Bigger Than Bioterror

No one wants to die of anthrax or smallpox or any disease cooked up in a lab by some sociopath. But as the threat of terrorism joins earthquakes and hurricanes as a part of the nation’s ever-present background anxiety, people are going to remember that complications of childbirth, or cancer, can leave a person no less dead. Then they probably will look askance at President Bush’s new budget, which showers public health officials with a whopping $11 billion over the next two years to protect against bioterrorism while depriving them of money to offer basic medical services to the nation’s poor.

Polls show that Americans consider health care to be a critically important election issue. Congress should take note and press Bush to move some of the money from the crucial task of fighting bioterrorism to the equally imperative job of bolstering a health system that effectively fights the diseases already undermining public well-being and morale. If the president resists, legislators will need to take the initiative.

For starters, they should reverse his proposed cutbacks of $57 million from the money the Centers for Disease Control now get to prevent chronic diseases like cancer and diabetes. They should also add money to help states with the soaring costs of Medicaid coverage for the poor and to roll back the $184 million in cutbacks the administration proposes next year for California hospitals serving low-income individuals and the uninsured.

To understand where Bush’s apparently sincere thinking on this subject goes off course, consider how he unveiled his plan. He had just toured a university hospital’s computerized biodefense network. The network is a way to track patterns in hospital databases--an outbreak of rashes or respiratory distress, say--that might signify a bioterrorist attack. Bush predicted that such systems, which he wisely wants to fund, will become as indispensable in detecting such assaults as the radar-based “distant early warning” system was at sounding the alarm about approaching Soviet aircraft during the Cold War. What was apparently lost on him was that the urban hospitals that serve the most people in America are so broke and behind the times they still keep patient records in file cabinets.

Bush won’t be able to win the war against terrorism with high-tech devices alone. He will need to invest not only in next-generation computers but also on old-fashioned outreach like well-staffed community health clinics. In addition, he will need to begin seriously grappling with health care costs, which are now soaring at 10 times the overall inflation rate. The current Bush budget doesn’t acknowledge, much less address, the cost problem.

Health care is a vital area where Bush could put his commitment to compassionate conservatism to the test. One reason Bill Clinton beat Bush’s father in 1992 was because the challenger made health care a cornerstone of his campaign. Given the younger Bush’s great popularity, he has an opportunity to do something Clinton couldn’t pull off--create a health care system that is conservative in controlling costs and compassionate in guaranteeing that even the poor will receive at least a measure of good care.