Swine flu and health reform bill both bring lessons

2009 in the Chinese astrological calendar was the year of the ox, but in matters of health, it felt more like the year of the pig, whose scientific name is Sus scrofa. The past 12 months were dominated by swine and pork: the emergence of swine flu, H1N1; and the pork-barrel monstrosity from Congress to reform American health care.

The swine virus was a surprise. Financially out-of-control legislative extravagances, sadly, are not. The pig influenza pandemic turned out to be a drill for the next deadly mutation. The reform legislation is also going to be a series of exercises testing the next system. The management of the disease and the legislative debate included compromises, errors and miscalculations, but hopefully lessons were learned, because both the bug and the status quo are deadly. Influenza is a threat to children, pregnant women and those with underlying debilitating conditions. It is no news these are the same populations at risk when the current fee-for-service health care fails. As a nation, we cannot just stand around and do nothing about the new biological threat. We also cannot continue to do nothing about health care.

The H1N1 pandemic showed the vulnerability of humans to an attack by the novel virus to which we have no immunity. The deadliness of the virus was demonstrated as it took the lives of many, especially those most weakened by pre-existing conditions. The health care reform also demonstrated the vulnerability of our political process that has become corrupted by dollars of special interests that have grown rich and powerful from the current perverse system. The H1N1 virus leaped from pigs to humans and very rapidly spread around the world from Mexico. The principle lesson that this outbreak taught was the virus was unpredictable. Just because it didn't kill as many as some had feared doesn't take away from the fact that a strain similar to this H1N1 did circle the globe in 1918 and left bodies and panic in its wake.

The positive lessons learned from this year's H1N1 invasion include the knowledge that a new vaccine could be produced in relatively short time. Authorities also used all the powers of the Internet to disseminate daily bulletins to report on the latest diagnostic and therapeutic recommendations. The negative lesson was that the fear for one's life prompted people to become hostile if the cure was not available. With a limited supply, distribution of the vaccine was the greatest challenge.