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Who's In Charge During the Ebola Crisis?

Lasrick writes: Epidemics test the leadership skills of politicians and medical infrastructures, which is clear as this article goes through the different ways West African countries have dealt with the Ebola crisis. Now that fears are spreading about a U.S. outbreak (highly unlikely, as this article points out), it may be time to look at the U.S. medical infrastructure, which, of course, in many ways is far superior to those West African countries where the virus has spread. But there is an interesting twist to how disease outbreaks are handled in the U.S.: "The U.S. Constitution—written approximately 100 years before the germ theory of disease was proven by French chemist Louis Pasteur and German physician Robert Koch — places responsibility for public health squarely on the shoulders of local and state political leaders ... one could argue that the United States is hobbled by an outdated constitution in responding to epidemics. State and local jurisdictions vary tremendously in their public health capabilities."

10 of 279 comments (clear)

  1. No difference here by damn_registrars · · Score: 3, Insightful

    In the US, the people in charge are still the health insurance companies. They will call the shots during this situation just as they have for decades (including during the writing of the 2010 "health care reform" bill). They will dictate who gets which care, and who gets to die in which ways. The 26 year old nurse in TX has probably already had her policy cancelled for a pre-existing condition (ie, she was alive and hence had the potential to be infected with ebola in her hazardous occupation).

    Just wait until the insurance companies quietly release their 2014 profit reports in another year or two and we see how handsomely we rewarded their top executives for this.

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    Damn_registrars has no butt-hole. Damn_registrars has no use for a butt-hole.
    1. Re:No difference here by Jeremi · · Score: 5, Insightful

      The 26 year old nurse in TX has probably already had her policy cancelled for a pre-existing condition

      Ah, good old "probably". A sure indicator that the poster hasn't bothered to actually research what he's claiming, but rather is just making something up that would support his pet conspiracy theory, if it were true.

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      I don't care if it's 90,000 hectares. That lake was not my doing.
    2. Re:No difference here by damn_registrars · · Score: 4, Insightful

      is just making something up that would support his pet conspiracy theory, if it were true.

      If you haven't been fucked by your insurance company yet, just wait until you're a bit older. I can guarantee you it will happen, it is only a matter of when and how badly. This is not a conspiracy theory, this is a guarantee. They hold all the cards and they set the rules of the game; you can't win or even hope to break even.

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      Damn_registrars has no butt-hole. Damn_registrars has no use for a butt-hole.
    3. Re:No difference here by nbauman · · Score: 2, Insightful

      And hospitals are already on the hook for uninsured patients due to the EMTALA laws.

      No, the article said:

      The Emergency Medical Treatment and Labor Act (EMTALA) of 1986 was enacted to prevent hospitals from refusing care to anyone needing urgent care and presenting at a hospital’s emergency room, regardless of insurance status. Unfortunately, EMTALA has sometimes been viewed as a mandate not funded by the federal government, and violations occur without reprisals or corrective actions.

      It's even worse in Texas. They refused to implement Obamacare, fought it, and kicked people out of Medicaid. I think MedPage Today's KevinMD had a blog entry by a doctor at one of the charity clinics who said that the hospitals were referring uninsured people to them (after the hospitals kicked them out) even though the clinic didn't even have an x-ray machine.

      Texas is a good example of the Republican health care plan -- you get sick, you die. http://online.wsj.com/articles... Legal Loophole Ensnares Breast-Cancer Patients; Shirley Loewe Chooses The Wrong Clinic And Starts Long Ordeal

  2. A bit early by sjames · · Score: 4, Insightful

    There has been one case of Ebola transmitted in the U.S. Isn't it a wee bit early to be writing an epitaph for the Constitution? Especially since none of that crap was part of TFA?

    TFA's commentary on patient zero being sent home with a bottle of antibiotics (for a virus, of course) was spot on though. That's what happens when you insist on running healthcare as a business.

  3. Re:No the constitution is fine.. by Jane+Q.+Public · · Score: 5, Insightful

    "general welfare" as part of the spending power section is all that congress needs to craft well considered laws.

    Not true. The historical record very clearly shows that the "general welfare" clause was a restrictive clause, not a permissive one.

    The point is that any Federal law which is otherwise Constitutional also has to be "for the general welfare", as opposed to for the welfare of just one, or a few, or some subgroup of the populace.

    The General Welfare clause does NOT grant license for the Federal government to exceed the powers enumerated in the Constitution. Period. It grants no new power at all, in fact. It does the opposite. It restricts all Federal laws to be for the good of everybody. That was its whole purpose.

  4. We train people for this. ebola.healthcare.gov by raymorris · · Score: 3, Insightful

    Yep. Where I work, we train first responders, mayors, governors and all sorts of people regarding their roles in an emergency.
    The states have their roles, the cities and county health departments and leadership have theirs, as do the hospitals, etc, and the CDC and others at the federal level.

    What we don't need us a mandate that everything has to be done through a federal agency, maybe via ebola.healthcare.gov.
    One interesting drill that covers not only infectious disease but also riot is the zombie drill. In the drill, their is a microbe that turns people into zombies. Healthcare workers practice inoculating a lot of people in a hurry, while treating those already infected. City managers and the like practice communications with FEMA,CDC, and other agencies to get the needed information and resources, public information officials stand in front of our TV cameras and practice getting the most important information out in a clear manner, etc. Instructors watch everything via one-way mirrors and record all phone calls, then review the students' performance.

  5. Re:No, that's not the problem by PapayaSF · · Score: 4, Insightful

    Since there are about 4-5,000 workplace fatalities a year, virtually all of them preventable, that's a good return for the money. [...] So if CDC doesn't do this stuff, nobody will.

    Then what is OSHA for?

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    Q: What does the "B." in Benoit B. Mandelbrot stand for? A: Benoit B. Mandelbrot
  6. Re:General Alexander Haig is in charge by Z00L00K · · Score: 2, Insightful

    Ebola is in charge - nobody controls Ebola right now.

    The only way to come to terms with the disease is isolation. It is the black plague of our time.

    Involving politicians into this means that there will be petty bickering all the time while the disease spreads.

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    If builders built buildings the way programmers wrote programs, then the first woodpecker would destroy civilization.
  7. Re:General Alexander Haig is in charge by aminorex · · Score: 4, Insightful

    Essentially, the OP is militating for a centralized dictator to deal with the emergency. "You never let a serious crisis go to waste. And what I mean by that it's an opportunity to do things you think you could not do before." Thus spake Rahm Emanuel. The tradition extends from Sulla to Napoleon to every petty Don, triad leader, or military dictator of our own era.

    In fact, when stuff gets real, there will be no lack of opportunists seizing all infrastructurally available power to respond to the crisis. The best process known for dealing with the pre-crisis stage is the democratic process. It is sub-optimal for any given threat, but has the merit of being a tolerable living condition which is capable of responding to the broad range of threats which arise in the ordinary course of events.

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