Flu Fears


John Barry's excellent book, The Great Influenza, provides a dramatic and detailed account of the extraordinary mistakes that were made, including many by governments, that led to the most deadly pandemic in recorded history in 1918. At least 30 million and possibly as many as 100 million people around the world died.

Nearly a century later, we have many more resources to arrest such a cataclysmic event:


  • Tracking and prevention: "For the first time in history we can track the evolution of a pandemic in real time," Dr. Margaret Chan, World Health Organization director-general, said yesterday. The Centers for Disease Control (CDC) and private-public partnerships are using sophisticated communications and tracking systems to quickly identify those sickened by the virus and their location. The Internet and even Twitter and YouTube are being used to collect information and disseminate advice to the public.


    And the CDC yesterday began sending test kits to the states so they can more quickly determine if they are dealing with the A/H1N1 flu strain. This is especially important since getting treatment to patients within the first 48 hours of symptoms is crucial.


  • Medical treatment: We now have antivirals such as Tamiflu and Relenza, which, if administered early, can curb the virus and most likely cure all but the weakest and most vulnerable patients. An estimated 50 million doses of the medicines are stockpiled and can be deployed within hours to target areas. And we have, of course, modern hospital facilities to treat and quarantine sick patients.


  • Research and innovation: The pharmaceutical industry is working overtime to develop other treatments for the H1N1 virus and to develop millions of doses of vaccines. The next time someone demonizes the pharmaceutical industry, we might remember who we are relying on — private companies with the experience and research and manufacturing capabilities to produce these treatments.


    Flu epidemics generally travel in waves as the virus mutates. Researchers are constantly working to stay ahead of the latest strain. Even when a vaccine is formulated, it takes up to six months before it's available. In the meantime, our limited vaccine production capabilities can be pressed to the limit, making it more difficult to produce the regular annual flu vaccine people will expect to receive in the fall.


    Perhaps we should think about this when contemplating imposing more regulations and price controls to further hamper this industry.



A few things we don't need:


  • Vice President Joe Biden and others making alarmist statements about not taking subways or airplanes or being in any confined spaces. Not all of us have chauffeured limousines, Secret Service protection, and private airliners. . .


    This is the flu, folks. Take precautions by washing your hands early and often, especially when you are in public spaces, and using hand sanitizer when you can't. If you do get sick, go to the doctor or a hospital emergency room quickly to be tested and get treatment.


  • And don't go out slaughtering innocent pigs, as the Egyptians reportedly are doing. The virus is not transmitted by eating bacon or pork but through active mucous droplets from live persons or animals.

We should all worry, also, about creating such an alarmist state that we desensitize people should it become a true pandemic.



All eyes on the Senate:

Pennsylvania Sen. Arlen Specter's switch to the Democratic party this week tees up new dynamics in Congress, making it much easier for the leadership and the White House to advance their agendas without minority votes. This, and the threat of reconciliation, will make passage of health reform legislation much easier, making it even more important for people to be informed about the content of the legislation when it is presented.

But all was sweetness and light at a Senate Finance Committee meeting this week, with Democratic chairman Sen. Baucus continuing to reassure his Republican colleagues that he does not want to jam health reform legislation through with only 51 Senate votes.

One rather telling moment came when Chairman Baucus talked about creating a new government agency to overhaul Medicare.

Baucus wondered whether the Centers for Medicare and Medicaid Services, the agency in charge of Medicare, "is up to the job" of modernizing the program. Baucus said some critics view the department as "hidebound, not very creative, a crank-turning bunch of folks there."

He said that lawmakers want a "transformative, game-changing new paradigm" for the nation's new health care system. "It is critical you, among many others . . . rejuvenate CMS and HHS in a very creative way so that the agency, the department, feels it's all on the same team," Baucus said during a nomination hearing for William Corr, the administration's pick for deputy secretary of HHS.

Sorry to be the bearer of bad news, Senator, but that is the nature of government. It is unavoidably "hidebound" by the very laws you pass and the regulations that the bureaucracy must write to implement those laws. Since it is a federal offense to violate them, there is not a lot of room for creativity.

If you want flexibility, you have no choice but to look to the private marketplace for solutions.

Grace-Marie Turner

Recent News Articles and Studies

Obama and Health Care: Big Hurdles Yet to Come
Reforming Health Care
The Real Price of a Public Health Plan: Less Innovation and Lower Quality
Take Two Aspirin and Tweet Me in the Morning: How Twitter, Facebook, and Other Social Media Are Reshaping Health Care
ER Visits, Costs in Mass. Climb
Ills of French Health System a Lesson on Reining In Costs
Ryan Shines as GOP Seeks Vision


Obama and Health Care: Big Hurdles Yet to Come
Julie Rovner
NPR, 04/29/09

's Julie Rovner reports on the health care accomplishments of President Obama's first 100 days in office and describes the challenges he faces moving forward. Despite ambitious timetables issued by leaders in Congress and promises from Republicans to try to reach bipartisan agreements, some remain wary. One big reason is what the Galen Institute's Grace-Marie Turner calls the "80-20 rule." The idea is that most of the public and health care interest groups are willing to go along with 80% of the agenda, but 20% causes them serious problems — and the 20% is different for different groups. "I do think the rubber's about to hit the road in how they're actually going to get to the details of some much more controversial pieces of health care reform. So the second 100 days is going to be particularly interesting," Turner said.

Reforming Health Care
The Washington Post, 04/27/09

The Washington Post editorialized this week against including a public plan option in Congress' health reform legislation. It called the fixation on a public plan "bizarre and counterproductive." It is difficult to imagine a truly level playing field that would simultaneously produce benefits from a government-run system, the Post writes. Medicare keeps costs under control in part because of its 800-pound-gorilla capacity to dictate prices — in effect, to force the private sector to subsidize it. Such power, if exercised in a public health option, eventually would produce a single-payer system; if that's where the country wants to go, it should do so explicitly, not by default, the Post writes.

The cost control benefit of public programs, such as Medicare and state-run markets similar to the one in Massachusetts, is illusory, write Senator Tom Coburn, M.D., and Regina Herzlinger of the Manhattan Institute and Harvard Business School. Any "savings" are achieved with accounting gimmicks that shift costs to taxpayers and future generations through deficits and unfunded liabilities, not through genuine innovations.

The Real Price of a Public Health Plan: Less Innovation and Lower Quality
Dennis G. Smith
The Heritage Foundation, 04/24/09

President Obama has repeatedly promised Americans that they would be able to keep the health insurance that they have today if they wish. But the proposal to create a new government-run health plan to "compete" with private-sector plans would make such a promise impossible to keep, writes Smith. Instead, the likelihood is that millions of Americans would lose their existing coverage, regardless of their personal preferences in the matter, and be pushed into the new public plan or Medicaid. Moreover, inasmuch as Medicare is the common model for a new government-run health care plan, it is fair to examine Medicare's record on delivery of high-quality health care. Medicare is not a quality leader in health care, and there is also evidence that current enrollees in government-run health plans are having problems with access to health care. Destroying the private health insurance of millions of Americans through rigged "competition" with a new public health plan, funded by taxpayer subsidies and artificial pricing, will result in reduced choice and competition, less innovation, and a lowering of overall health care quality.

Take Two Aspirin and Tweet Me in the Morning: How Twitter, Facebook, and Other Social Media Are Reshaping Health Care
Carleen Hawn
Health Affairs, March/April 2009

Across the health care industry, from large hospital networks to patient support groups, new medial tools like weblogs, instant messaging platforms, video chat, and social networks are reengineering the way doctors and patients interact, writes Hawn. Hello Health, for example, is a Brooklyn-based "concierge" practice that eschews the limitations of insurance-based medicine. Patients can sign up to be a part of Hello Health's practice for a basic enrollment fee of $35 a month. Quick emails and instant messages to the physicians are free, but if a "cyber-visit" like this takes longer, it costs patients $50 to $100. If patients need to come in to the office for a consultation, they are guaranteed one within 24 hours. Generic medications for acute problems, as well as lab tests that can be done in the clinic's offices, are free. Communicating with patients electronically cuts down on phone calls, while other e-health technologies reduce such administrative tasks as dictation and records documentation. Hello Health, for example, functions almost entirely as a paperless practice — and has no administrative staff at all, sharply reducing its operational overhead. More than 300 patients have already enrolled in Hello Health's practice, and demand has been so brisk that the practice opened its second office in Manhattan's Greenwich Village in February 2009.


ER Visits, Costs in Mass. Climb
Liz Kowalczyk
The Boston Globe, 04/24/09

More people are seeking care in hospital emergency rooms and the cost of caring for ER patients has soared 17% over two years, despite efforts to direct patients with non-urgent problems to primary care doctors, reports The Boston Globe. Visits to the state's emergency rooms grew 7% between 2005 and 2007, to 2,469,295 visits, since passage of Massachusetts' health reform legislation. The estimated cost of treating those patients — including salaries for caregivers, tests such as X-rays and CT scans, and medicines – jumped from $826 million to $973 million, according to data provided to the Globe. Massachusetts officials cautioned against drawing conclusions about whether the state's new insurance mandate has failed to ease overuse of the emergency room, but the numbers may provide an early view of how difficult it will be to meet the high expectations for the law. Several physicians and policymakers said the state information, along with other new data from Harvard researchers, suggests that emergency room crowding and rising costs will not be solved by providing people with health insurance alone, despite optimistic talk by politicians who advocated for the law.

The experience of Massachusetts is instructive, writes Robert Pear of The New York Times. The need for more doctors comes up at almost every congressional hearing and White House forum on health care. Obama administration officials, alarmed at doctor shortages, are looking for ways to increase the supply of physicians to meet the needs of an aging population and of millions of uninsured people who would gain coverage under legislation championed by the president. Increasing the supply of doctors would increase access to care but could make it more difficult to rein in costs, writes Pear.


Ills of French Health System a Lesson on Reining In Costs
Valentin Petkantchin, Institut économique Molinari
Atlanta Journal Constitution, 04/12/09

At first glance, the French health system seems to provide a blend of private competition and state intervention that delivers decent quality and affordable care to everyone. But the French system of compulsory insurance — something for which many Democratic leaders are calling for in America — has acted as a Trojan horse, allowing the government to seize control over increasing areas of health care, writes Petkantchin. Rarely a week goes by without the government coming up with some new cost-cutting scheme in which it uses its power over the insurance system to direct health care toward its own ends. Yet almost every one of these interventions has failed to rein in costs. The lessons for America are clear: Attempting to achieve universal coverage through compulsory insurance will not control costs but will certainly undermine quality of care.


Ryan Shines as GOP Seeks Vision
Craig Gilbert
Milwaukee Journal Sentinel, 04/25/09

Paul Ryan (R-WI) is one of his party's most touted young politicians, a GOP point man on the economy and a darling of the conservative movement, reports the Journal Sentinel. Ryan has clearly made the bet that he can offer detailed, controversial, conservative ideas (personal accounts for Social Security; vouchers for Medicare; lower tax rates for the wealthy; freezing most domestic spending) and still prosper politically, as long as voters see him as substantive, civil, inclusive and attentive. The result is a package very much patterned after Ronald Reagan and former congressman and vice-presidential candidate Jack Kemp, perhaps Ryan's most important political mentor, representing affable, big-tent, small-government conservatism. What excites many in the party and the conservative movement about Ryan is that he combines youth and political talent with an attachment to conservative ideas, especially the notion that limited government and free markets both have an economic rationale in growth and prosperity and a moral one in individual freedom and fulfillment.

Upcoming Events

Grace-Marie Turner speaking on Let's Just Talk with Kathryn Raaker
Nationally Syndicated Radio Broadcast
Saturday, May 2, 2009, 10:00 a.m. EDT

Health 2.0: Adopting Health Information Technology in the United States
The Brookings Institution Event
Monday, May 4, 2009, 12:00 p.m. – 1:30 p.m.
Washington, DC

Medicare Advantage: Lessons for the Future
Alliance for Health Reform Briefing
Monday, May 4, 2009, 12:15 p.m. – 2:00 p.m.
Washington, DC

Health Reform: Moving from talk to action
Philips Webinar
Tuesday, May 5, 2009, 1:30 p.m. -2:45 p.m. EDT

Health Reform in the 21st Century: A Conversation with Health and Human Services Secretary Kathleen Sebelius
House Committee on Ways and Means Hearing
Wednesday, May 6, 2009, 10:00 a.m.
Washington, DC

Medicare and Health Care: Prospects for Reform
National Center for Policy Analysis Briefing
Wednesday, May 6, 2009, 12:00 p.m.
Washington, DC
For more information please contact Charlie Sauer at 202-220-3082 or Charlie.Sauer@ncpa.org.

Long Term Care in America: The Agenda for Health Reform
Health Affairs and SCAN Foundation Conference
Thursday, May 7, 2009, 9:00 a.m. – 2:00 p.m.
Washington, DC

Medical Innovation: The 21st Century Solution for 21st Century Health Care
Center for Medicine in the Public Interest Event
Thursday, May 14, 2009, 9:30 a.m. – 10:30 a.m.
Washington, DC



Health Policy Matters is a weekly newsletter containing summaries of timely and informative studies and articles on free-market health reform. It features a commentary by Grace-Marie Turner on the major developments and issues of the week as well as summaries of writings by participants in the Health Policy Consensus Group and other articles of interest from the health policy world, plus announcements of coming events. Health Policy Matters is published by the Galen Institute, a not-for-profit public policy organization specializing in information and education on health policy. For more information about the newsletter and our organization, please visit our website at www.galen.org.

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