Applying the Lessons of War: We Need a National Health Policy

The following two discussions are excerpted from a dialogue with Lyndon LaRouche, which took place Dec. 12, 2000, at an EIR seminar in Washington, D.C. Dr. Frederick Seymour is the Director of Microbiology at D.C. General Hospital, and Dr. Abdul Alim Muhammad is Minister of Health for the Nation of Islam, and Director of the Abundant Life Clinic, Washington, D.C.

DR. FREDERICK SEYMOUR: D.C. General Hospital is a hospital for the homeless, the disenfranchised, and those without insurance, or sufficient insurance to cover their medical problems. We're in the middle of, apparently, a political battle, and many people here believe that it's already been decided.

I understand from a National Public Radio broadcast, that Dr. Edward Mueller, of Johns Hopkins, and two other presidents of medical schools, believe that part of the education of physicians in the world, certainly in this country, is being affected by the lack, or reduction, of medical facilities that are training hospitals. D.C. General has been rated as 25th in about 150 in this country. Certainly an honorable position, considering the difficulties of our budget, and the shortness of our annual stipend, to provide for the poor.

We know that other hospitals are being closed. The HMOs seem to be putting pressure, not only on the educational system, but on the welfare, the common welfare, for the poor. How do you think we can approach this, in our setting here? Here we are, in the nation's capital, and we're unable to provide assured health coverage for our citizens.

LYNDON LAROUCHE: Well, I think you know that the people who decide these kinds of policy trends in health care, know what they're doing. You know the effects, but they also know the effects.|...

Most people in the United States, who've been through world wars, or recent wars, through the 1960s, remember a relationship between the medical-support system, the public-health system, and wars, and the general population. Our history of medical policy in the United States, was developed largely as a by-product of our military medical policy. The Civil War was one of the big lessons: the great break in medicine occurred in the Civil War, the biggest war we ever fought, the greatest number of casualties, the greatest problems. The horror of what we weren't able to do in that war struck us.

The French and the British had a big experience in World War|I. We had some experience in World War|I, and watched what they had. We had also the experience of World War II. By the time we had finished World War II, what we knew, and what other countries knew, is what you have to do for public health.

We applied to that also, everything that we'd learned from fighting epidemics, long before we had antibiotics, back in dealing with the Black Death and earlier, other epidemics. We realized that if you're going to defend individual health, you have to defend public health. How can you defend an individual selectively, on the basis of, ``I like him, and he's got this disease.'' It can't work. In infectious disease, particularly, you've got to deal with the general problem.

Which means that, as with the Hill-Burton legislation, which was the result of our experience in World War II, we understood that what we had to mobilize for war, in terms of medical resources and support resources, and other logistics relevant to that, we had to maintain, for any kind of catastrophe, or general condition.

Great losses in warfare, generally, except for certain battles, come as a result of frictional losses, from sickness, from injury, accidents, and so forth. Therefore, the first line of defense of the health of the military force, was to defend the logistics of the general population, their welfare.

The Hill-Burton legislation, as policy adopted back in the 1940s, laid that out clearly.

No In-Depth Reserve

At a time where disease is spreading, we are more vulnerable to infectious disease than ever before; the antibiotic revolution has run out of steam, at least in the present form. We now have diseases, such as Lassa fever, spreading through globalization. You could have a disease come from someplace in Africa, hit someplace in the South Pacific, or someplace else at an airport, and conveyed to somebody who dies of the disease in Europe, or the United States, thereafter.

So, we are vulnerable to disease. And therefore, we have to have a national policy, which is consistent with the lessons we have learned, inclusively, from military medical history. We must have an infrastructural capability, which means, hospitals available, clinics available, in every area, to maintain public health, as the Hill-Burton legislation prescribed. That's the first requirement.

Don't say, you can't afford it. Can you afford to kill people, is the question. If you don't have those institutions, you have no front-line defense against disease, including infectious disease.

What we're doing now, this prescriptive kind of thing, is wrong. A physician must treat a patient, not a disease. You're talking about an institution that deals with people who largely are poorer. You're dealing with people who are coming in, not as diseases, but as patients. The special thing you describe about your institution, is that it's an institution which treats people. And you then find out what diseases they may have after they come in. The point is, to find out how to treat that person, and we need the capabilities for treating that person, as we did in the medical services, in our military in World War II. We need the same principle.

We must have the hospitals. We must have the institutional capability. We must have the physicians. We must have, above all, the training institutions, which give us the depth of capability. We must have the research capabilities, which we are not building.| ...

Therefore, the point is, the government has to take a policy and say: You sharpies, with your shareholder values, the first obligation of government, before we cut any taxes to benefit George Bush, the first obligation, is to find the way we used to do under Hill-Burton: a combination of private, municipal, state, local, and Federal agencies, must decide, under a Hill-Burton kind of standard, what every community in the United States requires. And decide on how they're going to raise the money to do that, and to have training institutions, as we used to.|...

If we can find the right policy, where the Federal government should be most concerned, in the Washington, D.C. area, to make sure we have a model policy on medical care, in this area, which has real target objectives--not the so-called shareholder value, paying customer, priorities--then we will set a policy in the nation's capital, which every member of Congress can see, and which they depend upon, which we can use as the model for approaching the United States as a whole.

We have to make that kind of decision, an FDR-type of decision. Otherwise, there's no solution. There's just a fight, a rearguard battle.

We Need Emergency Action Now

DR. ABDUL ALIM MUHAMMAD: I'd like to get your views on the current crisis in public health, here in the District of Columbia. As you know, D.C. General Hospital, which is almost 200 years old, founded in 1806, with current trends, in all likelihood, will close its doors sometime in March or April of 2001.

One week ago, approximately 250 employees received pink slips. In 1996, the City Council created the Public Benefit Corporation to manage the hospital and the public-health clinics. What they managed to do, is shut down the clinics and downsize the hospital. It's questionable whether, in its present form, the hospital is doing a competent job, but this past year, the appropriation for the hospital was about $50 million. What the hospital actually needs to function well, is about $150 million. So, it was clear that the hospital would run out of funds sometime at the end of January.

Obviously, this is the ``General Welfare'' question. What are your views concerning D.C. General Hospital and the public-health crisis here in the District of Columbia?

LYNDON LAROUCHE: First of all, I think you have to take this as a paradigmatic case, because it's the nation's capital. Therefore, what we do in the nation's capital, tells us what we're doing to the nation as a whole--or more.

What I would wish were done, would be to repeal the HMO act and restore the former act, Hill-Burton, which mandated the purpose of medical care--that was for the institutionalized aspects in particular--to provide the added, required level of medical care, per capita, for every county in the United States, as a goal; and that the direction of public funding and private cooperation in this matter would be to reach that.

We used to have the idea that teams of the state, local, Federal and private facilities would cooperate by making an annual budgetary process, in which they would find from public funds or private funds, altogether, funds adequate to meet certain specified objectives for improvements in the general welfare, the health category, for the coming year and beyond.

We have to go back to that kind of Hill-Burton philosophy, as a way to build the institutions, and to repeal the HMO bill, which is inherently against the general welfare.|...

While we're fighting the Scalias, and what they represent, while we're fighting to repeal HMO, and restore the Hill-Burton philosophy to medical practice, we're going to have to have some emergency action by government. And this has to be by Federal, state and local government together--emergency action which is consistent with the philosophy of Hill-Burton.

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Marker for the Nation

We've got a lot of poor people out there, or misemployed people. You're going to have a lot of people who've been working at Internet operations, they're going to be unemployed. You're probably going to have half of the upper 20% of family-income-bracket people suddenly unemployed, in the period immediately ahead.|...

We have to put some of these unemployed people to work. We're going to have to do what Roosevelt did with the unemployment problem. They may not be fully qualified for the job, but we'll train them on the job.... We have to start thinking about mobilizing, as Roosevelt did, these kinds of resources in the public area, to promote the rebuilding of the total economy.|...

Under Roosevelt, in the RFC [Reconstruction Finance Corporation] program, for every dollar that went through the public sector in the U.S., you had about a dollar and a half would go into the private sector, as a by-product of the impact of the public sector's employment.|...

We remember from the PWA [Public Works Administration] and the WPA [Works Progress Administration], and so forth, from the 1930s, this was a mess at the beginning, but it worked. It was a mess, but we made it work, and it worked. We'd have lost World War II if we hadn't done it. It worked. We have to do it again.

Obviously, among the primary objectives are: energy, adequate energy supplies--the D.C. area has a tremendous shortage of energy generation; it's a critical one. Better do something about it. We have a water management/sanitation problem in whole parts of the sector. Better do something about it. We have an educational crisis, in terms of the physical school system, as well as the educational programs. We need enriched programs to add to the school systems, to do something to reverse this downward trend in school systems.|...

So you need to say, let's build these things now, based on the needs of the population, and based on a performance criterion, which anyone does in an emergency. If something were to happen of the following type in this neighborhood, would we be able to deal with it? A major fire, for example--how are our burn units? How about these other kinds of things for emergencies. Can we get the patient picked up in time, delivered to the place where the care is to be delivered? Is the care available in a timely fashion, an effective fashion, there?

Why not take that as a mission objective, and say the Federal government is going to demonstrate what we can do to set a model for the nation in rebuilding these facilities? And do it because we're ashamed of what we look like in the face of the world under these conditions.

We're going to have to do what we did in the 1930s, after all the Teddy Roosevelt-Woodrow Wilson-Coolidge nonsense. We're going to have to take Federal government-steered, emergency action, in targetted areas. We don't have infinite resources. We're going to have to mobilize the resources we have, get lines of credit organized, get some government seed money to get these lines of credit moving, to get special banking arrangements to get this stuff funded, and say move ahead on saving institutions which should be saved, because we need them, as we have done back then under Roosevelt, and also rebuilding things we've lost.|...

We have the resources in terms of manpower--it's becoming available. We can mobilize them. We can train. We can rebuild. The thing that will make it work is the determination to do that.... I think it's the only thing that's going to work at this time, in a timely fashion. Maybe down the line we can revise legislation, get systems going. But right now, we need emergency action.