Wednesday, October 17, 2007

The Coming Epidemic, Part II

About a year ago, I wrote The Coming Epidemic, where I talked about a) the limits of employer-provided health insurance (it discourages preventative care because of high employee mobility), and b) the fact that lack of universal health care allows a large number of unhealthy uninsured people to become pools of infectious organisms which can then mutate into more virulent antibiotic-resistant varieties and jump to the insured. As I pointed out in comments, "pandemics don't care how much money is in your wallet or how much health insurance you have. They're equal opportunity killers." Thus it is in all of our best interests, no matter how much money you make, that we eliminate the large population of uninsured and get rid of employer-provided health insurance as a menace to public health. As I pointed out, "the anti-universal-healthcare nimnuts are putting their own lives at risk. But they care more about their precious ideological purity than about reality."

So where are we today? On the health insurance front, it looks like various iterations of RomneyCare are being proposed. These will still leave a reservoir of uninsured people. If you have a choice of buying health insurance or feeding your children this month, you will choose to disobey the law mandating that you buy health insurance and just bet that the State won't catch up with you. In addition, people who are here illegally are still not covered by any of these, and will continue to provide a reservoir of unhealthy people that can be used to incubate new super-bugs for a pandemic that can kill millions of Americans. So it appears that the need for universal health care in order to prevent a mass die-off of the world's population is still not taken seriously by the so-called "serious" people. If anybody in America cannot simply walk into any doctor's office anywhere in America and request treatment regardless of age, immigration status, or income, then you don't have universal health care, and you still have that disease reservoir incubating super-bugs.

So how are we doing on the disease front? Well, thankfully, the antibiotic-resistant untreatable TB variety I had my eyes on still hasn't made that one mutagenic leap for virulence that would result in millions of Americans dying, though it's just a matter of time. But it appears that we do have a new super-bug that is killing tens of thousands of Americans per year: a new antibiotic-resistant staph bacteria. It is spreading like wildfire in prisons, schools, and hospitals, and now kills more Americans per year than any other disease organism. I'm not sure whether this is "it" -- the epidemic that our own short-sightedness and stupidity will cause to kill millions of us. But it's just a matter of time. Just a matter of time. Because from what I can tell, shortsightedness and stupidity are in no less supply than they were a year ago, and the diseases just keep mutating away in that pool of unhealthy uninsured people. A few more mutations in the diseases bubbling away in that reservoir, and we could see a die-off that would make the Black Death look like child's play...

-- Badtux the Health Care Penguin


  1. Add to the pool the folks who have insurance, but since they can't take time off from work to see their doctor, they come in sick and infect the rest of the workers. Urgent care clinics are being used by some of my co-workers (after hours -- and they're not cheap), just so they won't have to miss work and/or have one too many absences/late marks against them.

  2. Which points to the main problem -- fragmentary and incomplete health care provision. The uninsured have access to health care only when they're in danger of dying (by going to the emergency room), so they might get a course of antibiotics, but then they don't get any more because they can't afford it -- thus helping breed yet another antibiotic-resistant version of a common bug. Someplace like, say, the Congo, where there's no health care at all, this isn't a problem, because the people just die when they get sick (dead people can't breed or spread super-bugs). But we've got the worst of both worlds here in America, since we keep that pool of disease vectors alive, but unhealthy.

  3. This is one of the points I keep making about SCHIP and other programs for kids - kids are plague carriers [no I don't have children] who gather in groups [schools, day care, sports, malls] to breed ever more virulent strains of disease. If they aren't treated early and often they will be incubators of something that will kill a major slice of the population.

    Publix markets, a supermarket chain down here with pharmacies, gives away a two week supply of several major generic antibiotics with a prescription.

    This is targeted at parents [to get them into stores] and to reduce the number of workers staying home with sick kids.

  4. Thanks, Badtux. As one who spent quite a while in the arena of public health computing, I've been saying for years that I've never encountered the virus or bacterium that could recognize a national or state boundary, or could distinguish an undocumented resident from one with papers, or even a citizen. Until we recognize that, and make it easy for everyone to obtain treatment for him- or herself, we are just breeding better, more antibiotic-resistant bugs. It's folly beyond all reason. And those who oppose universal solutions are acting in just that way... beyond all reason.


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