There is something intuitively appealing to me about possible parallels between a healthy homeland and a secure homeland.
Homeland security is about terrorism, disasters, national security and a few other things. Could it also be about health care?
The national attention is focused on health care. From an “all imaginable hazards” perspective, one might make the case that health care is a homeland security issue. I think there is a case, but its pulse is weak.
Public health is the most obvious connection to homeland security. Presumably a significant fraction of the country’s 50 million uninsured will delay seeking professional care if they develop flu-like symptoms this autumn. In a naïve theory about how things happen, this delay in seeking treatment could speed the spread of a Round Two H1N1 event.
But the little I know about pandemics suggests insurance status will not be a huge part of a prevention strategy. By the time symptoms show up in anyone — insured or not — the virus has already been shared.
If H1N1 or a related biological event gets really bad this fall, that might shine a wide light on the inadequacy of the country’s medical surge capacity. We already know there are nowhere near enough ventilators, for example, to take care of the hundreds of thousands of people who might need to be hospitalized. Where else is our medical care system vulnerable?
Public health and hospital capacity are important concerns. But it would be a stretch to tie them to the current health care debate.
Is there a compelling economic argument that can link homeland security and health care?
Approximately 20 cents of every dollar spent in this country goes to health care — actually, medical care; but any productive discussion about the difference between the two concepts has been drowned out by the squealing over euthanasia gulags.
If health care spending were contained, reduced, or directed more efficiently and effectively (pick your argument) that might free up funds for other concerns more directly related to preparedness, resilience, or rebuilding our infrastructure (pick your argument).
Congressman Peter DeFazio represents the district I live in. He held a town hall meeting on Wednesday to talk about health care and to find out what his constituents have to say. DeFazio is also a member of the House Committee on Homeland Security. I asked him (on a local radio talk show Wednesday morning) if there was a link between security and health. He tried to make a connection, but it didn’t sound like his heart was in it.
He was about to head off into the uncertainty of an August 2009 town hall meeting. My sense was he was primed more for death camp, socialism, and Obama-wasn’t-born-in-this-country questions, rather than noise from left field (ok, right field).
I went to his 9:30 AM town hall meeting. I was expecting to see a few youtube moments.
When I arrived, there were more than 400 people waiting to get into a room that held 250 people. They were waiting to talk about health care. The room was too small, so someone decided to move the meeting into a parking lot.
400 people. And this is in a town where three people in front of you at Safeway is a crowd, and something to talk about at night.
My initial thought when I saw all the people was “What would we have to do to get 400 people to show up to talk about the Quadrennial Homeland Security Review or about anything that has to do with homeland security?”
I couldn’t think of anything.
DeFazio answered questions for an hour. He agreed with some people and disagreed with others about a full plate of the usual issues: tort reform, payment systems, abortion, immigrants, quality of care, choice, costs, insurance companies, Medicare. Even euthanasia and socialism had the opportunity to rear their vacuous skulls.
No one brought up homeland security.
Facts, rumors, and more than a few sad personal stories and fears about medical issues filled the sometimes raucous parking lot. A few people yelled and interrupted questions and answers with talking point slogans. But only a very few.
(In a caricature of media distortion, at least one local television station featured a video that focused mostly on the screechers.)
There were a half dozen police officers standing in the wings. But the crowd policed itself, occasionally lifting signs that asked for discussion instead of disruption.
At the end of the hour, DeFazio said his goodbyes and moved on to the next town hall. Most of the 400 people left to resume their day. But a lot of people hung out in the parking lot talking about health care.
I doubt anyone’s mind was changed by this shchi of Q & A and street theater. I went away still unable to make a convincing connection between homeland security and the current health care conversation.
Or so I concluded as I walked back to my car.
During the rests of the day I thought about people in Iran who had been arrested and tortured for daring to do what the people in my town unreflectively consider their inalienable right. Someone made those signs that asked for Discussion and not Disruption, or warned about the Evils of Obamacare, or demanded a Single Payer System. In many countries, getting caught with a political sign can shift your life forever.
One thing our present fixation on health care demonstrates is that in many parts of the country representative democracy is pulsatingly alive. In spite of youtube and other media tumescence, people can come together in a public place, talk with — occasionally yell at — elected officials, agree or disagree about issues they care about. But they care.
I wish we could see that kind of passion in homeland security.
But maybe I did.
Perhaps that’s what I saw today.