What have the Olympics, oil and commodity prices, and supply and demand have to do with either pandemic preparedness or health reform? And what do either have to do with politics?
Pandemic preparedness is still an issue; pandemics are inevitable, and we are not yet prepared for one (follow the links for more, and go here to learn how to prepare). Health reform, which can mean either expanded access and coverage or cost control (it's both, actually along with rebuilding public health infrastructure and improving quality of care) is also obviously an issue. Yet, one problem seemingly separate from another problem quickly runs together to induce a major headache for the world, and one that is going to to be a major headache for the next President.
Here's an illustration of how that works: take the example of latex examining gloves. It's a staple of personal protective equipment (PPE) for health care workers for infection control, and a much needed barrier to protect against the spread of influenza (both seasonal and pandemic). One company, Medline, with 30% of the market share, is a big player. So this announcement raised eyebrows when it was released this week:
Hong Ray Enterprises of Shijiazhuang, China, the world's largest manufacturer of vinyl exam gloves and a major manufacturer of nitrile gloves, has notified Medline Industries, Inc., and other U.S. customers that they are facing "force majeure conditions" and that they will be unable to meet their normal agreements to customers. Hong Ray is Medline's largest exam glove supplier.
Force majeure means that large scale circumstances beyond control free the company for liability and obligation. In this case:
In its letter to Medline and its other U.S. customers, Hong Ray cited a long list of events and government actions that have led to its inability to fulfill its contracts. These include a fire at a major raw material manufacturer, dramatic changes in government policy impacting labor, taxes and credit and pollution-control measures associated with the Beijing Olympics.
According to Amdur, Hong Ray's situation is by no means unique.
"All of our suppliers are facing enormous and unexpected obstacles in fulfilling their contract obligations," said Amdur. "While Hong Ray is the first factory to formally declare 'force majeure,' other factories, including those that manufacture latex gloves, face similar circumstances. In Malaysia, for example, the government recently declared a change in pricing for natural gas, almost tripling the price overnight."
So, much needed medical supplies will either be absent or raise your medical bills just as surely as rising oil prices impact the airline industry.
"We are moving quickly to secure adequate supply for our customers through alternative factories, at ultimately a much higher cost. It is crucial that we act fast for exam gloves, however, because it's a high demand item that can spike in times of crisis situations such as SARS and the pandemic flu."
And with that background, look at the numbers from a previous post in March:
Those with insurance are satisfied with their own health care coverage (83% to 93% depending on the question), but fear paying more for care (41%) or losing coverage altogether (29%). That >80% satisfaction is a key finding, because people satisfied with what they have a) don't want to give it up and b) are less likely to push for change. And when asked to rank health care along with other important issues facing Americans, Democrats tend to rate health care as more important than either independents or Republicans, so the push for health reform is not unanimous by any means.
Another important difference is that Republicans are more worried about cost-containment and Democrats more interested in expanding coverage. This leads to the following caveat; while much of the public agrees with the goal of increased coverage, there is no agreement about the best solution to get there.
The slides are from kaiser.edu, which is a great resource on health care information. In conjunction with the Roper Center at the University of Connecticut, a list of recent health care polling can be found and put to good use. For example, from a Feb 08 AP/Ipsos poll:
(People have suggested various ways that the government could act to try to fix the economy. How much do you think each of the following would help fix the country's economic programs: a great deal, some, only a little, or no help at all?)...Increasing spending on domestic programs like health care, education, and housing
43% A great deal
16 Only a little
14 No help at all
Does that mean that increasing dollars for increasing price of gloves, oil, etc is what people had in mind? Not likely, any more than donors to colleges want their dollars to pay for electricity and heating oil when what they wanted was increased scholarships or educational programs.
But the reality of rising commodity prices (including food), international supply chains and a just-in-time economy put us at risk for key shortages that will, if not a sexy headline-grabbing issue, nonetheless need to be dealt with both in enacting health reform and preparing for pandemics.
The only way to approach this is with a sober, reality-based approach, and it's going to require the next President to understand the science behind the politics. That's why the public prefers the next President to know something about science, and why the 14 Science Questions the Next President Should Answer include
- Pandemics and Biosecurity. Some estimates suggest that if H5N1 Avian Flu becomes a pandemic it could kill more than 300 million people. In an era of constant and rapid international travel, what steps should the United States take to protect our population from global pandemics or deliberate biological attacks?
- Health. Americans are increasingly concerned with the cost, quality and availability of health care. How do you see science, research and technology contributing to improved health and quality of life?
in addition to questions about innovation, energy, national security and research. There's no way this approach is going to to be simple or easy. But whether it's the all-at-once or sequential approach, there's no question that a science-based and evidence-based approach to health care policy and politics is the right way to go. And those kinds of approaches will recognize that cost is a factor in the direction health reform goes, and will need to account for it, even as universal care remains the goal. Start with children if you want consensus
As you may know, President (George W.) Bush vetoed a bill passed by Congress that would create a program to spend 35 billion dollars to provide health insurance to some children in middle-income families. Do you think Congress should vote to create that program by overriding Bush's veto, or do you think Congress should vote to block that program by sustaining Bush's veto?
Congress should override veto 61
Congress should sustain veto 35
No opinion 4
and get everyone to where they need to be. But in this environment, cost and complexity and going to need to be accounted for, one way or another.