Tampa Prep 2009-2010 Impact Defense File
AT: Antibiotic Resistance
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- reform proposals also need to do much more in directly confronting the powerful demand side influences
- Gatekeeping is often associated with health care cost control
- 4. Impact Inevitable: Europe and Asia Epoch Times
AT: Antibiotic Resistance1. Too many alternative causes to solve for Savert ‘8 (Richard S., Associate Professor of Law & Co-Director, Health Law and Policy Institute, University of Houston Law Center. J.D. Stanford Law School, B.A. Harvard University, Boston University American Journal of Law and Medicine, “In Tepid Defense of Population Health: Physicians and Antibiotic Resistance,” P. Lexis//DN) Effective strategies for combating antibiotic resistance unfortunately remain elusive. This reflects the fact that antibiotic resistance has numerous, complex root causes, including: weak surveillance for resistance: n10 aggressive promotion of antibiotics by pharmaceutical companies: n11 lax infection control practices: n12 patients' irrational demand for antibiotics even when they may not be effective: n13 unwarranted clinical variation in the way physicians prescribe and monitor use of antibiotics; n14 inappropriate patterns of antibiotic use in agriculture and food-animal products that may impact human health; n15 and a possible downturn in discovery and commercial development of new antibiotics. n16 Recent reform proposals attracting considerable interest focus a great deal on supply side solutions. For example, the influential Infectious Diseases Society of America and other groups advocate tinkering with patent rights to provide pharmaceutical companies stronger incentives to discover novel antibiotics and to resist overselling their newer drugs already on the market. These strategies generally aim to encourage stockpiling of newer [*434] medications for future public health threats and to extend the useful life of antibiotics. n17 Congress has also considered legislative bills that would leverage intellectual property rights in this manner. n18 This Article argues that a primarily supply side focus unfortunately misses the mark. Attempts to increase the general supply of effective antibiotics of course remain important. But reform proposals also need to do much more in directly confronting the powerful demand side influences. Ordinarily expected supply side effects do not always occur in the complicated health care market. Because of agency relationships and information asymmetries, physicians perform as the key intermediary, in a position to induce, control, or at least heavily influence, overall demand and utilization of many goods and services, sometimes seemingly irrespective of changes in supply. n19 Considerable attention needs to be paid, therefore, regardless of any changes in the supply of effective antibiotics, to the physician's necessarily significant, yet traditionally neglected and problematic, role in antibiotic conservation. It must be remembered that, as in many other areas of health care, the physician performs a critical role as gatekeeper to limited resources. The ideal physician gatekeeper makes referrals and grants patient access to health care services and technology on a discretionary basis, considering effectiveness and cost as well as the patient's needs in an attempt to manage [*435] limited resources equitably for the benefit of patients as a whole. n20 Gatekeeping is often associated with health care cost control, particularly in managed care settings, a subject that continues to attract considerable debate and scholarly attention. n21 Yet there has been far less recognition in the academic literature of the important connection between physician gatekeeping and protection of public health. Indeed, in the antibiotic context, effective gatekeeping takes on increased importance for public health reasons because "[o]ther than certain vaccines, antibiotics are the only drug class whose use influences not just the patient being treated but the entire ecosystem . . . with potentially profound consequences." n22 This arises due to the "antibiotic paradox" - prescribing an antibiotic can have dual, contradictory effects as it combats targeted bacteria while also possibly increasing selection pressures in the larger environment for bacterial strains that are resistant to that antibiotic, potentially jeopardizing the medication's effectiveness when used again for future health threats. n23 It remains critically important, therefore, that physicians prescribe antibiotics prudently, preserving the limited arsenal of effective medications for socially optimal use. Arguably, this becomes as important for public health purposes as ensuring that physicians use the drugs at all. 2. Solves itself – we’ll just make new drugs. 3. Awful probability of an awful timeframe, animals have used antibiotics for over 60 years. Dale Rozeboom et. al.Michigan State Swine Specialist and Prof. of Animal Science at Michigan State University, April, 2008 “Antibiotics in the Environment and Antibiotic Resistance,” Michigan State University http://www.thepigsite.com/articles/8/biosecurity-disinfection/2220/antibiotics-in-the-environment-and-antibiotic-resistance Antibiotics have been used in animals over 60 years. However, antibiotic resistance only recently has become a major medical concern in hospitals. Whenever a population of bacteria, of importance to animals or humans, is exposed to an antibiotic it encourages the predominance of the most resistant strains of the bacteria. The most well-known example of this is how rapidly gonorrhea became resistant to penicillin. It is possible for resistant bacteria from animals to make their way into humans, but many barriers stand in their way. Most bacteria that cause animal diseases are specialized for that species (species-specific) and poorly invade humans. Zoonotic bacteria, such as certain species of Escherichia coli and Salmonella are of greater concern as they are transmissible from animals to humans. Usual precautions of washing hands and thoroughly cooking of foods eliminate the spread of these to humans, but these procedures do not help prevent environmental transmission (e.g., to drinking water). 4. Impact Inevitable: Europe and Asia Epoch Times 6/24/2k9 (“Animal Agriculture Boosts Antibiotic Resistance,” pg online @ http://www.theepochtimes.com/n2/content/view/18597/ //ef) Researchers have found the presence of methicillin-resistant Staphylococcus aureus (MRSA) on pig farms, where strains of MRSA have been discovered that can jump from swine to humans. These strains have been isolated in several countries, including Canada and the U.S. “Right now what’s been shown is that in Europe, the U.S., Canada, and I think in some Asian countries as well, contact with pigs has definitely been shown to be a risk factor for carrying MRSA, and some people who carry MRSA are going to get sick and then transfer it to other people who will get sick,” says Steve Roach, spokesperson for Keep Antibiotics Working. To prevent disease outbreaks and to stimulate growth, the hog industry adds more than 10 million pounds of antibiotics to its feed, according to UCS. The organization estimates that 70 percent of antibiotics and related drugs used in the U.S. are used in animals. Directory: files -> documents documents -> North Mankato Taylor Library documents -> In the Red and Brown Water documents -> - documents -> I. Disaster Summary Sheet II. 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