Ebola is a horrific disease that’s become a target of overreaction by frightened people who, like most, do a poor job in judging what’s a real risk.
But it’s also an example of how inadequate health programs are dangerous.
Even before Ebola came to our shores, government mattered. The lack of any credible public health infrastructure made it much harder to effectively contain the disease at its source.
As physician Paul Farmer wrote, “[W]eak health systems, not unprecedented virulence or a previously unknown mode of transmission, are to blame for Ebola’s rapid spread” in West Africa. “Weak health systems are also to blame for the high case-fatality rates in the current pandemic.”
Our country boasts highly trained experts in infectious disease and the excellent federal Center for Disease Control but spending for public health programs has been cut.
According to the Journal of the American Medical Association, “Overall, investment in key health system functions has been in decline. The CDC’s 2013 budget declined 10 percent, or nearly $1 billion, from 2012. Since 2008, state and local public health agencies have lost more than 50,000 staff (almost 20 percent of their workforce), requiring cuts to preparedness programs.”
Cuts have also hit research on Ebola. In 2010, the National Institute of Health devoted $37 million for an Ebola vaccine but was spending less than half of that in 2014. The head of NIH, Francis Collins, recently said that if cuts had not been made, “we probably would have had a vaccine” by now.
Now, no one can know for sure what researchers and public health officials would have been able to accomplish if funding were not slashed. And, even with adequate resources, the right decisions must be made.
But we most certainly know that those cuts were the direct result of the debt ceiling blackmail by congressional Republicans, which led to severe cuts in domestic spending via the so-called sequester and other budgetary constraints.
Like Bruce Poliquin, currently running to fill Mike Michaud’s seat in the U.S. House, those Republicans signed activist Grover Norquist’s no-tax pledge. This promise, as Poliquin’s primary rival Kevin Raye pointed out, would preclude votes closing loopholes for special interests like particular companies.
Poliquin’s refrain has been that taxes should be cut and that the debt and deficit are too high but he never outlines what spending would have to be reduced to make that math work.
Whenever you hear someone calling for cuts in spending without saying what programs will be hit, the likelihood is the budget axe will fall on some important program without a crew of high-priced lobbyists touting it. Big corporations and trade groups have many lobbyists. Public health efforts, although they save lives, have far fewer.
There hasn’t been any Ebola in Maine, thank goodness.
But in Maine, Gov. Paul LePage not only refused to expand MaineCare but dropped people from it.
During candidate debates, LePage has been bringing a letter from the federal government about MaineCare reimbursements and using it as a debate prop. But the letter doesn’t say what he asserts it does.
The governor falsely claims that everyone who would have been covered if not for his five MaineCare vetoes can just go out and get private subsidized insurance on the health care exchange. He is either misinformed or knows the truth and doesn’t want to acknowledge it.
Who is paying the price? The tens of thousands of Mainers in the coverage gap, who will be more likely to die of preventable conditions and to get sicker, and their loved ones.
This same governor considered having Riverview go without federal accreditation and proposed a budget that would have cut funding for rural hospitals and eliminated the Drugs for the Elderly program.
As for Ebola, although LePage has said Maine is prepared to deal with an outbreak, the head of the Maine State Nurses Association disagrees. According to Cokie Giles, “It is a lethal virus, and most of the hospitals — or maybe all of the hospitals — do not readily keep on hand many of the suggested resources that you need in order to protect the patient, yourself and the community against this virus.”
To protect Americans from Ebola and other illnesses, we need resources. Anti-government ideologies are not only simplistic but also harmful to our health.