How Does the World’s Leading Economy and the Rest of the World Prepare for Disease Outbreaks, Epidemics, and Pandemics?
The CDC
“As demonstrated in the PHEP funding chart above, CDC continues to work with reduced financial resources, which similarly affects state, local, and insular area public health departments. These and other funding decreases have resulted in more than 45,700 job losses at state and local health departments since 2008. These losses make it difficult for state and local health departments to continue to expand their preparedness capabilities, instead forcing them to focus on maintaining their current capabilities.”
The NIH
“NIH has been working on Ebola vaccines since 2001. It’s not like we suddenly woke up and thought, ‘Oh my gosh, we should have something ready here,'” Collins told The Huffington Post on Friday. “Frankly, if we had not gone through our 10-year slide in research support, we probably would have had a vaccine in time for this that would’ve gone through clinical trials and would have been ready.”
It’s not just the production of a vaccine that has been hampered by money shortfalls. Collins also said that some therapeutics to fight Ebola “were on a slower track than would’ve been ideal, or that would have happened if we had been on a stable research support trajectory.”
The PPACA
“The health law initially funded the Prevention Fund at $2 billion annually, with slightly smaller appropriations in the first few years as the program scaled up. This would be the only federal budget item dedicated to prevention and public health activities. The deficit reduction package that passed in February 2012 cut $6.5 billion from the Prevention and Public Health Fund, leaving it with the budget you see in green. The cut eliminated just over a third — 37 percent — of the Prevention Fund’s budget. Congress used these funds as part of a “doc-fix” package to keep Medicare provider payments stable.
Congressional gridlock has stopped Republican plans to eliminate the fund altogether from becoming law. But that doesn’t mean it’s safe: The Obama administration plans to use $454 million in Prevention Fund dollars to help pay for the federal health insurance exchange. That’s 45 percent of the $1 billion in Prevention Fund spending available this year — and what’s represented in the graph above, in yellow.”
The WHO
Peter Piot, the discoverer of Ebola responded: “On the one hand, it was because their African regional office isn’t staffed with the most capable people but with political appointees. And the headquarters in Geneva suffered large budget cuts that had been agreed to by member states. The department for hemorrhagic fever and the one responsible for the management of epidemic emergencies were hit hard…I think it is what people call a perfect storm: when every individual circumstance is a bit worse than normal and they then combine to create a disaster. And with this epidemic there were many factors that were disadvantageous from the very beginning.”
How did austerity, starving the beast, and politics get us ready for world disasters? It didn’t and I believe it is pretty plain to see we were unprepared to meet Ebola head-on due a lack of foresight, planning, and funds.
Notes and References:
– Republican budget cutting nearly halved CDC’s emergency preparedness since 2006 Huffington Post, October 13, 2014
– CDC Preparedness Report – Background “2013-2014 National Snapshot of Public Health Preparedness,” USHH CDC
– Ebola in the U.S.—Politics and Public Health Don’t Mix Scientific American October 6, 2014
– The Incredible Shrinking Prevention Fund Washington Post, Health Reform Watch blog, April 13, 2013
– Ebola and WHO Budgets Controversies in Hospital Infection Prevention blog, October 5, 2014
Question: How Does the World’s Leading Economy Prepare for Pandemics?
That’s easy, just name an Ebola Czar…….
What to make of Klain? Not a Dr., no knowledge of infectious diseases. He’s a lawyer who worked in D.C. politics most of his life. I like this line from his bio:
Klain helped Fannie Mae overcome “regulatory issues”.
Bruce:
Why not appoint a Surgeon General? The appointment of which has been blocked by Republicans. Typically the Surgeon General would lead the charge.
Will Ebola Vanquish the MBAs Who Run Our Hospitals?
Posted on October 16, 2014 by Yves Smith
“On the other hand, based on what we have been posting on Health Care Renewal for nearly 10 years, the conduct of the Texas Health Resources leaders should have come as no surprise. On Health Care Renewal we have been connecting the dots among severe problems with cost, quality and access on one hand, and huge problems with concentration and abuse of power, enabled by leadership of health care organizations that is ill-informed, incompetent, unsympathetic or hostile to health care professionals’ values, self-interested, conflicted, dishonest, or even corrupt and governance that fails to foster transparency, accountability, ethics and honesty.”
…
“In 1997, Doug Hawthorne helped reshape the health care industry in North Texas by leading the creation of Texas Health Resources, an alliance of Presbyterian Healthcare Resources, Harris Methodist Health System and Arlington Memorial Hospital.”
…
“Yet Mr Hawthorne had no direct patient care experience, public health experience, or biomedical or clinical science experience. Mr Hawthorne is on the board of directors of the LHP Hospital Group Inc, a for-profit that provides capital and services to non-profit hospitals.”
Denis:
This is not as much about MBAs as much as the consolidation of hospitals and the expansion of Medicaid. As I wrote here: “On the Horizon “After Obamacare” and the healthcare industry attempting to control pricing and increase profits. While Mr. Hawthorne is an MBA, the board is made up of doctors too. You can not escape that reality.
Texas did not expand Medicaid and I mentioned this on an earlier NC article. If a state does not expand Medicaid, it will lose Federal subsidies to cover the indigent who arrive at their ER looking for care. By law, hospitals only have to stabilize a patient and no treat them or cure them. If I remember correctly (perhaps Maggie will comment on this), the PPACA has a provision in it which will not allow the treatment of aliens either (I could be wrong on this point).
I don’t disagree with you about the funding.
But what struck me was the hubris of the medical community at the national level.
Their reassurances that we could do a much better job of controlling the spread of Ebola than the people in Africa were over the top. Yes we have advantages that they do not have. But we are still humans and humans make little mistakes on a regular basis.
The failure to foresee that mistakes would be made was the lesson of Dallas.
The hospital ER check in clerk did not very prominently warn the nurses and doctors of a patient’s recent arrival in country from west Africa. The ER doctor sent a patient home who had symptoms compatible with Ebola and who had recently been in west Africa. The personal protection equipment at that hospital was inadequate for dealing with Ebola. The medical staff continued their normal lives including travel after potentially being exposed to a very lethal virus.
We were regularly assured that contracting Ebola required physical contact, that there was no airborne transmission. But I have been reading that labs have seem transmission between animals in separate cages where physical contact was not possible. How does the CDC explain this away?
This virus has a very high mortality rate, public relations should have no place in the discussion. The population was treated like children, to be reassured. The risk was infinitesimally low for most of us but it was not zero.
And worse yet, hospital personnel around the country were also listening to those reassurances.
The best way to spend our money now, would be to help control the spread of this virus in Africa.
Run – Filling the Surgeon General position sounds like a good idea – but filling it with a TV talk show host? That’s gonna ‘fix’ things?? Please….
WaPo did a fact check on the question of whether blaming Republicans is a fair thing to do. It gave that notion “4 Pinocchios”. That rating is what what WaPo refers to as a “Whopper” of a lie.
http://www.washingtonpost.com/blogs/fact-checker/wp/2014/10/15/the-absurd-claim-that-only-republicans-are-to-blame-for-cuts-to-ebola-research/
Bruce:
No one has said such for Surgeon General. I can take your comment in two ways Bruce, either you are naive (short of calling you ignorant or stupid) or you are intentionally construing my words here. I am going to go with the later for now.
It is no secret the House creates the budget. Yes of course, the President can propose a budget; but, neither the House or the Senate has to follow it. It is also no secret the House has been controlled by the tea-bagger led Republicans since 2010 and their main role has been to block whatever initiative the President puts forward. The minority led but ever contentuous Senate Republicans have made it impossible to get anyone appointed without a sixty vote confirmation much less a motion passed. Mc Connell made it his personal mission to make Barack Obama a one time African American President in the big White House. Some have called his stance bigotry on a national level.
Most recently and again no secret to “most,” the President did suggest a sequester to which the House agreed, a result of their willingness to shut down the Nation to secure the tea-bagger led Republican demands on budget cuts and austerity during a slow recovery for 90% of the nation coming after a 2008 Wall Street crash resulting from TBTF Wall Street gamblers. The House and Senate tea-bagger led Republicans only interest has been to restore Defense funding which the US already overspends on and at the expense of NIH/CDC.
Kessler conveniently forgets the events leading up to all of this in awarding 4 pinochios in blaming the Republicans. Kessler also forgets the House prepares the budget, the House wanted budget cuts from 2010 onwards, and the House was willing to shut down the nation on a couple of occassions in order to do it. The graphs I posted are pretty specific and they go back much farther than the last 10 years. There has been a trend. Bush’s increase came after 911 and then it began to decrease from there. It stabilized when Obama took office as the graphs show. In 2010, the tea-bagger led Republicans take over the House and both the NIH and CDC funding begins to slide again. 40% of the CDC preparedness was cut due to budget reduction as led by the tea-bagger controled Republicans. It is a fact.
I would not get too cute with me as I have a low tolerance for cute and trolls.
Oops. What was I thinking!
“The ER doctor sent a patient home who had symptoms compatible with Ebola and who had recently been in west Africa.”
Should have been
The ER doctor sent a patient home who had symptoms consistent with Ebola and who had recently been in west Africa.
First, Run’s link to his article doesn’t work — this will: http://angrybearblog.strategydemo.com/2014/01/on-the-horizon-for-healthcare-costs.html
Second, after reading “After Obamacare” by Phillip Longman and Paul S. Hewitt, I am faced with: “a typical family of four has seen the amount it pays for health care, including premiums and out-of-pocket costs, rise from about 18 percent of its income in 2002 to 35 percent today” — and — “Assuming that the growth in family income remains at around 2 percent a year [when was the last time that happened?], the typical family of four would go from spending 35 percent of their income on health care today to over 50 percent within ten years and more than 63 percent by 2030.”
“Worse is the fact that we get virtually nothing in return for paying this added health care tax. Some 60 to 75 percent of rising health care costs reflects nothing more than higher prices for the same services. ”
http://www.washingtonmonthly.com/magazine/january_february_2014/features/after_obamacare048357.php?page=all
This is blamed mostly on hospitals or doctors combining to bargain as single units against insurance companies (centralized bargaining!).
(Maggie blames high costs on 1/3 of procedures unnecessary — certainly not mutually exclusive — but I am just getting my head around this issue which may take a year.)
My first “wonder” is if 80% of hospitals are non-profit (as they all should be) — and — if doctors pre-tax take home is 10% of medical costs, where is all the money going? Are Roman Catholic hospital groups sending money to the missions? 🙂
The answers to this and everything else wrong wit this country wont matter if nobody will be listening. You know what I’m going to say next — about getting Congress for example to listen: legally mandated, centralized bargaining for all! Automatically organizing the political financing and lobbying of the 99% to go with 99% of the votes.
When are we going to learn to start doing it back to everybody else — like the medical profession is doing to the insurance companies here? Or like labor has done around the world anywhere centralized bargaining is the labor market setup?
PS. About 1995 I paid $500 for a root canal. Recent price: $1400 — almost double in constant dollars. Ditto for other procedures I think, like extraction. I suspect that dental professionals saw medical insurance double over that span for the same treatments (possibly for more, new procedures I thought until lately) and figured that nobody would notice if they did the same thing.
Denis:
Hospitals have been consolidating for years. The pace has picked up in recent years for both hospitals and doctor groups and the whole purpose is vastly different from better care. It is the profit motive and negotiation with insurance companies. I depict the movement here:
Name hospitals have always been able to demand a higher price for procedures even though the procedure done at a lesser known hospital would be of similar quality with equivalent care. My own open heart surgery was done at MedCentral in Mansfield, Ohio where I was working at the time instead of University of Michigan hospital. MedCentral is top 5% for this procedure. The cost difference was high. Those nurses and PAs took excellent care of me.
Do not confuse the unecessary procedures done and the profit led consolidation by hospitals and doctors. They are both factors in driving healthcare costs up the same as pharma.
The link is fixed. Thank you for providing it as I was out of town yesterday.
Run – Let’s agree:
1) Sequestration is at the heart of the problem you describe. This was a meat axe approach. Bad legislation.
2) The WH first proposed this. They did it as a bluff. The assumption was that this was so stupid, that it would never happen.
3) But it happened. And Congress is to blame for this.
4) No one has clean hands in this story.
If the CDC’s budget had not been cut, would the CDC have found a cure
(or vaccine) for Ebola.?
Not likely. for two reasons.
1) We still haven’t found a vaccine for AIDS. Modern medicine is not
magic. It’s an infant science and there are still a great many things that
we don’t understand. For instance, we’ve now gone back to square 1 to
try to understand Alzheimer’s. And despite the fact that we have poured
billions into cancer research, we are still losing the war on Cancer. (See Clifton Leaf’s excellent book with that title.)
2) The chances of an Ebola epidemic hitting the U.S. have always been
slim to none.(The host is bat found in Africa near the Ebola river)
And Ebola is not spread through the air. Note that the patient in Texas
who died spent quite a bit of time with his family–and none of them got
sick.
Health care workers became sick because they were exposed to his
bodily fluids– specifically, vomit and diarrhea.
The CDC has now issued new rules for keeping hospital workers safer.
That makes sense.
CDC didn’t do this earlier because there were no Ebola patients in
U.S. Hospitals.
And there is no need for CDC to be working on a plan to fight Ebola
in the general population.
There are many things that the CDC can and should be doing.
Preparing for pandemics is not one of them.
When was the last time that a pandemic killed thousands of U.S. citizens?
AIDS. And we were slow to flight AIDS, not because CDC and NIH
didn’t have the budget, but because we thought that only Gays and
drug-users would contract the disease. (I was following AIDS in the 80s, back when the NYT had leveled it GRID (gay-related infectious
disease).
It wasn’t a lack of NIH or CDC funding that led to the AIDS epidemic, it was prejudice.
“Pandemics” just aren’t a major threat in the U.S. I’m not saying that
it can’t happen, but preparing for plagues should not be high on the
CDC’s list of priorities.
Smoking Cessation programs (which CDC does do) would do far more
to promote public health.
Gun control–Obama tried to get the CDC involve in research on gun violence (but the
GOP stopped that.)
NIH and CDC should make Alzheimer’s a top priority. Going forward,
1 out of 2 women who live into their 80s will die of Alzheimer’s.
Finally, the CDC money that was used to fund Obamacare is doing far more good that any CDC program aimed at infectious diseases. Obamacare is providing free preventive care, and the expanded Medicaid program is helping a huge number of Americans suffering from chronic diseases.
These are the plagues of the 21st century.
The media hysteria over what the CBC did or didn’t do regarding Ebola
is foolish.
This isn’t to say that Ebola does not represent a tragic problem for Africa (and possibly other places). It does.
That is why everyone who is concerned about EBola should be contributing to Doctors Without Borders.
And that is why the U.S. should have its own Doctors Without
Borders– a Corps of doctors and nurses willing to go to other
countries and fight disease, starvation, etc.
Giving more money to the CDC would not create the medical professionals willing to risk their lives to help the sick and dying in other countries.
Maggie:
“The media hysteria over what the CBC did or didn’t do regarding Ebola is foolish.”
Convince the rest of the world who are convinced the CDC should have done more. This is again mostly about Pres. Obama. Thank you for your comments.
Run–
The “rest of the world” is not convinced that the CDC should have done more.
The media (which loves to fear-monger] has turned this into a
story about the CDC.
Democrats, in turn, have tried to turn it into a story about Republicans and
Republican cost-cutting.
It is neither.
It is a story about Africa. Those are the people who are suffering.
And the CDC is not in a position to contain an epidemic in
Africa.
It does not have the expertise Doctors Without Borders does. .
Ideally, we, like the French, would create our own Doctors without
Borders–or at the very least, provide far more foreign aid for
organizations like Doctors Without Borders.
Maggie:
Seriously, do you really want to argue over this? To most, the media is the world, people follow the media, and they believe what the talking heads say. As you said one time, we can either leave it unanswered and people will believe the last comment made from the media or elsewhere as being acceptable or we can answer it. The only citation is from a NIH doctor:
“NIH has been working on Ebola vaccines since 2001. It’s not like we suddenly woke up and thought, ‘Oh my gosh, we should have something ready here,’” Collins told The Huffington Post on Friday. “Frankly, if we had not gone through our 10-year slide in research support, we probably would have had a vaccine in time for this that would’ve gone through clinical trials and would have been ready.”
I am not a doctor or researcher Maggie, are you? and neither am I the head of the CDC or the NIH. I can talk to making pills, CF and CD dialyzers, Dialysis Solution, bubble oxygenators or Fenwal Blood Bags.
The fact still remains the budget was cut as shown by the graphs and have been decreasing. The Repubs are using the media to exploit it during midterm elections.
This comment: “Ideally, we, like the French, would create our own Doctors without Borders–or at the very least, provide far more foreign aid for organizations like Doctors Without Borders.” would make a good post by you.
Run—
I am sorry to disagree with you—and it’s not that I “want to argue” —but
the fact that Republican are gong to spread misinformation about Ebola (blaming the CDC) makes it all the more important that we counter that campaign of disinformation with the truth.
This is what bloggers can contribute to political discourse: facts and truth.
–We are not censored by editors, or advertisers.
–We have unlimited space—plenty of room to present all of the facts.
–And we have time: we are not “on deadline.”
If Democrats are muddying the waters by arguing “It’s not the CDC’s fault—the Republicans cut the CDC’s budget”—that is all the more reason for us to raise the level of discourse, by telling the truth.
Otherwise, the whole Ebola controversy descends into another “he said/ she said” and no one learns anything.
The fact that the CDC budget was cut has nothing to do with the spread of Ebola in West Africa—or that a few people were infected here.
As I said in my last comment, the truth is that that the CDC doesn’t have the expertise to contain the disease either in West Africa or in the U.S.
Arthur Allen , author of The Fantastic Laboratory of Dr.Weigle: How Two Brave Scientists Battled Typhus” explains what I mean by “expertise” in a piece titled: “What the CDC Can’t Teach About Ebola- In dealing with a deadly outbreak,” there is no substitute for deep expertise
His article recently appeared on politico.com magazine.
http://www.politico.com/magazine/story/2014/10/what-a-nazi-era-medical-experiment-can-teach-us-about-ebola-111986.html#ixzz3GipJusWT
There, Allen points out that “More than 3,000 medical workers from Doctors Without Borders, the French charity, have been fighting the Ebola epidemic since March, but only about a dozen have become infected.”
WHY have so few of Doctors’ Without Borders medical workers become infected? Because Doctors Without Borders has Experience and Expertise in this area.. says Allen, who is an infectious disease expert.
“In all likelihood, “ Allen writes, “neither the CDC nor the Texas hospital was to blame for the infection of the nurses who cared for the late Thomas Duncan.
The CDC’s manual was based on the best available knowledge. The Texas nurses certainly did their best to follow instructions. What they lacked, however, was the undefinable expertise that comes with experience.”
: http://www.politico.com/magazine/story/2014/10/what-a-nazi-era-medical-experiment-can-teach-us-about-ebola-111986.html#ixzz3GidAfKae
No matter how much money the CDC had, money does not buy “deep expertise and experience.”
We just don’t have many epidemics in this country. By contrast, Doctors Without Borders goes to places where infectious epidemics are commonplace.
But if the CDC had more $$$, couldn’t it have found a cure?
No, says Dr. Anthony Fauci head of the National Institute of Allergy and Infectious Diseases (NIAID). In a recent appearance on Meet the Press, Dr. Anthony Fauci said he disagreed with NIH director Francis Collins about whether we would have an Ebola vaccine by now if not for budget cuts.
Chuck Todd: One of your colleagues seemed to hint that if you guys had been funded, had more money, you would have a vaccine today. Was that hyperbole?
Dr. Fauci: I don’t agree with that I have to tell you quite honestly. .. . . . You can’t say that. I think you can’t say we would or would not have this or that.
Dr. Fauci is the head of NIAID, the division of NIH which oversees Ebola research.
Run—in your last comment you (once again) quote Collins saying, “Frankly, if we had not gone through our 10-year slide in research support, we probably would have had a vaccine in time for this that would’ve gone through clinical trials and would have been ready.”
That was a silly thing for Collins to say. As Fauci notes, no one knows what the CDC would or would not have found. But the history of the CDC suggests that it would not have succeeded.
Collins was just trying to cover his ass by blaming budget cuts.
Who is Collins and how much does he know about infectious diseases?
Collins is a leader in investigating genetic diseases. http://mphprogramslist.com/potw-dr-francis-collins-nih-director/
Infectious diseases are not Collins’ specialty. He has been a leader in investigating cocaine addiction and that is great.
I applaud him for this research. But this doesn’t mean that I would believe him about what the CDC might have done when researching Ebola.
By contrast, Fauci (who I quote above) does have expertise and experience regarding infectious diseases.
i
I remember Fauci from the fight against AIDS in the 80s.
He is brilliant, and he understands how very, very difficult it is to
fight an infectious disease that is spread via “bodily fluids
As I mentioned, we still haven’t cracked AIDS. And this is not because the NIH or CDC budgets were cut.
Yes, Reagan and other Republicans slowed the war on AIDS.
But so did Democrats. In the 1980s, the country as a whole was severely homophobic. This includes supposedly “liberal” institutions like the New York
Times and the Democratic Party. At that time, politicians in the Democratic Party didn’t dare to come out of the closet.
Bottom line: we just can’t blame the Republicans for all o;f this
country’s problems. (Or the world’s problems)
Best,
Maggie
Until protective methods or equipment are proven to work effectively without “perfect” human performance, I think MDs ought to supervise health workers donning and getting out of Ebola protective gear.
As readers of the excellent book “The Hot Zone” are aware Ebola is capable of mutating to be able to spread by air (as in sneezing), which caused an outbreak among monkeys — which spread to humans — in a facillity in a D.C. suburb. Luckily, it simultaneously mutated not to harm humans. Whatever the chance of success, full fledged research into anything that might work might be a good idea.
Run,, Everyone
The post relies heavily on what Collins said. But
as Sarah Kliff recently pointed out:
”
“There are two assumptions embedded in Collins’ remarks. One is that Ebola vaccine research has been hurt by National Institute of Health budget cuts. The other is that, without those budget cuts, Ebola was on the fast path to a successful vaccine. Neither of these claims, when you dig into the data, appear to hold up especially well.”
Kliff goes on to point out that cuts to NIH funding have not been severe:
There was a decline in funding for Ebola research between 2010 and 2011, from $142 million to $101 million, respectively. This was when stimulus funding dollars ran out, and the entire agency had to cut back. Since 2011, funding has been Small and Slightly declining: research for Ebola and Marburg received $101 million in grants in 2011, $100 million in 2012 and $96 million in 2013, after the sequester took effect.
In fact, the cuts to Ebola research have been Less Severe than cuts for research on other diseases. The numbers show that Ebola research funding fell 4 percent between 2012 and 2013. During the same time frame, malaria funding fell by 7 percent — and overall NIAID dollars dropped by 5.5 percent.
The post above begins by focusing in Cuts to CDC funding– which really isn’t relevant. CDC is not responsible for developing vaccines– NIH is.
CDC is responsible to advising hospital workers as to how they can protect themselves. It is doing that (and is following Drew’s suggestion that
medical workers use a “buddy system” when getting in and out of protective clothing.
As I explain in my comment above, CDC didn’t suggest this when the first patient turned up in Texas because CDC didn’t have enough Experience and Expertise regarding Ebola. This is because Ebola has not been a problem in the U.S.
If NIH had had Slightly more money, could it have discovered a vaccine?
Kliff points out that “Drug research is incredibly unpredictable. Building any vaccine is a long, tedious job typically marked with failure. From the lab to the pharmacy, a typical drug takes about 12 years to build. Of the 5,000 different compounds that drug companies experiment with, five typically make it to human tests — and one gets approved for sale. . . .
The part of Collins’ statement that irks scientists is the sense of certainty, the idea that if only more money had been spent, we’d likely have a vaccine by now. They know that’s not how vaccine development works. Scientists don’t get to name a price for the development of a vaccine — the science is just too uncertain.”
In other words, Collins wasn’t speaking as a scientist. He was speaking as
a bureaucrat who was being attacked, and in an attempt to cover his ass,
he tried to shift blame to the Republican budget-cutters.
I’m sorry that the post repeats Collins remarks. In an age of “cut and paste” journalism, every time you quote something like this, it goes viral. That’s why I think we all need to question–and fact-check–quotes. Otherwise, we
only help the fear-mongers.
Finally, will Ebola hysteria have a significant effect on mid-term elections?
Not necessarily. The topic is cooling off, at least in the U.S.
The Spanish patient has now been declared free of the disease.
It’s not at all likely that 5 or 10 new cases are going to pop up in the U.S. over the next two weeks.
Memories are short.
And the World Health Organization (WHO) has announced that it might have a vaccine ready to be tested in Africa in January.
WHO, by the way, is the global organization that should be leading the fight in Africa, with help from Doctors Without Borders on the ground.
The notion that the U.S. was responsible for stopping Ebola in Africa–or that the world blames the U.S. for this scourge just doesn’t hold up.
Finally, yes, the hospital in Texas screwed up when it sent the patient (who later died) home with antibiotics. But this has absolutely nothing to do with cuts to the Prevention Fund, the CDC or NIH.
No doubt, the ER sent him home because he didn’t have health insurance.
Was this because Texas didn’t expand Medicaid?
No, even if it had, Medicaid wouldn’t automatically cover someone visiting the U.S.
(In many European countries tourists would be covered. But in the U.S.
we don’t even cover immigrants who have been here for 3 years.)
I should add–the CDC is not responsible for researching vaccines.
NIH is.
And, as Sarah Kliff recently pointed out
No speculation at Angry Bear Blog, Fact.