By now, we’re aware of the sobering predictions for this fall’s spread of H1N1 influenza.

But, as the Washington Post’s Ezra Klein points out, our health system is ill-suited to deal with the situation:

It’s simply too fractured to do anything different. Almost 50 million Americans have no insurance. Many more are underinsured. Many don’t have a particular doctor or even medical center where they feel comfortable receiving care. Many are uncertain about what is and isn’t covered in their health plan. Many have recently been uninsured, and so have no regular contact with the medical system and haven’t established an obvious way to begin having some.

The emergency room will be overwhelmed by patients concerned about flu-like symptoms, and when you consider the fact that a good proportion of health care professionals aren’t likely to get vaccinated themselves, it’s a recipe for disaster.

But will simply insuring everyone stem the spread of future pandemics? Well, that’s debatable as well, since the primary care system is also ill-equipped to deal with a surge of patients as well. Calling a physician’s office, only to receive an appointment weeks away also will drive patients to the ER.

Again, it starts with having enough primary care access to meet the demand of ill-visits brought on by H1N1. And that will stay true whether we have universal health coverage or not.