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Can Our Dysfunctional Health Care System Contain Ebola?

By       Message Roy M. Poses M.D.       (Page 1 of 5 pages)     Permalink

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Reprinted from hcrenewal.blogspot.com

Not to bury the lede, I think it can, but it will be a lot harder than the talking heads on television predict.

From commons.wikimedia.org/wiki/File:Ebola_Virus.jpg: Ebola Virus
Ebola Virus
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I have been writing about health care dysfunction since 2003. Lots of US politicians would have us believe we have the best health care system in the world (e.g., House of Representatives Speaker John Boehner (R-Ohio), here), Much of the commentary on Ebola also seems based on this "best health care system in the world" notion. For example, in an interview today (5 October, 2014) on Meet the Press, Dan Pfieffer, "senior White House adviser," said

There is no country in the world better prepared than the United States to deal with this. We have the best public health infrastructure and the best doctors in the world.

However, at least the statistics say compared to other developed countries, US processes and outcomes are at best mediocre using the best of some admittedly flawed metrics (look here), yet our costs are much higher than those of comparable countries. Furthermore, on Health Care Renewal we have been connecting the dots among severe problems with cost, quality and access on one hand, and huge problems with concentration and abuse of power, enabled by leadership of health care organizations that is ill-informed, incompetent, unsympathetic or hostile to health care professionals' values, self-interested, conflicted, dishonest, or even corrupt and governance that fails to foster transparency, accountability, ethics and honesty.

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Thus there is reason to worry that it will be harder than many expect for the US to deal with Ebola. There is already some evidence that some of the sorts of problems we have been discussing for years made it harder for the US to cope with even the so far limited incursion of Ebola.

Financialization of Pharmaceutical and Biotechnology Companies

George W Merck famously said,

We try never to forget that medicine is for the people. It is not for the profits. The profits follow, and if we have remembered that, they have never failed to appear. The better we have remembered it, the larger they have been.

In the pharmaceutical industry, the era of George W Merck is over. The failure to have access to an effective Ebola virus vaccine exemplifies how things have changed.

If we were to have an effective Ebola virus vaccine, we could have likely used it to vaccinate health care workers and contacts of infected patients and likely thus halt the epidemic early.

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A story in Modern Healthcare suggested that now many of the big experts on Ebola and public health are concluding having a vaccine available would be very helpful,

As West Africa's Ebola outbreak continues to rage, some experts are coming to the conclusion that it may take large amounts of vaccines and maybe even drugs -- all still experimental and in short supply -- to bring the outbreak under control.

Specifically,

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Clinical Associate Professor of Medicine at Brown University, co-founder Health Care Renewal, and President of FIRM - the Foundation for Integrity and Responsibility in Medicine, a not-for-profit organization (NGO) designed to raise (more...)
 

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