The health care debate-6: The curious case of the swine flu vaccine guidelines


(For previous posts on the issue of health care, see here.)

The US is preparing for an expected outbreak of the H1N1 (‘swine’) flu epidemic in the fall. Scientists are in the process of developing a vaccine that is due to be available in October. A federal advisory board to the Centers for Disease Control (CDC) issued guidelines on July 29 for who should get priority in vaccinations.

The committee recommended the vaccination efforts focus on five key populations. Vaccination efforts are designed to help reduce the impact and spread of novel H1N1. The key populations include those who are at higher risk of disease or complications, those who are likely to come in contact with novel H1N1, and those who could infect young infants. When vaccine is first available, the committee recommended that programs and providers try to vaccinate:

  • pregnant women,
  • people who live with or care for children younger than 6 months of age,
  • health care and emergency services personnel,
  • persons between the ages of 6 months through 24 years of age, and
  • people from ages 25 through 64 years who are at higher risk for novel H1N1 because of chronic health disorders or compromised immune systems.

In a press release, the CDC says:

There is some possibility that initially the vaccine will be available in limited quantities. In this setting, the committee recommended that the following groups receive the vaccine before others:

  • pregnant women,
  • people who live with or care for children younger than 6 months of age,
  • health care and emergency services personnel with direct patient contact,
  • children 6 months through 4 years of age, and
  • children 5 through 18 years of age who have chronic medical conditions.

Stop for a moment and listen. Isn’t there something strange? What you hear is silence. And yet look at what just happened. The very nightmare that anti-single payer and anti-socialized medicine zealots talk about the most has just come to pass: We are having “rationing of health care”, with the decisions on who should get treatment and who should not being made by “government bureaucrats”!

So why is there not an uproar about the awful government making decisions about your health care? Because once you leave the rarefied air of generalizations about the glorious virtues of the free market and come down to concrete cases involving public health, this is obviously the way to make sensible decisions. After all, who would they like to see making decisions as to who should get the vaccines and who should not?

A team of health care professionals weighing the merits of the various options and coming to some consensus decisions about how to get the maximum benefit from limited resources, without the possibility of enriching themselves by their decisions?

Or profit-seeking private drug companies and insurance companies figuring out how to make the most money for themselves and their shareholders, presumably by giving the vaccines to those who can pay the most for it, decisions being made by people whose income and bonuses is related to how much they can make from the vaccines?

Would people like to see the flu vaccine being sold by the private sector to those who can pay the highest price, so that they can make the most profit? Isn’t that how the glorious market forces should work?

The way the swine flu allocation decisions were made is exactly how, in a government-run single payer system, decisions about allocating medical resources will be made, by publicly accountable health care professionals weighing all the options and seeing how to obtain the maximum benefit.

Notice that in this specific swine flu situation, people over the age of 65 are told to go to the back of the line because the evidence suggests that they may have already developed an immunity to the swine flu from a variant from a long ago past flu. This is a switch from other flu vaccine situations where older people got priority. I would not be at all surprised if, as the news sinks in and the flu season approaches and promises to be serious, all the well-to-do seniors led by that greedy geezer lobbying group the American Association of Retired Persons (AARP), people who have long been pandered to at the expense of others because they vote in large numbers, will start pushing to get to the head of the line and demanding that they get the flu vaccine first, elbowing pregnant women and children aside.

Although I long ago qualified to join the AARP, I refuse to do so because it always seemed to me to have only the interests of better off older people in mind, especially when it comes to health care, at the expense of poor older people, children, and the rest of the general public. On health care reform, the AARP seems to want to protect the interests (and profits) of the health insurance industry and opposes single payer systems.

The AARP tries to scare its membership using fraudulent arguments. They know that their members love Medicare, and they suggest that single payer systems will eliminate it. Oh, the horror! The fact is that Medicare is a single payer system and what is being proposed by single payer advocates is to essentially expand Medicare to cover everyone, so that there will be no need for a separate program just for older people. But some greedy geezers have got so used to being treated better than everyone else that telling them that everyone will receive the same care as they do is enough to turn some of them away, fearing that they will not automatically be at the head of the line.
POST SCRIPT: The Daily Show on scared old people

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Comments

  1. Jared says

    Just as a note, AARP officially no longer stands for “American Association of Retired Persons”, but is now just supposed to be a meaningless acronym. The rationalization being that they represent ‘all americans’. Or at least that is the claim.

    Despite the change in name, the organization still concentrates on the elderly. However, while pandering to them is close to what they do, it is a little more cynical even than that. My wife spent a few months working for the organization (but, oh joy, no longer!) and her observation was that the association uses their “base” as a tool to get leverage with the politicians.

    I should at least be fair enough to put in the caveat that the local branches of AARP do occasionally bring forward positive issues. Yet I can’t help but wonder how the members would feel if they realized where the money came from to pay for the intense lobbying.

  2. Anonymous says

    Mono,
    We both enjoyed your talk at Panera Bread. I’m sorry we didn’t get to talk to you before we left but we live by the PA border and had to leave early.

    On the way back Dolores said it was the best talk she has attended. I agree with her! I hope Mark has you back for other meetings. We have tentative plans for a picnic at our Ohio house. If we do your and Shirmella are welcome to come.
    Don Boos

  3. says

    Good one, i liked the way you put it.You’re goddamn right, I’m angry about Our governments policy & all that stuffs.

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