Featuring Dr. Tony Iton, Senior Vice President for Healthy Communities at The California Endowment: Learn how deforestation and climate change are increasing the likelihood of future pandemics and what America can do to prepare for them. In this second of a podcast series with host Brenda Gazzar, Dr. Iton explains how our market-based healthcare system incentivizes profits over public health investments. How would Medicare for All help us respond to future crises? The answer is more complicated than you might think!
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(Opening MUSIC – “Talk Back” 5 seconds, fade down)
Welcome to Code WACK!, your podcast on America’s broken healthcare system and how Medicare for All could help. I’m your host Brenda Gazzar. Today we’ll hear from a public health expert about the coronavirus crisis and how America can be better prepared for the next pandemic.
We have Dr. Tony Iton again with us. He’s the senior vice president for Healthy Communities at the California Endowment, a statewide health foundation and he previously served for seven years as director of Alameda County’s Public Health Department. This is the second episode in a series with Dr. Iton about the deadly coronavirus.
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What can you tell us about these kinds of viruses and what can we expect going forward?
Iton: We know that for a variety of reasons, including climate change, we’re going to be facing epidemics and possibly pandemics of zoonotic infections… that generally are viruses that live in a reservoir, typically a wild animal reservoir because we’re cutting down forests and bring wild animals into markets and just encroaching upon wild spaces. Human beings are coming much more into contact with these reservoirs of wild viruses and those viruses are making the leap into humans and when they do, they’re now in a space where there’s no immunity and so they can move very quickly and that’s what happened with SARS and MERS and now COVID 19.
Climate change is forcing a lot of those kind of interactions both from people consuming wood and deforesting wild environments as well as temperature change, which is driving wild animals in search of food and in search of water into closer contact with human beings and of course you know you have vectors like mosquitoes and rodents and the like which can also facilitate the transmission of these viruses from animals to humans.
So as climate change progresses, we’ll likely see an increase in threats to our health. How should we respond? What health policies and practices should we consider?
Iton: Well, we have to essentially build up our defenses which is our public health system. I mean the failures that we had in this outbreak in testing supplies was not the first time we’ve seen that. We saw these very same failures in 2009. They didn’t have the same consequences but the delays in CDC and the federal government authorizing tests and facilitating testing standards to get to public health labs and the private labs happened exactly the same way in 2009. It’s like deja vu.
H1N1 ended up a good deal less destructive than coronavirus…So we need to fortify our public health defense structures and you know make sure that we have adequate both public health personnel as well as the laboratory capacity and the kinds of immediate response mechanisms that allow for information, surveillance information to come from a place like China or Africa or South America or even in the United States to quickly rise up and be flagged centrally so that we can trigger the kinds of public health defense responses that are necessary
Regarding surveillance and tracking, could having Medicare for All help?
Iton: If it’s designed right…We’d have to design our system to be tightly wedded to a good public health system particularly for purposes of surveillance and for purposes of doing disease control, responsive practices like vaccination and if there are therapeutics that need to be created to treat people quickly in the event of an emergency, we can design our system to be much more effectively guided by public health goals as opposed to just treatment goals.
Thank you. Are there other ways Medicare for All – as opposed to our current system – could help Americans respond to public health crises like this one?
Iton: This is the big question. What are the incentives in our healthcare system today and disproportionately even for the not-for-profit ones, disproportionately those incentives are an economic bottom line. For the not-for-profit ones, it’s basically survival in a competitive market. For the for-profit one, its shareholder value and if that’s the goal of your system is not going to want to make the kinds of investments in redundant capacity that’s necessary for something like a pandemic. It’s not going to want to make the kind of investments that are necessary for, you know, public health surveillance. All of that is essentially eating away at its bottom line so those aren’t things that these systems are going to try to optimize. If you take the profit motive out as does Medicare for All out of the healthcare insurance industry and to some extent out of the providers’ hands — you still have private providers participating in the single-payer system — but if you can construct incentives to try to improve health as opposed to try to maximize profits then yes you know Medicare-for-all can actually serve to better prepare us in the event of a pandemic because folks will be thinking, we need to have some extra capacity for ventilators or the ability to move some of our beds into ICU beds in the event of a pandemic because our goal now is to improve health, not just a profit.
Thank you so much, Dr. Iton! Find more Code WACK! episodes on ProgressiveVoices.com and on the PV app. You can also listen to our episodes at HEAL dash C-A dot org. This podcast is powered by HEAL California, which uplifts the voices of those fighting for healthcare reform around the country. I’m Brenda Gazzar.
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