title: Ebola crisis in the United States: a glimpse of its larger shadow.
abstract: This article is about readiness of the U.S. health care system to deal with crises. Using the Ebola crisis as a reference, first it examines the response to the current challenge. However, that is the smaller objective of the article. Lately, we are also being challenged to deal with other kinds of epidemics like obesity, mental health diseases, and violence. These crises are not dramatic like the Ebola crisis. However, these are no less insidious than Ebola. If we are not ready for them, then these crises have the potential to undermine the long-term health and prosperity of our society. In this context, and therefore mainly, this article is about two major long-standing systemic problems in the U.S. health care system that the unfolding of the Ebola crisis has bared. One is about how the inherent problem in the design of American federalist system regarding state autonomy on health matters is creating a dysfunctional health care system. The other is about the inertia of the research industry in the health care system in clinging to an archaic outdated inefficient mind-set and methodology that fails to generate the right information required for an appropriate decision making in matters of health care delivery, including crises. These problems are not small, nor their solutions easy. However, no matter how uncomfortable and tedious, facing them is necessary and inevitable. The discussions and arguments in this article are to outline their nature broadly and to make a call to further a dialogue.
authors.affiliation: George Mason University, Fairfax, VA, USA apatward@gmu.edu.
authors.forename: Avinash Raghunath
authors.initials: AR
authors.lastname: Patwardhan
mesh_terms: D003140:Communicable Disease Control / Q000458:organization & administration*; D003695:Delivery of Health Care / Q000458:organization & administration*; D006285:Health Planning; D019142:Hemorrhagic Fever, Ebola / Q000453:epidemiology* / Q000517:prevention & control*; D006801:Humans; D014481:United States / Q000453:epidemiology
keywords: Ebola; U.S. health care; complexity science; crisis; decision science; epidemics; health care research; preparedness; state autonomy