How do you think we would fare in a global epidemic, being the only country without Single Payer?

[SheilaT]

40. In the face of a global epidemic of some

very deadly and easily transmissible disease, what kind of health care system any country has will not matter at all.

Two problems underlie this. One is that Public Health systems everywhere have been systematically underfunded and partially dismantled in the last few decades. Laurie Garrett's excellent book, Betrayal of Trust, which came out in 2000 describes that problem quite well. And things have not improved in the decade and a half since then.

The other is that many hospitals are chronically short-staffed. It's partly a problem of deliberate policy on the part of hospital administration to staff as if it's a retail store and it doesn't really matter if patients then wait an extra fifteen minutes or six hours for treatment. It's also a problem of a very real shortage of nurses. There just aren't enough of them out there in the first place. So for many reasons hospitals are rarely fully staffed, which means among other things a lot of the people there are working overtime to fill in for the missing staff. And even if they had a full complement of nurses and such, they are still staffed at as minimal a level as the hospital can get away with. Right now the one and only hospital here in Santa Fe is engaged in a struggle with the nurses' union over the staffing issue, and it's ugly.

It will be even uglier if some sort of terrible epidemic breaks out, and people don't die quickly but can survive if given the right kind of care. It wouldn't take much to totally overwhelm this -- or any -- hospital's capacity to do so.