Monday, March 21, 2005

Fifteen Threats And The Need For A National Health System

In my original Draft Zinni post, I noted how health care had become a national security issue. In response to this, AlexC at pstupidonymous (his friends just call him stupid) wrote:
Defending against a bio-weapon IS NO REASON for National Health Care. Spend money on bio weapon research. On vaccinations and on intelligence to find them before their used.
Are there really no sound arguments for nationalize health care left? All that's left is fear?
How about being pro-active on bioterrorism?
Well, pstupid, last week that liberal bastion known as the Department of Homeland Security released a list of the fifteen most likely security threats(PDF, via Global guerrillas) that the American Public faces. The New York Times provides a nifty little graphic illustration. Take a good look at that list. How many of those threats require a surplus medical capacity (drugs/hospitals/professionals/etc)? How many of the threats can really be dealt with by "taking it to the enemy"?

Three out of the fifteen threats are large-scale biological events, with two being man made (Anthrax and Pneumonic Plague attacks), the third being a natural event (an influenza pandemic). Putting aside the question of how one could go about finding terrorists that have acquired weaponized biological agents (we're having a hard enough time finding Bin-Laden), I wonder how pstupid would go about "proactively protecting" our nation from an influenza pandemic. Maybe we could develop tiny little robots that would invade the bodies of every human on earth and attack the viruses, maybe pstupid would prefer to kill all of the animals that carry the strains that threaten to turn into a pandemic strain of the virus (i.e. birds, sheep, goats, etc). Or maybe we can threaten the nations where these diseases tend to originate from (can't you just picture Condi going to the U.N. to condemn China for allowing these viruses to mutate in the hopes of getting a resolution to attack China unless it halts the flu mutations happening within its borders?).

Back in reality (a place rarely visited by Republicans these days) there is no way to "take it to the enemy" when your enemy is a naturally occurring virus. But, hey, how dangerous could a little flu bug be?

According to the DHS the only thing that would be nearly as dangerous as a flu pandemic would be a nuclear explosion. They estimate that up to 300,000 people would need to be hospitalized, with 87,000 dying, and that, unfortunately, is a rosy scenario. According to the World Health Organization 30-40 percent of the populations of every nation could become infected by a pandemic flu, while the DHS report assumes a 15% infection rate. This means a more realistic number would be roughly 200,000 dead with somewhere over 600,000 hospitalized. For some perspective, the CDC reports that the National Disaster Medical System has voluntary access to approximately 100,000 hospital beds across the country to cope with a large-scale medical emergency. So where will those extra hospital beds come from in this type of emergency? Do people like pstupidonymous think that these beds will just pop up when they're needed?

Here are the "secondary" problems that the DHS report details:
The greatest secondary hazard will be the problems caused by shortages of medical supplies(e.g., vaccines and antiviral drugs), equipment (e.g., mechanical ventilators), hospital beds, and health care workers. Having a detailed system for allocating resources potentially can reduce such difficulties. This system ideally should be in place well before an influenza pandemic actually occurs. Also of particular concern is the real likelihood that health care systems, particularly hospitals, will be overwhelmed. Another important secondary hazard is the disruption that might occur in society. Institutions, such as schools and workplaces, may close because a large proportion of students or employees are ill. A large array of essential services may be limited because workers are off work due to pandemic influenza. Travel between cities and countries may be sharply reduced.
Hmm, hundreds of thousands hospitalized, up to a couple of hundred thousand dead, our current medical facilities overwhelmed to a breaking point, large scale societal disruptions, tens-of-billions of dollars in direct costs, several months in "recovery time", and people like AlexC at pstupidonymous don't think that we need to do anything to prepare for this type of event outside of investing in vaccinations (something that I'm all for- in addition to creating a surplus health capacity)?

And take a look at the other 14 events that the DHS looks at. How many of those would require a large response from our health systems? Seven. That means that out of the top 15 threats we face as a nation, over half would require a massive response from our health systems, which are currently unprepared to handle such scenarios.

Creating a national health system is not just a good policy for helping our nation deal with skyrocketing health costs (14% of all Americans currently have serious medical debts) it is also a national security issue, one that deserves our immediate attention. The fact that Republicans such as AlexC argue against creating such a system shows that not only do they have little regard for the personal and financial health of their fellow citizens, they also have little regard for national security when it doesn't coincide with their right-wing ideologies.