Could we be sitting on the brink of disaster? Unlikely, yet the possibility of a deadly swine flu pandemic hitting the United States is chilling in light of the current debate over health care reform.
An article in The Chicago Tribune released on October 11th pointed out that about one third of parents will not be vaccinating their children this year, mostly due to suspicions about ingredients used in the vaccine and the adverse reactions it may provoke in their children. Despite the fact that such arguments don’t hold up against the vast majority of scientific health studies, many parents remain wary of the shots, hopeful that the disease is not as serious as experts make it out to be: “If [my children] get swine flu, I have full confidence in their body’s ability to heal,” said one mother interviewed in the report. “Nature will win.”
High school and college students, although aware of the disease, have also shown little tangible concern about the possibility of an outbreak. And yet they absolutely should. While seasonal influenza often targets the elderly and people with severe medical conditions, H1N1 has not been shown to discriminate based upon age, and has so far been most prevalent in young children and healthy, middle-aged adults.
Disease is also more likely to spread quickly in a high school or college setting as a result of virtually continuous student-to-student contact in dorms, dining halls, and classrooms. Just this past weekend, a dozen or so cases of H1N1 were rumored to have broken out at San Francisco University High School, across the bay from UC Berkeley, along with many more students reporting feeling sick, a possible indication of how quickly disease may spread should it break out on a college campus.
Now maybe H1N1 will peter out, looked back upon as simply another case of seasonal flu. If it does not, however, the country is in for a shock, especially considering its current health care crisis.
A Nation in Crisis
As of today, over 47 million Americans do not have health insurance, mostly because they are unable to afford it. Although we spend twice more per capita on health care than any other country on earth, we aren’t any healthier for it. In fact, the staggering disparity between those who have insurance and those who do not in the United States contributed to our ranking 37th in the world in health care services. In life expectancy, we rank a dismal 24th.
This crisis is even more pressing for younger Americans, many of whom remain uninsured. A recent op-ed in the Daily Californian highlighted that 18-29 year olds represent 30% of this country’s non-elderly uninsured, despite the fact that we make up only 17% of that demographic. The article goes on to stress that college students are particularly at risk: according to a May 2008 Commonwealth Fund Report, 34 % will be uninsured for at least part of the year following graduation, and a startling 66% will forgo needed medical care because of costs.
Still not concerned? Well, you should be.
Over the weekend, the Tang Center at UC Berkeley announced that it would be making close to $2 million in cuts as a result of the State’s financial difficulties, a hit of over 20% just as we enter flu season. For students this means longer waits as staff are cut, fewer available appointment times, and more expensive care; as of this weekend, students can expect a new $15 patient c0-payment for primary care and a $30 charge per visit for urgent care, a hard pill to swallow in these difficult economic times, and proof that even those with private insurance are not immune to weaknesses in the health care system.
So how to remedy this crisis?
Critics of health care reform most often point to the high costs of the bills currently being proposed in Congress, citing fears that it will add tremendous weight to the budget deficit in the coming decade. Indeed, estimates place the cost of reform anywhere from around $1-2 trillion over the next ten years.
Yet, while reform represents a significant financial commitment, the cost of doing nothing is even greater. If the system remains as is, national health spending is expected to balloon to $4.4 trillion by 2018 from $2.5 trillion today, a 6.6% per year increase that exceeds the expected 4.1% per year increase in GDP.
Beyond fiscal considerations, I also agree with President Obama that health care is “above all, a moral issue”. It is quite simply unacceptable for the wealthiest nation on earth to have 47 million of its citizens go uninsured, each only one illness away from a life of debt and misery. According to the non-partisan Congressional Budget Office, the bills currently before Congress would extend health coverage to 97% of Americans, not to mention enforcing stricter regulation on private insurers so that those who already have insurance will not have to fear losing their coverage if they get sick.
And, lest we forget, despite the hefty cost that reform would entail, it would still probably cost the country less than the $2.5 trillion in tax cuts that the Bush administration enacted for the richest 5% of American taxpayers in the past 8 years, a tax cut readily supported by many of the same legislators griping about the cost of health care reform today.
Wake Up and Smell the Cough Syrup...
Americans, and especially its youngest citizens, are too lackadaisical about health reform, and from the current state of health care debates, it doesn’t seem like we’re going to wake up on this issue any time soon.
That could change, however, if Swine Flu were to become an important health threat, in large part because the country is woefully unprepared for a serious pandemic.
USA today reported that if 35% of Americans got sick from H1N1, there would be a shortage of hospital beds in 15 states. Add to that close to 15 million of the 47 million uninsured that could become sick and go without care, or seek treatment in already crowded emergency rooms, and suddenly you have the beginnings of a health care maelstrom on your hands.
Hopefully it will not take a national health crisis to jolt Americans into seeking better treatment and pushing for desperately needed health care reform. I am cautiously optimistic that the progress being made in Congress on the issue will bear fruit in the coming months (especially if a little more presidential pressure is brought into the picture...)
But as Tomás Aragón, Executive director of the Center for Infectious Diseases and Emergency Readiness at UC Berkeley points out in regards to Swine Flu, “It could peter out, or it could be major […] We’re in a mode of active surveillance now.”
If H1N1 does in fact become “major”, the nation is in for a very rude awakening.
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