by John Ringo
Most of this wasn't available in a "socialized medicine" country unless you went to the local clinic and waited all fucking day to see a doctor.
Study done in 2004 by the CDC. The way that good science works is that the scientist looks at something and says "What if?" He then develops a statement from that (a hypothesis) then tries to disprove his hypothesis. "The sky is yellow." He first defines yellow. He then tests to see if the sky is yellow. If it turns out that the sky is actually blue, his hypothesis gets disproved. But he still publishes the paper and comes up with another hypothesis. Say that the world is really round. If he cannot disprove his hypothesis, it then and only then becomes a theory. This is Science 101. Man-induced global warming was an hypothesis that had been repeatedly disproven. Anthropogenic (man-caused) global warming proponents weren't scientists, they were religious zealots.
Anyway, the CDC liked "universal healthcare." It was a government health program and government health programs were good. They were a government health program so any government health program had to be good.
Hypothesis: "Universal health care will increase the lifespan and general health of a population over free-market health care."
Conclusion: "Fuck, we were not only wrong we were really wrong!"
How could that possibly be? Seriously. Universal healthcare is, well, universal healthcare! Everybody gets the same quality of treatment, young and old, rich and poor! Nobody is turned away! It's perfect communism! With doctors!
Yeah, everybody gets the same quality of treatment: Bad.
Look, if you're between the ages of 7 and 50, in reasonably good overall condition, don't have fucked up genetics and don't really lose the lottery, you generally don't really need a doctor. People between the ages of 7 and 50 rarely realize how bad socialist medicine is. Because they don't have to depend on doctors.
Try getting a hip replacement in a country with socialized medicine. Or a gall bladder operation. Hell, try getting drugs that improve a heart condition without surgery. And even though you can't, you also can't get surgery. Not in any sort of real time. Go rushing into a socialized medicine hospital with a clogged artery. You're going to get a stent if you're lucky. And get put on a waiting list for a bypass. For various political reasons, drugs that in free-market economies are the first line of defense just aren't available.
In the U.S. the standard time to wait for a gall bladder operation was two weeks. In the UK it was nine months. In the U.S., if you needed a bypass you'd be out of the surgery less than fourteen hours after emergency admission. In the UK it was emergency admission, minimal support therapy, months wait. Some 35% of persons waiting for a bypass operation died before they got one.
They found an interesting statistical anomaly as well. Death rates amongst the elderly climbed sharply as the end of the fiscal year approached.
Doctors in socialized medicine programs worked for the same pay whether they fixed people or not. But they had quotas for operations. As the end of the fiscal year approached, most of them had filled their quotas and went on actual or virtual vacation.
And people died.
Average population age in most of the socialized medicine countries were only starting to climb to the levels where death rates due to poor medical care were going to be noticeable. But the truncation of ages was clear. As were quality of life indicators.
Persons in free-market medical environments lived longer, healthier, less pain-filled lives. Despite the evil doctors and HMOs and pharmaceutical companies? No, because of the evil doctors and HMOs and pharmaceutical companies. All three groups had a vested interest in keeping patients alive as long as possible. The longer they lived, the more money the "evil" guys made.
The U.S. had been repeatedly castigated for the cost of healthcare and especially pharmaceuticals. Also for over-prescription of the newest and most costly.
But.
In Europe there was no pressure to use pharmaceuticals. With costs capped by the government, there was no incentive for the pharmaceutical companies. Modern pharmaceuticals are enormously expensive to field. The first problem is the cost of development. Many of them are derived from natural substances, but it takes relentless searching to find a new natural substance. Cancer drugs were derived from rare South African pansies, new antibiotics were derived from fungus found on a stone in a Japanese temple. Then they had to be tested to find out if any benefits could be derived.
Here's the numbers:
Animal (screening) in rats—about 1–2 years, cost about $500k/year, in monkeys—about 2–5 years, cost $2 million a year. Phase I in humans is strictly toxicology: 2 years, $10–20 million a year. If it doesn't kill anybody, then move to Phase II testing for effectiveness: up to 10 years, cost $100+ million/year. If statistics suggest a beneficial effect, then on to Phase III to determine effective dosage, side effects, other benefits and "off-label" uses: 5–10 years at another. $100+ million a year. A (large) Pharma company will start with 10,000 compounds in screening, take about 200 into animal testing, then possibly get ten into Phase I to maybe get one into Phase II. In the last 10–20 years, about 95% of Alzheimer's disease drugs that got to Phase II on the basis of rodent testing were sent back because they had no effect in humans—hence the necessity for the added expense of monkey testing . . .
It was a hideously expensive process. Again, Do. The. Math. Easily a billion dollars invested in one drug. The reason that a new pharmaceutical was so expensive was not just the cost of developing that pharmaceutical but the brutal necessity of so many thousands and millions of failures that that one new shining hope bore upon its back. Billions of dollars lost when "miracle" drugs failed at one step or another. And all that money only being recouped by those limited shining hopes that made it through the process.
But the results were worth every penny. New drugs that cut the need for bypasses; one of the most lucrative surgeries of the 1980s had been almost eliminated in the U.S. by the time of the Plague. Stroke reducing medicines, anti-cancer medicines, cancer prophyllactics and, of course, Viagra, every old man's fantasy made real.
In Europe, in contrast, it was considered cheaper to just operate. Much more unpleasant for the patient but the doctors filled their quotas and the government wasn't forced to pay for the development of pharmaceuticals. Which was why most of the modern wonder drugs were coming out of America or from European businesses that were making most of their nut selling them in America.
Doctors in socialized medicine countries, and their bosses and the heads of departments, had no vested interest in keeping old people or the chronically sick alive. The doctors might have a personal desire to help people, otherwise they wouldn't have become doctors. But they had no actual benefit and if you've ever dealt with a bunch of crotchety old people you can see some of the actual detraction.
For doctors, hospitals and pharmaceutical companies in the U.S., those crotchety old people spelled money, money, money! So they researched and they worked and they studied ways to extend the time they could continue to suck the money out of them.
In the case of governments of socialized medicine countries, the primary users of the services, see: "crotchety old people," were their worst nightmares. The patients worked their whole lives, contributed to the economies of the countries and now expected to be paid back. Heavily. Socialized medicine wasn't the only benefit they expected. They retired early with pensions that nearly equalled their salaries when working. And they paid little or no taxes. And as any health insurance actuary will tell you, they consumed 90+% of the health budget. Mostly in their last six months of life. And what was the point of that?
It would be unfair to say that the politicians just wanted to see them all go away and that cutting off access to vital health services thus killed two birds with one stone. Save money and quietly kill off the primary users.
Or would it? Health care spending as adjusted for inflation had dropped steadily in socialized medicine countries in Europe even as the need had increased. All a
ccess to medicine was rationed. And in the Netherlands people who were "beyond help" were denied access to healthcare on a regular basis and even "medically terminated," put to death, against the wishes of their care-givers. Not only old people but children with chronic health care problems. "Terminal" cancer? Which sometimes was treatable or even erasable in the U.S.? In the Netherlands, they just turned up the morphine drip until you quietly passed into the Long Dark.
A corollary effect was on the members of the health profession. A doctor in Britain who worked ninety hours a week got paid exactly the same as a doctor who worked forty hours per week. (Often they worked less.) And it was rare that there were any changes for quality. World-renowned surgeons in Germany and France made only a fraction more than less competent doctors.
In the U.S., on the other hand, they could write their ticket.
The brain drain was not severe at the time of the Plague but it was telling. More and more top-flight doctors had left to find greener pastures. For that matter, doctors in less developed countries had flooded into the U.S., where they might not make a fortune but they got paid in more than chickens and hummus. They filled the corner "Minor Emergency Centers" as well as being the front line general practicioners, a field most American born doctors disdained as the most plebian of medical fields.
This was what the good doctors at the CDC learned when they set out to prove that American healthcare, with its dependence on the free-market, doctor/patient choice, HMOs and pharmaceutical companies was far inferior to the enlightened healthcare of "socialized medicine" countries.
They discovered the irrefutable truth that when you put the same sort of people that run the Post Office in charge of your healthcare you get Postal Workers for health care providers. And more people die in less necessary ways.
So let's go back and look at the effect of H5N1 on populations.
In its initial discovery, mortality among affected populations, primarily Chinese poultry workers, was right at 60%. Two out of three who were infected died despite best efforts on the part of local (socialized medicine) doctors. This continued as a pattern during the long period that H5N1 was confined to avian to human transmission.
Across the board in unimmunized populations with access to "universal healthcare" the same pattern emerged. Two in three unimmunized patients who were admitted to healthcare environments (less than 10% of the affected at the height of the Plague) died.
In the U.S. the rate was one in three.
Thirty percent vs. sixty percent. Still a horrific number, total death-toll from direct effects of the Plague are estimated to be around a hundred million. But if the rate had been the same as Europe's, the death toll would have been twice that.
Why?
It had been a puzzler even before the Plague. One reason that there was a somewhat slower response among the public to H5N1 was that there had been an earlier scare involving something called SARS, Severe Acute Respiratory Syndrome. It had also started in China, there had been a cover-up that affected a large and never clearly documented number of cases with estimates ranging from five hundred to fifty thousand and mortality rates similar to H5N1. It had broken out into Thailand and Singapore and even spread into Canada. Everywhere the rate was the same, serious pulmonary distress that led to death in five of ten cases. Including in Canada, which was prepared for it and responded very fast to the discovered cases.
Cases that reached the U.S. were given a different name: MARS; Mild Acute Respiratory Syndrome.
Same exact bug. Fifty documented cases in the U.S. No. One. Died.
Why?
Think of Dr. Van. A physician who cooled his heels for nine hours in a waiting room after telling the triage nurse that he probably had a deathly illness.
By the same token, cases in the U.S. called their private general practitioner and told him that they were very sick. They were seen within no more than two hours and admitted within less than an hour afterwards to the hospital.
Cases in Canada which were detected through investigation got similar speedy care. More of them survived than those who were first cases. Speed of care was preeminent. Yes, too often it simply didn't work. And as cases burgeoned the healthcare system in every country became overloaded. But in the U.S., people didn't just have to go to the local health clinic. As hospitals became overloaded, doctors often shifted to the old fashioned home-visit. Where they could not, there were thousands of minor healthcare providers, mostly LPNs and Medical Assistants, from that increasingly lucrative industry who were pressed into service. The number of providers in the healthcare industry in the U.S. had been exploding as the population aged while it had been more or less stagnant in Europe. Because there was money in them there old people there were just more healthcare workers per patient.
Many of them worked through the height of the Plague for little or no money. The economy was tanking, fast. They worked in the hopes that they'd get paid and eventually most of them did.
This was one reason that the mortality rate from direct effect of the Plague was lower in the U.S. than in other modern countries. (Countries which never had their act together simply sank lower. I'll discuss my personal experiences of that later.)
A secondary reason is debatable. It had been debated as far back as the SARS scare and still remains questionable. But there is now some corroborating evidence based on analysis of mortality rates in various populations based on their lifestyle. It is, however, detested by most health care persons and every remaining "organic lifestyle" lover on the planet.
Hormones.
We're back to industrial farming. Yep, we injected our livestock with all sorts of shit. Growth hormones for the beef and goat stock. (Yes, we raised goats for meat. There was a pretty good market before the Plague.) Milk generating hormones in the milk cows. We used "genetically modified" seeds that were hyper-resistant to dozens of pathogens. We sprayed herbicides and pesticides and laid down fields with ammonium nitrate (the stuff terrorists use in big bombs) to increase yields. We used every trick in the book and most of the bigger farm corporations we competed against used the same tricks, just not as well as we did or we'd have gone out of business.
And you all ate it every day. For that matter, at the food factories, and there is no other term for the way that food was processed, it was then injected with more "stuff." In some cases it was vitamins. Preservatives. Colorations.
The U.S. was the most heavily chemicaled food on earth. Sure it had some effect. Was it a contributor to obesity? Don't know and there's no clinical evidence. Ditto "early maturation": those cute little girls that got their boobies way too soon. But it was in your bodies. If you weren't a health nut. And be glad you weren't.
One study that is roundly castigated still but pretty hard to argue showed that people who were "uncaring" in their food choices had a five percent lower mortality rate than people who were "careful" in their food choices. The language of "uncaring" vs. "caring" was explained in the codicil that "caring" meant they ate, to the greatest extent possible, organic and natural foods. Uncaring meant they stuffed whatever in their maw and didn't give a shit how it was raised or what was in it as long as it was tasty.
The problem with the study, with which I agree, is that there is no mechanism explained for the effect. Got that. But that was what the pope's Inquisition said about Galileo. Sure, he thought that the Earth revolved around the sun but he didn't have a mechanism. Gosh, he might even have evidence, but he couldn't show why that was the case whereas the "scientists" of his day had thousands of years of built-up stories about how the sun revolved around the Earth. And my answer is the same as his: "It still moves!"
In the U.S. SARS, a huge health threat everywhere else it touched, became MARS, a very bad cold.
Part of that was, unquestionably, free-market medicine vs. socialized. Absolutely. But another fraction, also as unquestionably, was that Americans had so much shit in their bodies it was amazing we decayed at all. All those chemicals had some negative effects,
sure. But they also have some positive. That's the part that healthcare nuts and organic fruits don't want anyone to realize or talk about.
Fuck 'em. It still moves.
Here is another that relates purely to H5N1. It's just a hypothesis because nobody has been able to do a good clinical study on it. (Several people have tried.) And it's kind of weird.
Social distance.
First I've got to talk about, yeah, virology and binding. (Lord I was trying to avoid this.) Prepare for major MEGO.
The common "seasonal" flus are referred to as H3N2 and H1N1. Both have a binding protein that binds to specific proteins in the upper respiratory system. (Can you say sinus pain? And fever and all the rest once your good old immune system kicks in.) Then, maybe, it moves to the lungs and you get coughing and if it gets bad a secondary bacterial infection (pneumonia or bronchitis depending on how bad it is).
H5N1 in its classic "bird flu" form bound to receptors in avian intestines. (It's an intestinal flu for them.) Which was why at first only poultry workers got it. They got it from breathing in chicken poop. Because there are similar receptor proteins in human lungs. Not the same. Similar.
(By the way, on an interesting aside. Influenza, in general, may be the oldest pathogen around. The genetics indicate that it goes all the way back to intestinal flu in dinosaurs. So the next time you're sneezing and coughing, just remember: Species come and go but the flu is here to stay. Take it like a man. End aside.)
