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Silver Bullets Do Not A Health System Make.

Posted on | November 10, 2020 | 3 Comments

Mike Magee

As Americans cover-up against second and third waves of Covid-19, Americans once again place their hopes and prayers on a great scientific discovery to snatch us from the flames. The latest miracle cure, a hoped for Pfizer vaccine that appears to be highly efficacious and anxiously awaits safety data, may in fact provide some emergency relief in the months ahead. But a single cure does not a health system make.

When Donald Trump expressed his cluelessness—”nobody knew that health care could be so complicated”—before a meeting of state governors in February 2017, he was exposing a pattern of both arrogance and ignorance that remains on full display.

CODE BLUE: Inside the Medical Industrial Complex was published four months later, and accurately predicted that – stressed by a health crisis like Covid-19 – our fundamentally flawed health system would buckle under the pressure. As of today, some 242,000 Americans have died, many of them needlessly.

And yet, today we witness a group of Republican Attorneys General appealing to the Supreme Court to dismantle the ACA and the protections it offers to those with pre-existing conditions including Covid-19.

At the very same time this week, our President-elect named a group of leading scientists and experts as transition advisers to help take the Biden-Harris COVID plan and convert it into an action blueprint that starts on Jan. 20, 2021.

The Biden coronavirus task force will be led by former Surgeon General Dr. Vivek Murthy and Dr. David Kessler. But what if the Supreme Court dismantles the ACA?

We would be left with a convoluted system of third-party payers, and the pretzel positions our politicians weave in and out of as they try to justify it, reform it, then un-reform it. And Republican loyalists would likely continue to find solace in telling themselves, “Well, we still have the best health care in the world.”

In point of fact, we’re not even close to having the best health care in the world. As legendary Princeton health economist Uwe Reinhardt prophetically remarked two years prior to COVID-19, “At international health care conferences, arguing that a certain proposed policy would drive some country’s system closer to the U.S. model usually is the kiss of death.”

It is at times like these that system weaknesses expose themselves. The inability to swiftly and efficiently test a population for COVID-19, share those results, and rationally plan a swift, coordinated, and effective response is a reflection of the gross inadequacies of our health care system. So is a leaky and disjointed supply system that can’t manage demand for cue tips, let alone ventilators and manpower.

In a review of CODE BLUE last year, John Rother, President and CEO of the National Coalition on Health Care wrote, “Code Blue will make you mad, but it will also make you better informed and better able to understand what we need to do as a country to fix it. I can’t think of a more persuasive book on the need for change.”

The need for change that John forecasted not only included matters of justice, planning, and equitable distribution of health care resources, but also the capacity to respond to a global public health event of the magnitude of COVID-19.

How broken must a system be when our nation can’t keep up with nations like South Korea and Italy in testing for the virus? What does our “patchwork response”, variable across states and communities, lacking any private-public planning and coordination, and absent clarity on pricing, access, eligibility and prioritization, and raft with confusion even on what protections are necessary for health care workers collecting samples, tell us about our need for a fundamental restructuring of our health care system?

God Bless Anthony Fauci, but is our system so fragile that the fate of Americans rests on a single individual having the temerity to speak truth to power in the face of executive incompetence? And how are we to reconcile a Presidential veto on testing kits months ago.

A half-century of systematic underfunding of public health, planning and prevention in deference to entrepreneurial scientists in pursuit of profit and patents over patients and families, ends here – in crisis. We will survive this “Code Blue” calamity, but we need to assure through new leadership and deliberate action by the new Biden/Harris administration that it will never happen again.

Comments

3 Responses to “Silver Bullets Do Not A Health System Make.”

  1. Sue Ross
    November 10th, 2020 @ 1:02 pm

    Amen to that!

  2. Bionaze
    November 11th, 2020 @ 2:09 am

    People want an easy solution, but there simply isn’t one. The challenge of finding a single, silver bullet solution is rooted in a very complex, multi-variate problem, where there are complicated and competing interests and incentives from a large and varied set of stakeholders.

  3. Mike Magee
    November 11th, 2020 @ 9:03 am

    Agree. It’s complicated – but manageable.

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