Ebola

“Although hospitals are prohibited from denying treatment to patients seeking emergency care, it should be expected that they will charge for services provided. Emergency charges are usually covered in full by most insurance programs. Uninsured patients will be responsible for costs following treatment.”

And that is because in the US health care is seen more as an industry providing services for individuals than anything else.

In a sense this situation is perfectly understandable. Yersinia Pestis is endemic in the Western US but America has never seen a major outbreak of plague. Why? Simple. American cities are far apart and were built way after humankind learned that washing yourself is good for you. This is why America, as a nation, has never experienced a major pandemic except for the Spanish flu in 1918 when 20 to 40% of worldwide population fell ill and 670 000 Americans died.
Only this was children’s play compared to the European experience. While for most of the Americans ‘plague’ is some biblical punishment that zealots keep threatening us with for Europeans the word brings back memories of the Great Death that has visited  the continent from 1347 up to 1600. OK, most of us weren’t present at that time but an epidemic that kills one third of the population – as it happened in 1347-1398 – leaves more than a scar on the collective memory of the population. It alters the way society works.
I won’t enter into details now but experiences like that prompted ‘political’ rulers to ponder upon the need to take care of the ailing/sick portion of the population. Both to prevent such diseases from spreading so violently and to mitigate their effects once they had befallen on their subjects. And no, they weren’t soft-hearted lefties but hard core pragmatists: every major epidemic left behind not only a deficit of workforce but also it drastically reduced the number of ‘conscriptable’ males, something very dangerous for a kingdom in an era of constant ‘international’ aggression.

Here is what britannica.com has to say about this: “Stirred by the Black Death, public officials created a system of sanitary control to combat contagious diseases, using observation stations, isolation hospitals, and disinfection procedures. Major efforts to improve sanitation included the development of pure water supplies, garbage and sewage disposal, and food inspection. These efforts were especially important in the cities, where people lived in crowded conditions in a rural manner with many animals around their homes.”

In fact this is how the European style Public Health System came into being. If you’d compare a community with an organism it would be the social equivalent to the immune system, a section of the whole thing that (automatically) fights infection without individual cells having to bother with anything.

“But we are not MINDLESS CELLS, we are FREE human beings!” I hear some some of my conservative friends shouting at me.
“If they want protection they should get insurance!”

Fair enough, only:

We humans are not at all independent but, at most, autonomous. Try living by yourself, isolated somewhere if you don’t believe me.

I’m not talking about individuals here but about whole communities. The Black Death didn’t bring any benefits to any of the peoples of Europe, it didn’t just cull the misfits leaving more breathing space for the powerful to develop their potential. The disappearance of one third of the population teared apart the entire social fabric and I don’t think there where many, if any, people glad of what had happened in those times.

Insurers and service providers work for profit, not as a public service. As such any insurance is limited, one way or another, and each service provided bears an individual cost that is accrued to the total bill. Even Lloyds, the only place in the world where somebody could buy unlimited liability insurance has drastically curtailed the practice.
So, in the present conditions, who is going to pick up the tab if a real pandemic will happen in the US?

Not to mention the ‘technical’ and regulatory hurdles that appear due to the in-existence of a ‘national health care system’:
“U.S. hospitals may be unprepared to safely dispose of the infectious waste generated by any Ebola virus disease patient to arrive unannounced in the country, potentially putting the wider community at risk, biosafety experts said.
Waste management companies are refusing to haul away the soiled sheets and virus-spattered protective gear associated with treating the disease, citing federal guidelines that require Ebola-related waste to be handled in special packaging by people with hazardous materials training, infectious disease and biosafety experts told Reuters.”
“CDC advises hospitals to place Ebola-infected items in leak-proof containers and discard them as they would other biohazards that fall into the category of “regulated medical waste.” According to DOT guidelines, items in this category can’t be in a form that can cause human harm. The DOT classifies Ebola as a Category A agent, or one that is potentially life-threatening.
DOT regulations say transporting Category A items requires special packaging and hazmat training.
CDC spokesman Tom Skinner said the agency isn’t aware of any packaging that is approved for handling Ebola waste.
As a result, conventional waste management contractors believe they can’t legally haul Ebola waste, said Thomas Metzger, communication director for the National Waste & Recycling Association trade group.”

As of now individual solutions have been worked out. Americans are inventive and resourceful people but so far they had to deal only with isolated incidents. I hope things will peter out before anything more intense will take place but I also hope that those with vision will use this opportunity to educate the wider public about the necessity of a nation wide system capable to deal with medical problems of this magnitude.