Aff - Medicare - Michigan 7 2023 BEJJP

Aff – Medicare For All
Big thanks to Andrew, Arish, Calista, Dylan, Ian M, Jamie, Kailey, Kavneer, Neha, Risha and Sarah J for their help generating this file.
I’m sure thanks are also due to the college debate community in 2017-2018.
1AC
1AC – Health
America is critically weak to health crisis following covid – investment is necessary
Trust for America's Health (TFAH) 23, is a non-profit, non-partisan health policy advocacy organization, DOA 6/25/23, “Ready or Not 2023: Protecting the Public’s Health from Diseases, Disasters, and Bioterrorism”, March 23rd 2023, https://www.tfah.org/report-details/ready-or-not-2023/ ,// JL
(March 23, 2023) Ready or Not 2023: Protecting the Public’s Health from Diseases, Disasters, and Bioterrorism measures states’ readiness to respond to a spectrum of health emergencies and to provide ongoing public health services. The report gives federal and state health officials and policymakers actionable data and recommends policies to improve the nation’s emergency preparedness at a time when health emergencies are increasing. During 2022, the U.S. surpassed 1 million deaths due to COVID-19 and saw decreasing rates of routine vaccinations and increasing prevalence of health misinformation. In addition, the past year was the eighth consecutive year the U.S. experienced 10 or more billion-dollar weather-related disasters.
The report tiers states and the District of Columbia into three performance levels for health emergency preparedness: high, middle, and low. This year’s report placed 19 states and DC in the high-performance tier, 16 states in the middle performance tier, and 15 states in the low performance tier.
The report’s findings showed both areas of strength within the nation’s public health system and areas that need attention
Areas of strong performance include:
A majority of states have made preparations to expand healthcare and public health laboratory capacity in an emergency.
Most states are accredited in the areas of public health or emergency management. Some states are accredited in both.
Most U.S. residents who received their household water through a community water system had access to safe water. However recent water system failures in Jackson, Mississippi and Newark, New Jersey demonstrate the importance of continued attention to the integrity of municipal water systems.
Areas that need attention include:
Too few people were vaccinated against seasonal flu last year despite significant improvement in flu vaccination rates in recent years. During the 2021-2022 flu season, 51 percent of Americans ages 6 months or older received a flu vaccine, well short of the 70 percent goal established by Healthy People 2030.
Only about half the U.S. population is served by a comprehensive public health system. Comprehensive public health systems ensure that necessary health services are available to all residents.
Only 26 percent of hospitals in states, on average, earned a top-quality patient safety grade in 2022. Hospital safety scores measure performance on such issues as healthcare-associated infection rates, intensive-care capacity, and an overall culture of error prevention.
“Increased and sustained investment in public health infrastructure, emergency preparedness, and health equity will save lives,” said J. Nadine Gracia, M.D., MSCE, President and CEO of Trust for America’s Health. “Federal, state, and local officials as well as leaders in the healthcare and business sectors should use our findings to identify and address gaps in public health preparedness. Neglecting to do so will mean that the country will not be as prepared as it needs to be for the next public health emergency.”
Upcoming bioterror and pandemic attacks will be 50x stronger than covid – best strategies for deflecting them require detecting and managing outbreaks
Robert Redfield 5/30, Robert Redfield is a Virologist and Infectious Disease Physician; Cofounder, Prevention, Diagnosis, Treatment Inc.; Director, Centers for Disease Control and Prevention, DOA 6/22/23, “Next pandemic could be 50 times deadlier than Covid, top scientists warn”, Worldwide Speaker Group, May 30th 2023, https://wwsg.com/speaker-news/next-pandemic-could-be-50-times-deadlier-than-covid-top-scientists-warn/ ,// JL
A looming “great pandemic” could be 50 times more deadly than coronavirus, top scientists warned today.
Latest figures show 223,906 people in the UK who died had Covid-19 on their death certificates.
Millions more were infected, leaving hundreds of thousands thought to be suffering from Long Covid.
But experts fear another pandemic could infect and kill even more.
American virologist Dr Robert Redfield, who served as director of the Centers for Disease Control and Prevention from 2018 to 2021, feared his grandchildren would be faced with an even bigger crisis.
He told the BBC : “I think they are at high risk for a great pandemic in the next decade or two and I think that pandemic is going to be caused by man not nature – either intentional bioterrorism or possibly just a lab accident.”
Oxford University’s Regius Professor of Medicine, Professor Sir John Bell, said the Covid-19 pandemic “could have been a lot worse”.
“What are we going to do about detecting and managing the next pandemic, because that’s where trouble comes from?,” he said.“I don’t want to dismiss this last pandemic – a lot of people suffered a lot, there were lots of lives lost and it was a great tragedy … it could have been a lot worse.”
He said that if the Omicron variant had hit before the original Wuhan strain – which gave those it infected and who survived some immunity, and allowed vaccines to be developed – it would have claimed many more victims.
Modelling suggested that “if the first virus that appeared in Wuhan had not been the Wuhan strain but had been the Omicron strain – which we all know is much, much more infectious – and that had hit an immunologically naive population – in other words a population that had never seen the virus before – the peak mortality in the UK would be about five times what it was with the original Wuhan strain,” he said.
“Those were pretty dark days in April and May 2020 and I don’t think we would have wanted five times the number of people dying.
“Had it been avian flu it would have been 50 times, so I think when we hear there’s a great pandemic coming – if either one of those things were to happen it would be a great deal worse than what we saw.”
Sir John warned the next pandemic could come either from zoonotic transmission – where it is passed from animals to humans – or an accidental lab leak.
He pointed to the 2002-04 outbreak of severe adult respiratory syndrome which was first identified in China and killed 774 people worldwide.
“We know historically that we do get pathogens that come from the animal kingdom that get into man that cause these sorts of outbreaks – the previous Sars outbreak is one but also occasional avian flu cases have come from animals,” he said.
“We know that happens. We also know that labs that look after these very pathogenic viruses do leak.”
He even raised fears of terrorists trying to steal viruses and use them as biological weapons.
Sir John said: “Don’ forget that most terrorist organisations around the world have seen the havoc that can be provoked by these kinds of pathogens, so the concept that this is a biosecurity issue more widely shouldn’t be a new one, it should be something that we are thinking about all the time.”
Pathogen emergence and transmission are guaranteed.
Andrew Leigh 21; Fellow of the Australian Academy of Social Sciences, Ph.D. in Public Policy from Harvard University, former Professor in the Research School of Economics at the Australian National University; 12/2/21; "Chapter 2: Bad Bugs," in What’s the Worst that Could Happen? Existential Risks and Extreme Politics, eBook; acronym expanded in brackets
Diseases have been called “our deadliest enemy,” often posing a greater danger than combat. A century ago, the 1918 influenza pandemic infected one-third of the world’s population, killing one in fifty people.7 Twice as many people died from that pandemic as were slaughtered in combat in World War I. Over the full twentieth century, infectious diseases—what some scientists dubbed the “oldie moldies”—killed twenty times as many US citizens as wars.8
Yet the twentieth century also marked a turning point in the war against disease. In 1900, infectious diseases were the leading killers in the United States, with pneumonia, influenza, tuberculosis, and gastrointestinal infections ranking as the top causes of death.9 By the start of the twenty-first century, following a hundred years of advances in vaccines, antibiotics, and sanitation, infectious diseases were not among the top five causes of death in the United States. Only in the poorest nations were people more likely to die from infectious disease than anything else. From 1970 to 2016, worldwide mortality from infectious diseases dropped from fifteen million (35 percent of all deaths) to eight million (15 percent of all deaths).10 Consequently, people began to think of public health less as a matter of collective action, and more as a function of personal decisions such as diet and exercise.
Then, at the end of 2019, a new infectious disease threw the world into chaos. COVID-19 is a coronavirus—a specific kind of RNA virus that has proven especially virulent. SARS and MERS are forms of coronaviruses. Many coronaviruses are mild. When you catch a cold, there’s about a one in six chance it’s a coronavirus (the rest of our colds are rhinoviruses, which are also RNA viruses, but lacking some of the features of coronaviruses such as a viral envelope). Designing a vaccine against a coronavirus is tricky. Coronaviruses infect the upper respiratory tract, an area that we think of as being inside our body, but that our immune system regards as almost external. As one expert remarked, “It’s a bit like trying to get a vaccine to kill a virus on the surface of your skin.”11
COVID-19 is also highly infectious. Doctors measure disease transmission by calculating the reproduction ratio, or R0. This measures how many people each patient can be expected to infect. If the R0 is above one, then the disease will spread. If it is below one, the disease will die out because it cannot infect enough people. Seasonal flu has an R0 of one to two, meaning that each person who gets it infects one or two others. Common colds have an R0 of two to three. Smallpox has an R0 of five to seven.12 Without physical distancing, COVID-19 has an R0 of between two and six, meaning that each person can be expected to infect two to six others.13 Some who contract COVID-19, especially younger patients, may be infectious despite having no symptoms. In February 2020, COVID-19 was spreading so rapidly through Italy that the number of cases was doubling daily. Vaccines, mask-wearing, social distancing, and enforced lockdown measures help slow the spread, but more infectious virus strains (such as variant B.1.1.7) have a higher R0, making them harder to control.
In 2020, COVID-19 claimed 1.8 million lives, and the death toll in 2021 is likely to be higher still. These huge numbers are of a similar magnitude to tuberculosis, which kills 1.3 million people annually. The economic cost of avoiding the virus has been massive. Globally, hundreds of millions of people have lost their jobs, and as much as $9 trillion of economic activity may be destroyed.14 For the first time in the twenty-first century, world poverty rates are expected to rise.15 The Great Lockdown led to the worst economic slump since the Great Depression.
COVID-19 has also been a reminder of how modern living has affected the ability of viruses to jump the species barrier. The spread of human settlements and livestock farms next to natural forests raise the odds of animal viruses infecting humans.16 Three-quarters of new human diseases—including HIV/AIDS and Ebola—have their source in other animals.17 Each year, five new diseases emerge.18 When researchers took blood samples from bats in twenty countries, they estimated that there are over three thousand potential coronaviruses, most of which are yet to be described.19 Transmission to humans is commonplace. Every year, more than a million people are infected by bat coronaviruses.20
With their mind-boggling numbers and ability to replicate speedily, viruses mutate more rapidly than any other organism.21 Over the past eight million years, humans have evolved by 1 percent.22 Many viruses can evolve by more than this in just a few days. As COVID-19 has shown, the factors that have driven prosperity—urbanization, busy workplaces, and global travel—also allow viruses and bacteria to spread further and faster than they could in the era of the black death.
The coronavirus pandemic has prompted an unprecedented surge of research into how the virus emerged, and how to treat it. “Wet markets”—wild animal markets, in which dozens of different species are caged close together and sold for human consumption—have been described as “the perfect place” for viruses or bacteria to jump the species barrier.23 As Laurence Fishburne’s character says in the film Contagion, “Someone doesn’t have to weaponize the bird flu—the birds are already doing that.” China’s wet markets were partially shut down after the 2003 SARS, 2013–2014 bird flu, and 2019–2020 coronavirus outbreaks. Many have pushed for a permanent end to the trade, though experts note that a full ban would also require a strategy for curtailing the unregulated black market that would inevitably emerge in response.24
Put enough monkeys in a room with enough typewriters, and it’s a sure bet that one monkey will eventually murder another with a typewriter. Likewise, the mathematics of viral replication is guaranteed to keep creating new diseases. As molecular biologist Joshua Lederberg ruefully observed of new infectious diseases, “It’s our wits versus their genes.”25 Viruses are not alive; they are virtual organisms, running on the hardware of plants or animals, and reproducing by infecting cells. Viruses outnumber all living things by a factor of ten. A gallon of seawater or pound of dried soil contains around four hundred billion virus particles.26 So pure chance will invariably lead to new diseases, and close-knit societies risk spreading them quicker than ever.
But bad luck isn’t all we have to worry about. Bad actors are looking to create and weaponize biological agents too. Biological warfare dates back more than two thousand years.27 In the Trojan War, archers dipped their arrows into poison. Roman commanders poisoned the wells of besieged towns. Mongol attackers catapulted the bodies of plague victims over castle walls. In the Ohio River valley, British soldiers gave smallpox-infected blankets to Native Americans. During World War I, Germany attempted to infect Allied horses with anthrax.
In World War II, advances in microbiology led the Soviet Union, Germany, Britain, and the United States to develop bioweapons programs. Japan created plague epidemics by dropping infected fleas from aircraft into Chinese cities. During the 1950s and 1960s, the United States carried out an active bioweapons program, investigating yellow fever, typhus, and the plague.28 The program also experimented with how to disperse the germs, using pseudo biological weapons. In 1965, government agents at what is now Reagan National Airport secretly sprayed harmless bacteria onto passengers. In New York the following year, agents smashed bacteria-filled light bulbs in the subway. The government sprayed chemicals from aircraft onto north central Texas and from ships into the San Francisco Bay. By the time it was shut down in 1969, the program had mass-produced a half-dozen biological weapons, including anthrax, tularemia, and botulism. These weapons were destroyed over the next few years, as the United States signed onto the Biological Weapons Convention, banning all biological weapons.
The Soviet Union signed the Biological Weapons Convention as well, but continued to secretly develop biological weapons through the 1970s and 1980s. Employing thirty thousand people across eighteen laboratories and production centers, the Soviet Biopreparat program created “veepox,” a hybrid of Venezuelan equine encephalitis with smallpox, and “ebolapox,” a hybrid of Ebola with smallpox.29 It stockpiled twenty tons of smallpox, twenty tons of bubonic plague, and hundreds of tons of anthrax.30 Only when leading scientists defected and exposed the program did the Russian leadership admit its existence and begin closing it down.
The Soviets weren’t the only ones skirting the law. During the 1980s, Saddam Hussein produced over a hundred million gallons of biological weapons, including botulinum toxin, anthrax, and aflatoxin.31 So lax were the international controls that Hussein’s scientists were able to source much of their equipment and materials from Germany, France, and the United States. Adhering to guidelines that encouraged the free exchange of samples among researchers, the American Type Culture Collection in Virginia mailed strains of the bubonic plague, West Nile virus, and dengue fever to Basra and Baghdad, where they were used to develop Iraqi germ weapons.32 In the twenty-first century, most government-run biological weapons programs seem to have ceased, though the Syrian regime, aided by the Russian government, appears to have used chemical weapons (chlorine and sarin) to attack dissidents.33
Beyond governments, terrorist groups have recruited scientists to work on germ warfare. In 1984, the worst biological terror attack in US history took place in the Dalles, a farming town of about 10,000 people situated an hour and a half’s drive west of Portland, Oregon. Thousands of members of a religious cult run by Bhagwan Shree Rajneesh had established a commune and won political control of the nearest town, Antelope (which they renamed “Rajneesh”). They planned to win county elections in Wasco County by deterring other residents from voting. To achieve their goal, they sprinkled salmonella into the salad bars of ten restaurants, poisoning 751 people, all of whom eventually recovered. The decision to use a nonlethal bacteria came only after cult members had considered deadlier alternatives. As part of their planning, they obtained samples that would have caused typhoid fever, tularemia, and shigellosis. They also tried to culture HIV/AIDS, drawing blood from a homeless man who was infected with the virus.34
Among the most advanced terrorist biological weapons program was that of the Japanese Aum Shinrikyo doomsday cult, which aimed to bring about the end of the world so its followers could attain salvation. In the early 1990s, cult members attempted to obtain Ebola virus in Zaire and carried out three unsuccessful biological attacks. Later interviews with cult members revealed how close they came to unleashing botulism and anthrax, failing in one case merely because they used a vaccine strain of anthrax rather than a lethal one.35 In 1995, cult members released sarin gas into the Tokyo subway system during rush hour, injuring six thousand people and killing fourteen.36 When officials later raided the cult’s headquarters at the foot of Mount Fuji, they found enough sarin to kill over four million people.37
The leading danger today arises from synthetic biology—techniques that blend physical and genetic engineering to create new life-forms. Many applications of the technology can have enormous benefits, such as helping create higher-yielding crops, novel health treatments, and new biofuels. But the same technology can be misused to alter existing bacteria or viruses in order to make them more dangerous. This might involve creating superbugs by adapting bacteria so that they are resistant to antibiotics, making vaccine-resistant diseases, changing bugs so that they

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