For doctors, hospitals and pharmaceutical companies in the U.S., those crotchety old people spelled money, money, money! So they researched and they worked and they studied ways to extend the time they could continue to suck the money out of them.
In the case of governments of socialized medicine countries, the primary users of the services, see: "crotchety old people," were their worst nightmares. The patients worked their whole lives, contributed to the economies of the countries and now expected to be paid back. Heavily. Socialized medicine wasn't the only benefit they expected. They retired early with pensions that nearly equalled their salaries when working. And they paid little or no taxes. And as any health insurance actuary will tell you, they consumed 90+% of the health budget. Mostly in their last six months of life. And what was the point of that?
It would be unfair to say that the politicians just wanted to see them all go away and that cutting off access to vital health services thus killed two birds with one stone. Save money and quietly kill off the primary users.
Or would it? Health care spending as adjusted for inflation had dropped steadily in socialized medicine countries in Europe even as the need had increased. All access to medicine was rationed. And in the Netherlands people who were "beyond help" were denied access to healthcare on a regular basis and even "medically terminated," put to death, against the wishes of their care-givers. Not only old people but children with chronic health care problems. "Terminal" cancer? Which sometimes was treatable or even erasable in the U.S.? In the Netherlands, they just turned up the morphine drip until you quietly passed into the Long Dark.
A corollary effect was on the members of the health profession. A doctor in Britain who worked ninety hours a week got paid exactly the same as a doctor who worked forty hours per week. (Often they worked less.) And it was rare that there were any changes for quality. World-renowned surgeons in Germany and France made only a fraction more than less competent doctors.
In the U.S., on the other hand, they could write their ticket.
The brain drain was not severe at the time of the Plague but it was telling. More and more top-flight doctors had left to find greener pastures. For that matter, doctors in less developed countries had flooded into the U.S., where they might not make a fortune but they got paid in more than chickens and hummus. They filled the corner "Minor Emergency Centers" as well as being the front line general practicioners, a field most American born doctors disdained as the most plebian of medical fields.
This was what the good doctors at the CDC learned when they set out to prove that American healthcare, with its dependence on the free-market, doctor/patient choice, HMOs and pharmaceutical companies was far inferior to the enlightened healthcare of "socialized medicine" countries.
They discovered the irrefutable truth that when you put the same sort of people that run the Post Office in charge of your healthcare you get Postal Workers for health care providers. And more people die in less necessary ways.
So let's go back and look at the effect of H5N1 on populations.
In its initial discovery, mortality among affected populations, primarily Chinese poultry workers, was right at 60%. Two out of three who were infected died despite best efforts on the part of local (socialized medicine) doctors. This continued as a pattern during the long period that H5N1 was confined to avian to human transmission.
Across the board in unimmunized populations with access to "universal healthcare" the same pattern emerged. Two in three unimmunized patients who were admitted to healthcare environments (less than 10% of the affected at the height of the Plague) died.
In the U.S. the rate was one in three.
Thirty percent vs. sixty percent. Still a horrific number, total death-toll from direct effects of the Plague are estimated to be around a hundred million. But if the rate had been the same as Europe's, the death toll would have been twice that.
Why?
It had been a puzzler even before the Plague. One reason that there was a somewhat slower response among the public to H5N1 was that there had been an earlier scare involving something called SARS, Severe Acute Respiratory Syndrome. It had also started in China, there had been a cover-up that affected a large and never clearly documented number of cases with estimates ranging from five hundred to fifty thousand and mortality rates similar to H5N1. It had broken out into Thailand and Singapore and even spread into Canada. Everywhere the rate was the same, serious pulmonary distress that led to death in five of ten cases. Including in Canada, which was prepared for it and responded very fast to the discovered cases.
Cases that reached the U.S. were given a different name: MARS; Mild Acute Respiratory Syndrome.
Same exact bug. Fifty documented cases in the U.S. No. One. Died.
Why?
Think of Dr. Van. A physician who cooled his heels for nine hours in a waiting room after telling the triage nurse that he probably had a deathly illness.
By the same token, cases in the U.S. called their private general practitioner and told him that they were very sick. They were seen within no more than two hours and admitted within less than an hour afterwards to the hospital.
Cases in Canada which were detected through investigation got similar speedy care. More of them survived than those who were first cases. Speed of care was preeminent. Yes, too often it simply didn't work. And as cases burgeoned the healthcare system in every country became overloaded. But in the U.S., people didn't just have to go to the local health clinic. As hospitals became overloaded, doctors often shifted to the old fashioned home-visit. Where they could not, there were thousands of minor healthcare providers, mostly LPNs and Medical Assistants, from that increasingly lucrative industry who were pressed into service. The number of providers in the healthcare industry in the U.S. had been exploding as the population aged while it had been more or less stagnant in Europe. Because there was money in them there old people there were just more healthcare workers per patient.
Many of them worked through the height of the Plague for little or no money. The economy was tanking, fast. They worked in the hopes that they'd get paid and eventually most of them did.
This was one reason that the mortality rate from direct effect of the Plague was lower in the U.S. than in other modern countries. (Countries which never had their act together simply sank lower. I'll discuss my personal experiences of that later.)
A secondary reason is debatable. It had been debated as far back as the SARS scare and still remains questionable. But there is now some corroborating evidence based on analysis of mortality rates in various populations based on their lifestyle. It is, however, detested by most health care persons and every remaining "organic lifestyle" lover on the planet.
Hormones.
We're back to industrial farming. Yep, we injected our livestock with all sorts of shit. Growth hormones for the beef and goat stock. (Yes, we raised goats for meat. There was a pretty good market before the Plague.) Milk generating hormones in the milk cows. We used "genetically modified" seeds that were hyper-resistant to dozens of pathogens. We sprayed herbicides and pesticides and laid down fields with ammonium nitrate (the stuff terrorists use in big bombs) to increase yields. We used every trick in the book and most of the bigger farm corporations we competed against used the same tricks, just not as well as we did or we'd have gone out of business.