Ebola in Texas: For-profit health care system exposed

On the evening of Sept. 25, Thomas Duncan walked into the emergency room of Texas Health Presbyterian Hospital in Dallas. He told the nurse that he felt ill with strong stomach cramps. He was found to have a fever. He also told the nurse that a few days earlier he had arrived in Dallas from his home country of Liberia, which is suffering from an epidemic of Ebola.

Instead of following federally issued guidelines that a patient with a fever from an Ebola-ravaged country must be admitted and placed in isolation, Texas Health Hospital gave Duncan a prescription for antibiotics and sent him out the door.

Frantic relatives called Texas and U.S. health officials, including the Centers for Disease Control, as Duncan’s condition worsened. They did nothing. On Sept. 28, a full three days later, as Duncan became violently ill, an ambulance crew with three emergency workers was summoned and took him back to Texas Health Hospital.  The workers were not warned that their patient might be suffering from Ebola.

Thomas Duncan was admitted to the hospital and placed in isolation. Two days later, the Ebola diagnosis was confirmed.  Only then were the people whom Thomas Duncan was visiting notified that they were in quarantine. The same happened to the three ambulance workers and other hospital workers. Five children whom Duncan had had contact with subsequently spent a day at school, and another went to school for two days.

Duncan’s soiled linens remained locked in quarantine with the families for a number of days before they were removed.  The delay, it was announced, was due to “a paperwork snafu.”

Why did Texas Health Hospital fail to properly treat Thomas Duncan when he first appeared there?

Millions lack health coverage

Hospital management at first said that the emergency room nurse failed to report to the doctors that Duncan had recently been in Liberia.  Then they changed their story to blame a computer software glitch that prevented other staff from being fully informed. Finally, they said that all the information was indeed relayed to the staff, offering no explanation for their failure to treat it seriously.

Could it be that Thomas Duncan was not admitted to the hospital for more careful diagnosis because he has no health insurance? Is it a coincidence that this happened in Texas, where the right-wing governor and legislature have prevented Medicaid insurance coverage for millions of people? Texas has one of the highest rates of uninsured people in the country.

This Medicaid denial has swamped emergency rooms like the one at Texas Health with people who cannot afford to go to a doctor or an urgent care clinic. The results are particularly alarming at Texas Health.

“The hospital scored significantly worse than the state and national averages in five of six emergency care indicators, with emergency room wait times twice as long as the averages, according to data from the U.S. Centers for Medicare and Medicaid Services.” (“Before Ebola failure, Dallas hospital saw long emergency waits,” dallasnews.com, Oct. 2)

Some 13.8 percent of workers and their families in the U.S. — 43.3 million people — still do not have health insurance, even with the startup of Obamacare.  Millions more would be charged such high copayments that they simply cannot afford to sign up for medical insurance.

“This reality,” says one newspaper, “is compounded by a weakened public health infrastructure: 52 health agencies, including 48 states, three territories and Washington, D.C., have reported budget cuts since 2008.” (“The uninsured in U.S. raise Ebola risk,” chicagotribune.com, Oct. 2)

Ebola is a terrible disease. It has killed more than 3,000 people in western Africa and threatens millions more.  It flourishes in countries ravaged by the exploitation and greed of decades of colonial rule, by conflicts between communities sparked by divisions created by those same imperialists, and by the denial of any meaningful development of health, education, transportation or other necessary services.

In short, U.S. and European imperialism created the perfect incubator for diseases like Ebola and denied the people of those countries the tools to fight it. And although the first cases of the disease were reported nearly four decades ago, the giant drug companies have not expected enough “monetary incentive” (profit!) to develop a vaccine.

Now that this disease has arrived in the U.S. with the case of Thomas Duncan, the fundamental failure of the U.S. health care system is being exposed. Its ability to protect the people from diseases like Ebola is compromised because it is designed to make profits for health insurance companies, hospitals and drug companies. Those who cannot afford to pay, very often get the runaround, which, as in Duncan’s case, can expose many others to dangerous diseases.

Profit-driven decisions regarding health care endanger all workers and communities everywhere, here and abroad.  Only when health care is provided as a basic human right for all will we be able to effectively combat the threat of this awful affliction and others like it.