Government's swine flu response: a factor in health reform?

Delays in swine flu vaccines may lead to less confidence in government's ability to manage any big expansion of new duties under health reform legislation. Some defend US swine-flu response.

Frank Polich/REUTERS
Some 1,200 people braved rain 39-degree-temperatures on October 24 to queue up for a free H1N1 flu vaccine at Richard J. Daley College in Chicago. President Obama has declared the H1N1 virus a national emergency.

As Congress finalizes a reform bill that seems poised to expand government's role in the healthcare sector, Americans are watching how the government handles a real-life, real-time public health issue: the swine flu.

The short supplies of a new swine flu vaccine, for instance, could make one or two lawmakers think twice about voting for a health reform bill that gives more authority to government – perhaps enough to change the vote outcome. Proponents of comprehensive health reform, on the other hand, say the government's handling of the pandemic has been competent overall and indicates that Washington can indeed help manage the nation's healthcare system.

"I anticipate that swine flu will come up in the [health reform] debate in the Senate and the House" in coming weeks, says Julius Hobson, a long-time health policy analyst in Washington.

The White House has acknowledged at least twice that broader judgments about the administration's swine-flu response could play into the broader healthcare reform debate.

In late summer, a senior White House official told The Wall Street Journal that "the expectation is that we should be able to [handle the swine flu pandemic] competently ... and judging the government by how well it does with this is not unreasonable."

Another administration official, also without attribution, told Newsweek's Howard Fineman last month: "Here is a chance to show government at its best, doing what only government can do well. Unless we screw it up."

Shortages of swine flu vaccine (more here, for one, have already cast doubt on the government's ability to react with speed and precision to a major health issue.

John Leifer, a health insurance and policy analyst, told the Kansas City Star that the White House may have allowed expectations to outgrow the availability and effectiveness of the swine flu vaccine, thus jeopardizing critical votes on a reform package.

"I think it is a political problem," Mr. Leifer told the Star's Dave Helling. "We all got the message 'The sky is falling, the sky is falling,' and now it's, 'Oops, the sky is falling and there's not much we can do about it.' "

Government officials expected as many as 120 million vaccine doses to have been available to Americans by now, but about 16.5 million have actually materialized. "I don't blame President Obama," writes the conservative Powerline Blog. "I blame the fact that the federal government isn't very good at delivering most services in a timely manner."

While the Centers for Disease Control and Prevention (CDC) and the Department of Health and Human Services (HSS) may have made some mistakes in gauging demand and availability, the vaccine shortage ultimately has more to do with the unforeseen difficulty some firms are having manufacturing the vaccine. On the whole, the five-month turnaround for a new vaccine is a record.

Mr. Hobson suggests that it will take "the hardiest of antigovernment people" to use the swine-flu response as an argument against healthcare reform.

"One reason the swine flu pandemic may turn out not to be as deadly as it might've been is the fact that [the government] was able to get folks' attention to change lifestyles," says Hobson. "Just look around: More people are [sneezing into their elbows] and everyone has installed those hand-wash boxes."


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