Tuesday, October 14, 2014

Ten Billion Dollars Shot To Hell

So the other day, among the conga-line of jacktards bloviating on Ebola, some supergenius came out and tried to palm off Ebola, and the lack of a vaccine to prevent it, on Republican cuts to the CDC and the NIH.

Which only has two problems: The budget for the Dept. of Health and Human Services has risen in every year, probably as far back as you'd like to check. And while my concept of the powers of government may be a bit fuzzy, I seem to recall that the Department of Health and Human Services is a cabinet-level agency in the executive branch of the federal government, and that the Secretary of HHS is appointed by, and serves at the direction and pleasure of the President of the United States.

So if there's some shortage of money, and it isn't getting spent on the important things, maybe someone can tell me who the hell's been the president since January 20, 2009?

And secondly, maybe show me the links to stories stating who the ever-missing "they" are, who were crying, wailing, and begging on their knees for more money for an Ebola vaccine, until the mean old Republicans said "No!".

Ferris Beuller...?

Yeah, thought so.
This isn't about partisanship, it's about competence. Or the lack of it.

So, I got to wondering what has it been like over at CDC anytime lately.
Let's check the videotape, sportsfans:

CDC.GOV Budget Overview FY2012(at the bottom of Pg. 4 if you're checking)
 Improving Preparedness and Response to Public Health Emergencies
The FY 2012 Budget request provides more than $1 billion for biodefense and emergency preparedness activities in CDC, a decrease of $70 million below FY 2010. Within the total, $643 million is requested for the Public Health and Emergency Preparedness grants, a decrease of $72 million below FY 2010. Great progress in preparing for public health emergencies has been made at the State and local level with the Federal investment of nearly $9 billion in funding from 2001-2012 for these efforts. CDC will work with states to prioritize preparedness activities and focus on areas of need. These grants support local public health preparedness efforts.

That was Fiscal Year 2012. Three years ago. Under two presidents. So I'm sure they got more than another $Billion since then, but I'm frankly too disgusted to get into that detail, and would rather understate it than overstate it. It's clearly been at last $10,000,000,000 since 2001.

For "Biodefense and Emergency Preparedness Activities".

Which, a reasonably intelligent person might be forgiven for assuming, ought to have conveyed some bare rudimentary ability to deal with one Ebola patient arriving on our doorstep.

The Reality: Not just no, but HELL NO!

Were we prepared to put protocols in place to prevent the entry of infected persons, after some pestilence overseas had run wildly out of control for 6 months?
Did we have any screening methods in place that would prevent someone infected from bringing a deadly disease to the heartland of the country?
Were there any procedures that all hospitals were so well-drilled in, that were an infected person to seek treatment, they would be properly noted, safely sequestered, medically isolated, and properly treated?
Are there standards and guidelines for every hospital that are easily referenced and foolproof in practice, that would ensure the flawless activation of response and containment, should such an infected person turn up here anyways?
Have any lists of proper equipment, isolation and treatment procedures, and clinical area layouts been proposed, rigorously tested in the field, modified by clinical experts, and then disseminated to every hospital in the country, and who've been drilled on them not less than annually, in case of any sort of biological outbreak crisis or terrorist attack emergency?
Is there a vast reference library of government information available on the internet, including well-thought out and expert peer-reviewed protocols and procedures, along with government-produced explicit training videos, updated regularly, and available to anyone who'd ever want them, free and instantly, at the click of a mouse on the Internet, to cover every major and minor aspect of proper preparation and performance?
Oh God No.

Which can only lead one to wonder,

  "I have no frickin' idea where that money went."


Shrimp said...

Ah, but politics....

If the news media can bleat repeatedly that this was the fault of someone else (i.e. Republicans), then the Democrats could possibly win the midterms.

So, never let a crisis go to waste.

Anonymous said...

Having been involved in emergency preparedness and safety, I can say that MOST corporate preparedness and safety programs (especially for low likelihood things like ebola) consist of developing a 3 ring binder of "processes" and putting it on a shelf somewhere. Most of the "developing" consist of purchasing an off the shelf plan, or cutting and pasting stuff off the internet.

Very few people outside of the person assembling the binder ever even open it. When you do open it, it is usually full of VERY general statements. After all, you can't get in trouble for making a wrong recommendation, if you don't make any.

The number of mandated plans that companies and facilities are required to produce is staggering. And like most .gov mandates, there is no extra money provided (I don't know where the CDC money got distributed, but it certainly wasn't to anyone I worked for.) So the plans get done as quickly and cheaply as possible-- with the reasonable expectation that this is nothing more than an check box requirement, and they will never be looked at let alone USED.

Unfortunately, when you DO need the plan, you are F'd.


Percy said...

Not surprising, but remarkable all the same.

For a smaller, but similar, "Then what the hell were you doing with all that money?" demonstration of utter governmental incompetence and indifference to life, when the responsible agency was established precisely to be virtuous and protective instead, see yesterday's revelations about auto highway guardrails turning into deadly spears in crashes by the NY Times ("Highway Guardrail May be Deadly," October 13, 2014). This demonstrates yet again, on a smaller canvas, the continuing indolence and indifference of the federal government to something threatening everyone who takes to the road in an automobile.

Surely this is so throughout government, no matter what political party is in charge. That is, the problem is endemic. It is not because bad or mentally stunted people are at work in these agencies. It is something else. I suspect that, as usual, it is mostly all about the money: protecting businesses, individual reputations (read job retention, future job prospects, reelection prospects, and so on), the ability of the state to avoid expenditures it feels it cannot afford and does not wish to take on (because it is already stretched in what it is paying out in other, relatively meaningless or, worse, entirely corrupt payoffs to political cronies and the like). And the simple, recurrent factor of not embarrassing the boss if you want to stay and get ahead.

The real mystery is why this has not been enough to bring out mobs with torches, guillotines, and nooses. Is it because we are all human and therefore flawed, regularly being doing cowardly, stupid, selfish things -- and therefore understand (the "they're doing the best they can" meme) and forgive the culpable? That is, who among us would be spared from the blade or the rope?

Anyway, here at last, with ebola, we have a potential extinction event, not comparable to deadly highway guardrails and other relatively small beer. At the very least the CDC should be cleansed of those responsible -- and at once. Those should be publicly disgraced, though they are doing a pretty good job of that themselves (if only we knew all of their names and what each looks like). Perhaps criminal prosecution might be available.

Even losing football teams know how to get rid of failed coaches. Can't we muster that same will to do better here? If further delayed in the case of dealing with ebola, it could soon be too late (that is, not just losses of games, but no more football team). Maybe it is already.

Anonymous said...

This is very good stuff, please keep posting. It makes me angry and concerned unfortunately but reality is a bitch sometimes.

I sincerely hope that more and more people read it and become worried about the incredible complacency, wastefulness, and incompetence exhibited by some of those who we are paying to protect us.