Health Care Rationing In America

Winter is coming on fast and people are starting to get worried about the second round of the H1N1 virus. A few months ago, a vaccine was created. This was good news, but enough couldn't be made in time for everyone to get the immunization at the same time, so the CDC created a list of those who should receive the first batches of the vaccine.

The following groups were to receive the vaccine before the general population did -- pregnant women, health care workers, people ages 2 through 24, caregivers for babies under 6 months old, and people ages 25 through 64 with chronic health conditions that made them susceptible to the flu.

This made perfect sense to me, and I was willing to step back and let these groups go first. But it just hasn't worked out that way. Those of us that actually thought these high-risk groups would get to go first should have known better. We obviously forgot the way health care is rationed in the United States.

In those countries with "socialized medicine", health care (including vaccinations) are given first to those with the greatest need. The Republicans call this "rationing", and I suppose it is. At least it's a system of rationing that makes sense. Those with the greatest need should be put at the head of the line.

We also have a system of rationing health care here in the United States. But our system has nothing to do with actual need. It is based on wealth. Those with the most money receive the best and most health care, and those with the least money receive the least (or no) health care. It's not a fair system of rationing, but it is our system.

So it shouldn't have surprised anyone that wealthy corporations got first crack at the H1N1 vaccine. The CDC (to their shame) approved the sale of varying amounts of the vaccine (from hundreds of doses to thousands of doses) to at least a dozen huge Wall Street financial organizations like Goldman-Sachs. Large private health organizations like Kaiser Permanente have also received a large supply of the vaccine.

Meanwhile, many of those in the target groups with the most need have been unable to get the vaccine. Some may think something went wrong in the distribution of the vaccine, but that's just not true. America's rationing system worked just like it always has -- the rich go first and everyone else fights for whatever is left.

If you don't like this system of rationing, it's time to contact your Congress and demand real health care reform. The rich and their allies, Big Pharma and Big Insurance, won't give in without a fight. But then, no good change has come in this country without a fight, and real health care reform (with a public option) is worth fighting for.

We're Not Out Of The Woods Yet

Last week, I wrote a post about the H1N1 virus (swine flu) and how scientists have discovered that it has some genetic differences from the first time the H1N1 virus spread in 1918. That time it was known as the Spanish Flu, and it wound up killing more people than World War I did (combatants and civilians combined).

The scientists said the genetic difference meant that the current strain of H1N1 was probably no more deadly than a regular yearly flu outbreak, which kills around 36,000 in a normal year. It looks like the scientists were right. The swine flu has turned out to not be the pandemic killer that health officials had feared, and in fact, they seem to be getting a hold on this outbreak.

Now you might think I would be pretty pleased with myself for posting that while others were still beating the pandemic drum. I'm not. That's because I know a little bit about the Spanish Flu (my own grandfather died from it in 1919). Yes, I said 1919.

The outbreak in the Spring of 1918 was not the huge killer. It came back in a second and third wave in the Fall of 1918 and Winter of 1919. It was these second and third waves that turned out to be the nasty killers. The second and third waves were far more virulent than the first.

If you'll forgive me for using a euphemism, we're not out of the woods yet. The normal time for the flu season is Fall and Winter, and it's entirely possible that the H1N1 virus may pay us a second and possibly even a third visit at that time.

Any scientist will tell you that a virus can evolve (or mutate) very fast. What if it has mutated into a much more deadly form when it returns? We could still have a repeat of the pandemic known as Spanish Flu.

I'm not trying to be an alarmist, just a realist. It may not come back. If it does, it may still be fairly benign. But it could also be very nasty and create a real mess. The point is, we must remain vigilant. We can't be caught napping if it returns in a few months.

Could You Be Immune To Swine Flu ?

In 1918, the Spanish flu raged around the world, killing many millions of people. That pandemic was caused by a strain of the flu virus called H1N1. A few days ago, the H1N1 virus popped up again. This time it was called Swine flu. Although it was believed to have started in Mexico (that's where the largest number of patients and deaths are so far), it spread quickly and in just a few days has shown up in several countries on several continents.

When the deaths began to pile up, and most of those affected were young healthy people, just like the Spanish flu, it is easy to see how the World Health Organization (WHO) was afraid they might be looking at another deadly flu pandemic -- just like the one 91 years ago.

The WHO, the USCDC (Center for Disease Control) and state health departments have quickly taken action to try and head off the feared new pandemic. People with any flu symptoms are urged not to go to work or school. Drugstores are selling out of face masks. Events have been cancelled and schools have been closed. News of the new flu have been covered extensively by all types of media.

These may be reasonable actions or may be overreactions. No one knows yet. But scientists who have been studying the new H1N1 virus think the new flu may be more benign than was previously believed. They have found some small differences between the current version of H1N1 and the 1918 H1N1.

One of these differences is the absence of an amino acid in the current version. This amino acid helped the 1918 virus to replicate itself very rapidly once it entered the lungs. This made the virus extremely deadly. The absence of this amino acid could be why the current version of H1N1 is not as virulent.

This does not mean the virus is not dangerous. It obviously has killed. But it may turn out to be no more deadly than more common strains of flu (which can kill 30,000 to 40,000 people each year in the United States). That is a tragic figure, but nowhere near the death toll racked up by the 1918 Spanish flu.

Another oddity of this new Swine flu is that it is not striking the elderly. Normally, the elderly and children are the groups most likely to die from the flu. Why is this virus different?

The scientists think they may know. There was a flu pandemic in 1957 that killed around 2 million people. It is believed that those who were exposed to the 1957 flu may have an immunity to the current H1N1 virus. That would basically cover those in their mid-fifties and older.

Other than gaining a bit of wisdom, there aren't a lot of advantages to growing old. But it looks like this could be one of those few advantages.