The collapse of public health care through decades of deliberate neglect in the U.S. makes the country as vulnerable to a flu pandemic as any bottom tier third world country, and it may be too late to do anything about that.

When it comes to a bird flu pandemic, the problem that America faces is not immunizations, though there needs to be a crash program to get one ready and stockpiled. Nor is it whether or not to use the military to run quarantines, though most health experts agree this is a really stupid idea, because quarantines only really work if the people trust the ones in charge, and having the military fencing people in would only lead to mass efforts to sneak through the line.

The real problem is that the public health system in the U.S. is almost non-existent.

Think about it. There is no system of primary care for the 45 million Americans who have no health insurance. Even those with Medicaid have only the most limited access to primary physicians and end up having to use emergency rooms at hospitals for most of their care because ordinary doctors won’t accept Medicaid.

Given this sorry fact, and the reality that decades of conservative governments in Washington have gutted funding for health clinics in urban communities, what are poor people going to do when they get the flu? Most will ignore the early symptoms and go on with their lives as best they can.

If they are the working poor, they will continue to go to work, because most lower-paying employers don’t offer sick leave, and people need money for food and rent.

All this means massive exposure of those on the transit system and at work to early stage flu — which is when the disease is most contagious. It also means massive exposure to the rest of us, since many of those low-wage workers work in the service industry, handling our food, our clothes and our mail.

The only solution to this disaster-waiting-to-happen is for the Bush administration and Congress to immediately start a crash program to re-establish the network of primary care health clinics that were common in medically underserved urban and rural areas in the late 1960’s.

While they’re at it, they should pass a bill mandating a policy of 5 to 10 paid sick days for all employers, large and small. Sure, the Chamber of Commerce will howl bloody murder, but everyone needs to realize that if people are unable to afford to stay home when they’re feeling sick, we’re all at risk.

For that matter, even ignoring the humanitarian and personal threat issues and just using cost-benefit logic, the cost of an epidemic — in terms of lost economic growth, medical costs and increased taxes (which will reportedly be in the hundreds of billions of dollars) — will be at least an order of magnitude and more likely several orders of magnitude greater than the cost of providing primary healthcare for all Americans and granting everyone sick leave.

If it’s important to rebuild the levees in New Orleans to prevent the next flood, it is just as important to rebuild the medical levees in our cities to prevent the next viral tsunami that is sure to strike sooner or later.

Award-winning investigative reporter Dave Lindorff has been working as a journalist for 30 years. A regular columnist for CounterPunch, he also writes frequently for In These Times and Salon, as well as for Businessweek, the Nation and Treasury & Risk Management Magazine. This article is reprinted from the “Swapping Stories” section of the Web site of the International Labor Communications Association of which Allegro is a member.