Thursday, October 27, 2005

Democrats, bird flu and "the vision thing"

I'm sorry to keep bashing Democrats. On balance they are so much better than Republicans (or at least not anywhere near as bad). But they are always such a disappointment.

They are now on the bird flu train. Better late than never, but much better not to have been so late. But now that they are on the train it would be nice if they exhibited a little imagination. You know, "the vision thing," as George H. W. once called it.
Senate Democrats proposed $8 billion in new spending on preparedness against avian flu Wednesday, in an attempt to increase funding by more than double over what was passed less than a month ago.

The Democrats used their bill as an occasion to criticize what they said was a slow Bush administration response to the threat of a bird flu pandemic. That angered Republicans, who charged the Democrats with using the threat for political purposes.

The bill, which could reach the Senate floor as early as Wednesday night, calls for the federal government to spend $3.3 billion to stockpile a now-experimental vaccine against the H5N1 avian flu virus strain. The administration approved an initial $100 million deal with vaccine maker Sanofi Pasteur in late August to begin filling government stockpiles.

The package also spends $3.3 billion to increase stocks significantly of anti-viral drugs, such as Roche`s Tamiflu, and devotes other money to increasing both hospital capacity and disease-surveillance capabilities.

The bill more than doubles the $3.9 billion senators had agreed to add to a defense spending bill on Oct. 3. Democrats said the increase was needed to speed preparations. (via Monsters and Critics)
OK. Criticism of the slowness of the Bush administration is warranted. And dollars will be helpful. But a little thought to go with the money toss isn't too much to expect, is it? Instead we have a proposal to use most of the money to stockpile an experimental vaccine (which essentially doesn't exist) and stockpile Tamiflu (which will do little except at the margin). Hospital beds and surveillance. Good ideas, but missing context. The biggest need is to repair a crumbling public health system. Hospital beds don't take care of patients. Staffed hospital beds do. And with cuts being proposed for medicaid and other health care services, beds won't matter much. What the Democrats should be doing now--and should have been doing for the last five years (not to mention the years when they had the Whitehouse) is beating the drum to improve public health infrastructure--all of it. Not the "bioterrorism" components but politically unsexy routine, bread and butter public health: maternal and child health, immunization programs, substance abuse, STDs and AIDS, communicable disease, vital records and vital statistics, routine monitoring and surveillance, outbreak investigations, food safety, water and wastewater, etc., etc. They haven't done it because there wasn't enough (or any) political mileage in it. The old saw, "When public health works, nothing happens," is not a formula for an active constituency. So championing it requires leadership, and leadership requires vision, a vision of the role of government.

In public health we are talking about things people can't do for themselves that make our communities healthier, more satisfying places to live and work. Republicans are fond of saying people know better what to do with their money than the government does. I don't know about that. But I do know that if you give me back $300 in tax cuts, I can't buy better public health with it. I can only do that if I put my $300 together with your $50 and your $1000 and your $3000, etc. The Democrats need to articulate clearly those purposes for which pooling our individual resources make sense. And surely most would agree public health is on that list. With a robust and healthy public health infrastructure we would be much, much better able to cope with a pandemic. As it is, we will be improvising and desperately trying to stick our fingers in the dike.

As lacking in imagination as it is, the Democratic proposal is stillborn anyway. The Republicans will see to that:
The plan incensed at least some key Republicans, who branded it a vehicle for political attacks on a White House already facing criticism for a slow response to Hurricane Katrina.

'It`s political gimmickry,' a visibly angered Sen. Ted Stevens, R-Alaska, told UPI. 'That`s just throwing money at the wall. You can`t spend that kind of money,' Stevens, who chairs the Appropriations Committee, said of the bill`s $8 billion.

A senior GOP Senate aide said Republican leaders were unworried about the large spending increase in Wednesday`s amendment. Even if it gains Senate approval, the increase is unlikely to survive a conference with the House, leaving lawmakers to deal with the $3.9 billion they passed in the military spending bill, the aide said.
Ah, yes. The "visibly angered" Ted Stevens of Alaska. The asshole who would rather spend $200+ million on a bridge in Alaska for fifty people than on hurricane relief for the Gulf. It's his vision we have to live with until a better one comes along. And he convinced all but 15 of his Senate colleagues to see it his way. That included most Democrats.

I'm still waiting for another vision.