The United States’ broken health system adds to the risk of potentially catastrophic epidemic.
Doctors Margaret Flowers, Walter Tsou, and Jill Stein of the Green Shadow Cabinet comment on the U.S. health system in light of the global epidemic and the first confirmed case in Texas, Thomas Eric Duncan, who tragically died this morning.
Dr Margaret Flowers, Green Shadow Health Secretary:
Ebola is going to test health systems around the world in the coming months, and as we’ve seen in Africa, the measure of the impact will correlate with the ability of nations to implement universal public health measures. Here in the United States, corporate interest and its control of the political process has created the most expensive and exclusionary health system in the developed world. This is a dangerous setting for an epidemic.
We have a system designed first and foremost for profit, not for better health outcomes. This has not only created a sub-class of millions without coverage, but has also fragmented the system into private institutions, all with different systems and technologies. A major outbreak in the U.S. of Ebola, or some other disease, would find fertile incubation conditions like those in poorer communities and would be compounded by an uncoordinated response.
If this happens there will be a call for Government intervention, and those private health profiteers who rallied against public health on free-market ideological grounds, will demand assistance - a taxpayer bailout. The risk of an epidemic and its potential effect on markets should shake Wall Street’s belief in perpetuating the cruel and inefficient for-profit health system.
Dr. Walter Tsou, Green Shadow Surgeon General:
Media outlets stated that the diagnosis was missed because crucial travel information was not relayed through the electronic medical records system. But it was not widely publicized is that Mr. Duncan was a Liberian national on a US visa. It is very likely because US disallows Medicaid coverage for the first five years of immigration that he was also uninsured. What role did Thomas Duncan’s insurance status play in his initial dismissal from the emergency room?
Unfortunately, this is not a rare occurrence. Crowded housing conditions and barriers to health care, there could be substantial risk - even potentially a perfect storm in the making for Ebola to take root in the U.S. There are several lessons being driven home within the U.S. as around the world:
- First, our health care system which explicitly discriminates against immigrants is a disaster that is ill equipped to deal with uninsured individuals with highly infectious diseases like Ebola. Only a true single payer, universal health care system, inclusive of all immigrants, documented and undocumented, will be able to stop an epidemic.
- Second, our reliance on a for profit pharmaceutical industry which concentrates its research dollars on the chronic illnesses of wealthy developed countries like the US means that tropical diseases and filoviruses like Ebola and Marburg get ignored with no research dollars for vaccines or treatment for decades while we spend billions on erectile dysfunction drugs. After long neglecting the developing world, we are suddenly scrambling, grasping for anything that could be a cure when we should have been working for a cure for the past 30 years.
- Third, we ignore public health at great peril to our nation. There is almost nothing that could bring a world power like China to its knees, but in 2003 SARS did precisely that. China, who like the U.S. had high health access inequality, found that people with SARS like symptoms were not seeking medical care because they could not afford the bill. Instead they were spreading SARS throughout the country. It was only after they instituted a policy that all patients with respiratory symptoms would be seen regardless of ability to pay were they able to stop the epidemic. In a recognition of how important public health was to their economy, they tripled the budget of their CDC and built them a new campus.
The discussion of Ebola in the US has been sorely lacking in a public health reality check, which Dr. Flowers has raised. In fact, the massive gaps in US health care create pockets of vulnerability, that could seed local Ebola hot spots in the US.
The missed diagnosis of the first US Ebola case in Dallas is a red flag. This signal event resulted in a tragic delay of treatment and isolation, exposing up to 100 contacts, and potentially contributing to the patient's death. The diagnosis was missed because crucial information was not relayed through the electronic medical records system. Unfortunately, this is not a rare occurrence. Add to that crowded housing conditions and barriers to health care, there could be substantial risk - even potentially a perfect storm in the making for Ebola to take root in the US.
The lesson is being driven home within the US as around the world: Health injustice anywhere is a threat to health everywhere. A truly health-protective response to Ebola should include urgent measures to implement a Medicare-for-all health care system to insure we are all protected from Ebola now and from future epidemics that inevitably lie ahead.