Begin with one of the most appalling statistics about American health care–our infant and young children’s mortality rates, which for people of color in some parts of the American South ranks with that in Third World countries, countries with health care systems Americans see as much worse than ours.

H1N1 is already having an impact on those rates. It will be interesting to see when the World Health Organization releases its numbers for this year how much is that impact.

Nothing is more heart-rending than the death of a child. Nothing is more morally indefensible than the unnecessary death of a child. Nothing says more about a society’s values than how it treats its youngest and most vulnerable.

Each of those tragic deaths leaves a hole in the fabric of our society that can never be mended.

That is one reason I chose the image of the Star-Spangled banner for this blog, because like that flag, this society has many holes in it. Its fabric has been torn and shredded by injustice and inequality. But I still believe in the values that gave birth to that flag however imperfectly we have managed to carry them out.

If we could just get on the “high” side of medical care; into the prevention of the diseases we would ALL be better off and it would cost ALL of us less.

I belong to Kaiser Permanente; and I cannot debate the problems that people of color have had with them but I look at their model of health maintenance and figure that they are rationally picking what costs less. On the plan that I have and I think the majority of their plans things like vaccines, lab work, mammograms etc are included at no extra charge to encourage their clients to use them. So if everyone had these things offered to them and used them then overall medical costs would decline. Early discovery of many medical conditions would greatly reduce the dollar cost and the human misery involved. Can you imagine the early detection and treatment of diabetes? It would reduce the damage of high blood pressure, heart disease, atheroscloersis, the kidney disease and the number of amputations performed on diabetics. The high blood pressure and damage done by high blood sugar to the brain could be reduced and lower the amount of dementia. Why wait until 65? start early and it could cost a whole lot less; and in so many ways.

I know some readers are becoming frustrated with my references to systems thinking, but the lack of dealing with problems is a great example of that. Some may remember the old rhyme about “The House that Jack Built” which tells about a home in which one seemingly minor problem leads to another. If we think of health care as a system, then having people who are not insured an unable to access care (and BTW we are the only advanced democracy that persists in such a despicable practice) means that any one of those people could harbor a potentially deadly disease that has gone untreated for so long that it has spread widely before we realize it. The cost of the scenario in lives lost stands to far outweigh any terrorist attack.

Hathor, as usual you come up with another series of insights. The lack of trust by people of color of major social institutions is a serious issue and one that is rarely discussed or considered.

As for the vaccine itself, I am not enough of a medical expert to comment on its effectiveness, but sheer evidence would suggest that if there were serious problems they would have emerged by now.

The more serious issue that has been raised by some researchers is the whole question of over-prescription not of the vaccine but of antivirals. Everybody with a bad cold is going to want antiviral drugs. Overuse of these could produce a more resistant–and hence more deadly–form of the virus.

One reason people want antivirals at the first signs of a possible flu infection is the hype over H1N1. This, as I pointed out, is major failing on the part of the CDC in refusing to release more detailed statistics. Which points to your second observation: people do not have reliable information.

When you look at the three studies cited in the articles above, a large number of H1N1 cases that ended up in the ICU involved high-risk or other complicating factors. Yet each day the media announces another death from H1N1 without telling us the details. So we assume the disease kills at random–which it does not.

All this brings me back to the point in the article–H1N1 serves to point out the flaws in our health care system, a system that needs to be fixed.

One more point Hathor raises–the lack of people of color in the health professions. Field has a great post this week on his site about the possible closing of historically black colleges, institutions which traditionally have produced a significant number of black medical professionals.