Free Markets, Free People
GOP Know-Nothings Fought Pandemic Preparedness
posted by John Nichols on 04/27/2009 @ 08:00am
When House Appropriations Committee chairman David Obey, the Wisconsin Democrat who has long championed investment in pandemic preparation, included roughly $900 million for that purpose in this year’s emergency stimulus bill, he was ridiculed by conservative operatives and congressional Republicans.
Obey and other advocates for the spending argued, correctly, that a pandemic hitting in the midst of an economic downturn could turn a recession into something far worse — with workers ordered to remain in their homes, workplaces shuttered to avoid the spread of disease, transportation systems grinding to a halt and demand for emergency services and public health interventions skyrocketing. Indeed, they suggested, pandemic preparation was essential to any responsible plan for renewing the U.S. economy.
But former White House political czar Karl Rove and key congressional Republicans — led by Maine Senator Susan Collins — aggressively attacked the notion that there was a connection between pandemic preparation and economic recovery.
Now, as the World Health Organization says a deadly swine flu outbreak that apparently began in Mexico but has spread to the United States has the potential to develop into a pandemic, Obey’s attempt to secure the money seems eerily prescient.
And his partisan attacks on his efforts seem not just creepy, but dangerous.
According to this theory, if not for GOP opposition to one particular line item in the stimulus bill, everything would be perfectly hunky-dory right now. The leftosphere, having received their marching orders, responded dutifully:
Christy Hardin Smith: “Pandemic preparedness? Another GOP casualty. Dude, where’s my planning?”
Washington Monthly: GREAT MOMENTS IN POLITICAL INSIGHT (“On Feb. 5, the same as Collins unfortunate remarks, Karl Rove had an op-ed in the Wall Street Journal complaining about stimulus package, in part because it included money for ‘pandemic flu preparations.’
Sometimes, these folks just don’t think ahead.”)
It’s hard to know where to begin with this sort of nonsense. Competing for most ridiculous premise is the idea that a couple of remarks from Susan Collins and Karl Rove (who does not vote in Congress) were able to back off the entire Democratic Party. You know, the ones who control the House and Senate? I mean, how spineless do you have to be if you control the House, the Senate, and the White House, but you can’t stand up to one little old lady from Maine and a former politico? Pretty wimpy I’d say.
We’re also apparently expected to believe that pandemic flu was a big issue during the days of stimulus debate, instead of the impending financial collapse unless Congress did something (anything!). My recollection of those heady days in January and February conjures up much back-and-forth about whether the bill would save jobs, but nothing about whether we should do more to prevent a flu pandemic. Come to think of it, isn’t that why it was called the “stimulus bill” in the first place, as in to stimulate the economy? And wasn’t there a bunch of hullabaloo about so much pork being in the bill? Yes, I’m sure I read about that somewhere. Indeed, even Chuck Schumer was calling appropriations for pandemic preparations “porky”:
He [Chuck Schumer] said the compromise hammered out between Senate Democrats and moderate Republicans – which has enough support to get it past any threat of a filibuster – was far better than that passed by the House on Jan. 29.
“All those little porky things that the House put in, the money for the [National] Mall or the sexually transmitted diseases or the flu pandemic, they’re all out,” Schumer said.
Clearly, beefing up the federal government’s response to a flu outbreak was not the priority during the stimulus debate.
The “GOP did it” analysis also seems to suffer from that problem of time beginning on the day Obama was elected. It’s further complicated by the fact that, even if Obey’s appropriation had been included in the stimulus bill, it wouldn’t have the government in any better of a position than it is now (a fact which the legislators seem to understand since they had exempted Obey’s provision from the requirements that the money appropriated be used within 30 to 90 days (i.e. section 1103)). Regardless, the idea that the money appropriated less than two months ago would save our bacon today is unrealistic at best.
But doesn’t that just beg the question: what preparations have been made for a flu pandemic? Seeing as it’s so frightfully important that we are ready and eager to blame an entire political party for potential ill health, why is it that we’re only hearing about it now? What took Congress so long? Well, nothing actually:
What’s scarier in Washington, the prospect of a flu virus that could kill millions or the possibility that voters will toss out any politician who fails to prepare the nation for such a disaster? A pandemic could be a true global catastrophe, of course. But along the Potomac the second threat is also very real. That’s a big reason why both the White House and Congress are rushing to boost America’s capacity to produce vaccines and drugs against flu and other diseases.
On Oct. 18 the Senate Health, Education, Labor & Pensions Committee hurriedly passed a bill that would offer vaccine makers new liability protections and incentives for research. And the Administration is about to issue a flu pandemic plan expected to be extremely aggressive. “There is a sense of urgency on both sides of Pennsylvania Avenue,” says Senate Budget Committee Chairman Judd Gregg (R-N.H.).
That would be an article from October 2005 when the “White House” referred to President Bush, and “Congress” referred to the Republican controlled body. Seems like the Republicans were worried about a flu outbreak after all. How worried? Enough to spend gobs of money on it which, although comparatively paltry in these post-bailout days, completely dwarfs the proposal from Rep. Obey:
In 2004, Congress approved Project BioShield, a plan that would spend $5.6 billion over 10 years to jump-start production of vaccines and drugs to counter bioterror threats.
Again, that would be a GOP-controlled Congress. Of course, the GOP hasn’t always been in control. Many will recall that the Democrats swept into power in 2006. This was heralded as the harbinger of great change, and the first wave of the Democratic majority. What fun! Seeing as how important legislating against a flu pandemic is to the Democrats, surely they did something to improve upon the meager sum approved under the reign of the hated Republicans:
The fiscal 2008 Consolidated Appropriations Act working its way through Congress this week allocates only $76 million for pandemic influenza preparedness funding for the Health and Human Services Department, though the Bush administration requested a budget of $870 million for it.
The bill also chopped in half requested funding for the HHS office managing efforts to develop a national electronic health record system.
While House and Senate appropriations committees said they continue to support HHS pandemic flu preparation efforts, they indicated in the bill that they decided to cut the 2008 pandemic preparation budget because approximately $1.2 billion remains available from funds provided in previous appropriations.
Oops … I wonder how much of that $76 million is still left? It kinda makes you think that preventing and/or preparing for a flu pandemic wasn’t really such a big priority for the Dems, now doesn’t it? Yet somehow, in the heat of the debate over whether it was a good idea to mortgage the future of a few generations of Americans, it’s Susan Collins’ and the GOP’s fault that a swine flu outbreak has occurred, and the federal government may not be prepared for it. Yeah, that makes sense.
Well, I guess we should just chalk it all up to another crisis that Rahm doesn’t want to go to waste. Nothing like the good ole game of playing politics with people’s fears of becoming deathly ill. Not that any of the leftosphere would ever approve of such tactics, seeing as how moral and sanctimonious they seem to get. [/eyeroll]
MORE: I wonder which would be more effective in dealing with the swine flu outbreak — appropriating hundreds of millions more dollars on pandemic preparations, or staffing the HHS that would be in charge of actually spending the money? I know how John Nichols and the Nation (and, therefore, the leftosphere) would answer. For them, this must just be an inconvenient distraction:
The Obama administration declared a “public health emergency” Sunday to confront the swine flu — but is heading into its first medical outbreak without a secretary of Health and Human Services or appointees in any of the department’s 19 key posts.
President Barack Obama has not yet chosen a surgeon general or the head of the Centers for Disease Control and Prevention. His choice to run the Food and Drug Administration awaits confirmation.
Smoothest transition EVAH!
EVEN MORE: I’m guessing that the fact-checkers at the Nation have been sacked:
(1) It’s a good point to make that Collins somehow thought pandemic preparation money was not an economic issue deserving of inclusion in the stimulus package. But Collins was for the money being included in some other form. Now, I think her reasoning is stupid — pandemic prevention is part of a recovery plan. But it’s not like she was against the very idea of it.
In fact she has voted for a number of bills that included pandemic prevention in the past, including the war funding bill of 2007. This undermines her point about which basket the funding is in, but also proves that she’s not against the idea of it.
(2) Relatedly, this money is actually the tail end of money ($7.1 billion worth) that President George W. Bush pushed for in 2005. So this is actually Bush money! To pin all this on the GOP is, thus, a little silly.
(4) Importantly, the vast majority of the pandemic prevention money was passed in March’s omnibus bill, which passed the Senate by (uncounted) voice vote.
And that’s from a Kosmonaut [via: MM].
This story typifies, at least to me, the problem we can expect in the health care field if government becomes even more involved than it is now:
Obama administration officials, alarmed at doctor shortages, are looking for ways to increase the supply of physicians to meet the needs of an aging population and millions of uninsured people who would gain coverage under legislation championed by the president.
The officials said they were particularly concerned about shortages of primary care providers who are the main source of health care for most Americans.
One proposal — to increase Medicare payments to general practitioners, at the expense of high-paid specialists — has touched off a lobbying fight.
Family doctors and internists are pressing Congress for an increase in their Medicare payments. But medical specialists are lobbying against any change that would cut their reimbursements. Congress, the specialists say, should find additional money to pay for primary care and should not redistribute dollars among doctors — a difficult argument at a time of huge budget deficits.
The trend for years has been away from general practice and toward specialties. Part of that stems from the fact that specialists are paid more than generalists.
Most of us understand that most of our medical care will take place in our latter years with the obvious exception of certain genetic and chronic diseases which afflict a portion of the younger population. So Medicare, which kicks in at 65 whether you want it or not, is a major payer (and player) to family practice doctors who care for older Americans that make up the bulk of their practice.
With that being the case, we’re seeing fewer and fewer medical students option to become family practitioners, preferring the more lucrative pay specialists earn. The consequent result of low pay, huge patient loads and little recourse for changing that has seen family practice numbers in medical universities drop alarmingly. Why spend all that time and money learning a particular craft when the rewards aren’t as great as you want?
So here we have the market for family practitioners reacting to a distortion in the market created by the government refusing to pay at what the doctors feel is an adequate rate for the treatment of the majority of their patients. The market’s feedback mechanism sends the signal to the potential doctor to look at areas which would be more lucrative than family practice to receive adequate compensation. That area is specialization.
The reason I bring this particular example up is the competing proposals. One say, “hey, if you want more family practitioners, pay them more – that provide the incentive to become a generalist”. On the other hand, there’s a proposal to do that, but to accomplish that increase at the expense of specialists who take medicare.
How do you suppose specialists will react? Well if they do as two of mine have, they’ll simply say, “sorry, we don’t treat Medicare patients”.
And how do you suppose such a decision would effect the number of family practitioners. Well, that would depend on how much they’re willing to increase payments to them.
In the era of massive budget cuts and the promise by government to “decrease” the costs of health care, any increase in my estimation, would by minimal and not enough to change the tide concerning family practice. But taking that increase out of what is paid specialists certainly might be the tipping point for many of them to declare they’ll no longer treat Medicare patients.
Certainly our old friend the Law of Unintended Consequences again at work.
You know, when you’re in DC it seems such a calm and beautiful place, and yet, the cynical machinations of politicians continue unabated.
We now have Nancy Pelosi under fire for essentially sanctioning the “advanced interrogation techiniques” by not speaking up against them or opposing them when she was briefed about their use many years ago:
Nancy Pelosi didn’t cry foul when the Bush administration briefed her on “enhanced interrogation” of terror suspects in 2002, but her team was locked and loaded to counter hypocrisy charges when the “torture” memos were released last week.
Many Republicans obliged, led by former CIA chief Porter Goss, who is accusing Democrats like Pelosi of “amnesia” for demanding investigations in 2009 after failing to raise objections seven years ago when she first learned of the legal basis for the program.
She and her staff can be as “locked and loaded” as they wish, but the fact remains that she’s said nothing about the use of those techniques for 7 years – not a single, solitary word to anyone about opposing them on any grounds.
So the use of these techniques wasn’t something which was going on in a dark corner out of the view or knowledge of Congressional leadership. Democrats have tried to sell that as the “conventional wisdom” – a fascist and authoritarian president making decisions that violate human rights behind closed doors and without the knowledge of the enlightened Dems who would surely have stopped it if they had only known.
But they did know – and said nothing. In the realm of Washington politics that is the same as giving something sanction.
More importantly, Democrats would like for you to believe that these things took place due to an out-of-control executive branch. However, and as usual, this all took place because both Republicans and Democrats in Congress allowed it to take place. When you have the information necessary to stop something you supposedly oppose and do nothing, you become as complicit as anyone.
So as I said in the beginning, Pelosi’s staff as “locked and cocked” as they wish, and they can spin it until they puke, but the fact remains she can’t plead ignorance and she certainly can’t say she did or said anything in opposition, and that that speaks louder than anything her spin machine can gin up in her defense.
Whether or not you agree with the use of the techniques doesn’t change the fact that when it came to “put up or shut up” time where leadership and principle were called to the fore, Nancy Pelosi blew it and any criticism or spin she or her staff now puts forward has the horrific stench of hypocrisy emanating from it.