There is a risk, with a reemergence of a new strain of flu, that the weaknesses in how we provide health care in the United States will be exposed to the breaking point. While the CBO does not consider the short term value of preventing illness through providing universal preventive and primary care, the CBO and everyone familiar with an overburdened emergency department understands how costly it is to everyone, patients, hospitals, insurers, and the insured, when people without access to a primary care physician become ill and require emergency care. The price this year for not already having these measures in place could be tremendous.
The H1N1(2009-A) virus has characteristics that indicate a propensity for the lower respiratory tract, or the lungs. Accounts from Australia suggest that artificial ventilation is often required when the disease progresses beyond its early stages. Countering this concerning news is the rapid development of vaccines and the success had in treating this disease with anti-virals that are already in large scale production. Unfortunately for the U.S., versus most other industrially developed nations, tens of millions of our citizens will not have a provider to see to get a vaccination before being infected or treatment with anti-virals within the first forty-eight hours of initial symptoms. For those who do not get better with rest and fluids, intensive care will be common to an extent not seen in our lifetime. A shortage of ventilators could leave people dying in hospitals across the nation. Use of ventilators will cost hospitals dearly, and these costs will be passed along to the rest of us. With all due respect to the CBO, it is obvious to almost all close to the issue that preventive and primary care provided to all will save a great deal in terms of finances and lives.
I sometimes wonder how bad it has to get before the status quo in health care will be fundamentally reworked. This fall, the emergence of this new flu will give us another chance to compare our system to our peers in Canada, Europe, Japan and elsewhere. We will see, if we care to look, how well we stack up when our emergency departments fill up and there are no more vents available to keep people alive. What Churchill would call an “Era of Consequences” appears to be coming over the horizon. This time the costs may be too great to continue doing business as usual.