ABSTRACT
Introduction A paradigm shift is in progress. The old paradigm is to try to conform the disaster to the response: to control. The new paradigm is to conform the response to the disaster: to adapt. The goal is simple: to create a system based on a realistic set of assumptions in order to prevent tactical events from assuming strategic proportions. While it may not be possible to prevent future attacks entirely, it is possible to ameliorate, contain, and mitigate their social and political effects. Doing so is crucial to the preservation of national capabilities and political will, and with them U.S. leadership both domestically and abroad. Biological threats are potentially so devastating in part because our healthcare system in its current state is itself a strategic vulnerability. Therefore revolutionizing our response capabilities has to involve improving our delivery of healthcare. Investing large amounts of time and money retrofitting a system that we hope to never use may be politically unpalatable, even if it would serve as a deterrent to attack, since our current system practically invites it. However, reorganizing a dual-use system of healthcare would not only benefit our citizens on a daily basis but also protect America from natural pandemics and even biological terrorism.
