Don’t Depend on the Bureaucracy

What in the world do we need an Ebola czar and a new multi-layered bureaucracy when we already have a Surgeon General of the United States who has been designated the highest public health officer in the federal government and whose duties are to protect, promote and advance the health of the nation?

Dr. Boris Lusniak is the acting surgeon general and is an expert in skin diseases and holds a master’s degree in public health. He also has broad experience in special medical assignments across the world. He’s qualified and, as indicated by his biography, has been an effective leader in dealing with world-wide health problems. Theoretically he heads up an elite corp of 6,800 uniformed officer public health personnel and has military status (rear admiral).

Instead we get a political mover and shaker (and fund raiser/spinner) Ron Klain, with no medical experience or knowledge that anyone has bragged about. He replaces Dr. Thomas Frieden, chief of the Center for Disease Control who has the credentials and knowledge but made a series of mistakes. I say “replaces” but that’s not accurate. Dr. Frieden wasn’t replaced, but supplanted by pure politics. Dr. Frieden, for all his purported mistakes, had as his biggest problem that this country was not prepared – in spite of a huge bureaucracy looking after our health – to cope with an incident that was as the president said was, “very unlikely to occur here.” We spend more time and effort on designing nutritional school lunches.

Even critics of the administration think someone should head up the effort to deal with the threat of Ebola. They just don’t think it should be Klain. I agree, but find it appalling that the existing executive branch of government with all its money, knowledge and expertise, and millions of employees (including the surgeon general’s office and the CDC) has to create a new bureaucracy to handle any new problem. That’s a sad commentary on the organization of our government. Our government just doesn’t work very well for all its power and size – which might just be the problem.

No. I still don’t think we are going to have a full blown epidemic here. A handful of cases aren’t an epidemic. And, yes, other diseases such as flu are more widespread and kill thousands a year. The problem with Ebola is that it appears to be 70 percent fatal, plus or minus depending upon circumstances.

Also, it’s stupid not to stop people coming here from West Africa or quarantine those who do. In 2009, during the swine flu epidemic, my daughter-in-law and grandchildren, who were on a Christian missionary trip to China, were quarantined in their rooms for a week when they arrived. That made sense, too.

I agree, too, that the best way to control the epidemic is to stop it in West Africa. We’re helping to do that now – way too late and probably without enough vigor. Half measures aren’t going to do it. We have to rally the world to that cause. That’s partly the fault of another badly functioning organization: the World Health Organization. They have openly admitted that they didn’t move soon enough on the epidemic and that most of the WHO appointees in those countries are unqualified political hacks. That’s according to a recent internal memo obtained by the Associated Press.

All in all, the performance of government has been lacking mainly because we’re expecting too much. The federal government can’t oversee a country of this population and diversity and size. We have to be prepared on the local level. The Dallas hospital that handled the fatal case wasn’t, but just thought they were. Interestingly, the hospital at Emory University in Atlanta where the CDC is headquartered were and is. Why, for instance, didn’t officials at the Dallas hospital contact the Emory hospital which had already dealt with the problem and ask them for advice?

Having an Ebola Czar and a new bureaucracy is a waste of money and time, time being the most important aspect. The faster we bring implementation down to the state and local level the better off we’ll be. A little common sense would help, too.


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