely to cooperate with the HMO).
Bipartisan Support
Because Democrats controlled Congress at the time, Nixon obviously needed considerable Democratic support to get his HMO Act passed. He got it, in part because the AFL-CIO was so enthusiastic about HMOs. Democrats such as Senators Ted Kennedy, Walter Mondale, and Warren Magnuson, and Representatives Wilbur Mills and Paul Rogers, all lent their names to HMO legislation introduced during the 1971-73 period.
See, there’s Teddy, helping sell out the American people LONG before he slapped his name onto Republican travesties like No Child Left Behind he was helping pass things like the HMO Act. Big Labor, too, failed the very people it was supposed to fight for. Our public institutions have been failing us in more and more spectacular fashion over the years, bringing us here to this moment in the Twenty First Century where we are each on our own. The social darwinism so loved by the Robber Barons is in full effect now.
Sadly, not enough of the citizenry is awake to the root causes of the danger we are in. The ability for the government at the Federal level to accomplish anything more than the indiscriminate slaughter of Iraqi civilians has been shredded by BOTH political parties, servants of the very wealthy and the investor class. We have some way to fall apparently before we’re ready to stand up for ourselves again, either to take back the Democratic Party or to build a viable third party, a task that may have to be approached from scratch.
The building blocks for a populist movement are all clearly apparent to anybody who cares to look. A real movement could be built around a promise to provide universal health care for ALL residents of this country. We hear over and over again that privatization will cut costs through efficiencies driven by the profit motive, but what we all witness every day of our lives is how this DOESN’T work. We all experience bureaucracies at our jobs, in the corporations where we work. We know that they are no more efficient than government, and sometimes less. They become less efficient when they can operate without oversight, without regulation, any organization does. When looking to provide something as vital as health care, do we really want to siphon off money to feed the voracious demands of Wall Street? Shouldn’t every penny we have go toward actually treating sick people (and providing preventative care before people get sick)?
When will we stop distracting ourselves with bullshit stories comparing meaningless groups of people and start working together again, commit ourselves to being a real country again, and not merely a market? Can we, or have we fallen too far?
