With state revenues continuing to make like a drop of water at Niagara Falls, you're beginning to hear murmurs from political leaders about the costs of health-care reform. David Guarino - former PR person for former Speakah Sal DiMasi - discusses the possibility that this "sacred cow" might have to be led to the slaughterhouse:

... [I]f the trends continue and the choices are to raise taxes a lot more, lay off thousands more firefighters, teachers and cops or cut programs – even the ones that are working well, the sacred cows might just find themselves getting herded up.

The Boston Business Journal reports Bostonians wait an average 50 days for an appointment with a doctor - but up to 70 days to see an OB/GYN. Those world-class numbers compare to a puny 11.2 days to see a doctor in Atlanta.

Paul Levy reports that all the bar-code scanners in the world are still not a substitute for a trained nurse - who thought the bag of medicine she'd just checked out was "slightly heavier than usual" and sure enough, the dosage was higher than it should have been, due to what turned out to be a mistake at the drug wholesaler.

As a part of WBUR's series on End of Life Care, Radio Boston this Friday at 1 will look at how end of life care differs in Boston. Call in or comment at www.radioboston.org.

Davis Square statue this morning. Photo by Ringsided.

None of your employees were really worried about swine flu until you all decided this week to send out memos about it. Now they're worried. Please stop taking communications lessons from the Herald, which apparently hasn't gotten the news that while four Massachusetts children died this past winter from boring regular flu, nobody's actually died here from KILLER FLU.

Mike the Mad Biologist compares the hysteria over swine flu with our ho-hum reaction to boring old regular flu, which kills 36,000 people a year:

... That's double HIV/AIDS deaths. But nobody gets paranoid about handwashing (WASH YOUR DAMN HANDS!!). There's no serious awareness of 'coughing' hygiene. It's just shrugged off, even though a successful vaccination strategy would save tens of thousands of lives. Clearly, nobody cares about these deaths: if the public as a whole did care, vaccination would be a sacrament.

But suddenly TEH SWINEY FLOO emerges and suddenly everybody becomes a public health maven. I don't mean to downplay the potential seriousness of this particular influenza, but, so far, it's in roughly the same mortality ballpark as most other influenzas. There needs to be vigilance, but, if this influenza burns out (or even if it doesn't), we'll still have to deal with the seasonal influenza pandemic (which is what it should be called). ...

Apparently, enough people have been calling up the Boston Public Health Commission that the commission felt compelled to issue a statement today:

Dr. Anita Barry, director of the Infectious Disease Bureau at the Boston Public Health Commission, issued the following statement in response to questions from residents about whether it is safe to attend large public events because of the swine flu alert:

"Given that there are no confirmed cases in Boston or Massachusetts, large gatherings in the community need not be cancelled at this time. People who are not ill do not need to restrict their activities; they should continue to follow the advice of state and local public health officials, who will notify the community and work with institutions if and when cases are confirmed and if and when large-scale events need to be cancelled.

It is always a good idea for people who are ill to refrain from going to large public gatherings not only because of swine flu but also other infections. In addition, people with underlying medical conditions who are at high risk for complications of influenza may wish to consider avoiding large gatherings. The Public Health Commission will carefully monitor case finding information and get guidance from the Massachusetts Department of Public Health and the US Centers for Disease Control and Prevention in order to make appropriate changes to this directive as warranted."

Or as Karen Wise tweets:

Good thing about swine flu pandemic: I haven't worried about MRSA all week.

Dr. Anita Barry, director of the Infectious Disease Bureau at the Boston Public Health Commission, talks about, well, you know:

MSNBC vaguely reports.

I know that to some this post will be alarmist, even silly, and -- thankfully at this juncture -- unrelated to Boston, but the flu outbreak in Mexico that shows signs of spreading into the Western and Southwestern states has grabbed my attention.

If you haven't caught the news: boston.com...mexico_struggles_to_contain_swine_flu_outbreak/