Tuesday, October 19, 2004

Vaccine from the Pit of Hell

When thinking about this here vaccine shortage, it's hard not to remember these stirring words from the harebrained, spiritually repulsive GOP dimwit Debbie Riddle (R-Texas):

Where did this idea come from that everybody deserves free education, free medical care, free whatever? It comes from Moscow, from Russia. It comes straight out of the pit of hell.
The gag is, BushCo's now reduced to pleading with the socialist weasels who run the third-world nation of Canada, in hopes they'll give us some of their dangerous, untrustworthy medicines.
[I]n Canada, they've got a secure supply of flu vaccine. Dr. John Carsley, Montreal Public Health said, "Purchased by the Provincial governments and made available to people at high risk and their entourage free of charge so obviously we can't offer that to the Americans because its targeted at our high risk population."
Meanwhile, according to the LA Times,
Thirty-six thousand Americans die of the flu every year. If that number rises by just a tenth because we have only half as much flu vaccine as we need, the increase in deaths will exceed the number killed by Osama bin Laden on Sept. 11, 2001.
Thirty-six thousand Americans will die of flu in the coming months? Sounds like a Homeland Security issue to me! Good thing the Canadians - with their superior health system - are bailing us out.

7 comments:

Pastabagel said...

You have a nice blog.

First, there is no such thing as free education, healthcare, etc. Someone pays, even if it isn't the recipient of the service.

And the flu vaccince fiasco simply proves the larger point that the government cannot be trusted with administrating, managing, or mandating healthcare. Not republican or democratic governments, but no government. Government always does the job of the private sector worse. There's increasingly more evidence supporting this point, and none against it.

And as meaningless anecdotal evidence, I never get a flu shot, and I haven't had the flu since I was a kid.

THEY CALL ME PASTABAGEL

Phila said...

Of course, governments have historically done a TERRIFIC job of vaccinating people. That's why polio was pretty much eradicated. That's why smallpox was eradicated. That's why we don't see people dying of tetanus and diptheria anymore. It's only with the gutting of traditional public-health systems under the banner of privatization that the system's started screwing up this badly; to use the current shortage as an argument for privatization is kind of like hobbling someone, and then calling him slow. Beyond that, the fact is that the government is at the mercy of private industry now; vaccine manufacturers sign contracts with the government, and are in a position to dictate terms, even at the expense of the public good (see my post on adenovirus below for a irrefutable example of this).

The classic libertarian line is that the only business of government is to protect the public from attack. If that applies to bioterrorism, it applies to epidemic disease generally; no one dying of smallpox or cholera is going to be comforted by the fact that it occurred naturally, especially in this day and age. And indeed, the Right generally LOVES the idea of governmentally enforced quarantines to protect the public health. Vaccines, similarly, are intended not merely to protect the individual, but to protect society at large As such, this really is a "homeland security" issue; it's one of those things that only the government has the resources and the authority to address. There's no logical profit motive in vaccines, which rarely involve repeat doses. Other first-world countries offer them for free, and we should too. If empathy doesn't compel one to agree, than self-interest must.

Dickens, who saw laissez-faire at its ugliest, makes this precise point in Bleak House: allowing disease to flourish among the poor has uncomfortable repercussions for the wealthy. One character, in a delirium from smallpox, which she caught from a street child, imagines her head as one among many beads on a necklace from which she can't get loose; his point is that we're bound together by common humanity, whether we like it or not. But as I've complained elsewhere, it's the Right's business to make us forget everything we ever knew as a culture, and to discard everyday commonsense and shared experience in favor of the false dictates of their own invincible ignorance.

Interestingly, the most staunch advocate of this thinking I know, who seriously insists that anyone who can't afford healthcare might as well die, is a former drunk who was literally pulled out of the gutter and cured - for free - by the very people he now sneers at as "do-gooders." The problem with the people who believe this stuff is that they're worthless and weak, and that deep down they know it.

Pastabagel said...

Polio and smallpox are counterexamples in the sense that they are only required once, so the government can mandate that everyone get one, but it doesn't buy the vaccinces, you get it through your doctor, and you (or your insurace or medicaid or whatever) pay him for him. He gets it from a vaccine manufacturer. The government plays no role except as an insurer of last resort.

In the 50's the analogy breaks down because healthcare was primitive in comparison to now. It is extremely unlikely that a single researcher can invent a new cure or make a medical breakthrough the way salk did with polio. The field is so advanced that it takes many researchers, a long time, and lots of money to come up with breakthroughs.

But why is the government negotiating contracts for flu vaccine, and not mumps or any of the others? The fiasco occured because the government tried to become a vaccine supplier (or distributor whatever) instead of an insurer.

The problem is not that the right thinks poor people who get sick should die, or that sick people should be quarantined (which is how our culture used to deal with the sick, btw). This is idiotic, no reasonable person thinks this way. The question is how best to allocate scare resources so that people who can't afford basic healthcare can get it without collapsing the rest of the system.

The problem is that we have to define 'basic'. Does that include MRI's? Psychiatric medication? Recently invented new drug treatments? No system can support giving the latest and best to most at no cost and having few pick up the cost for everyone else. This is because the newest generation of drugs will generally cost more to produce than the previous generation, so the costs will increase.

Also, keep in mind that because prevention is always cheaper than treatment to the one that ultimately has to pay. If some people do not have to pay for treatments, then the prevention becomes more expensive to them. In other words, if the government pays for treatment for poor people related to obesity, then to the poor it is cheaper to get the treatment than eat healthy, exercise, etc throughout their lives.

So the debate is not over whether the private sector is perfect, it isn't. But the flu fiasco proves that it is better than the government at getting medicine to people who need it.

My guess is that your formerly drunk friend pas pulled out of the gutter by a charitable organization ot affiliated with the government? If so, doesn't that also prove the point that the government isn't needed?

THEY CALL ME PASTABAGEL

Phila said...

I responded at great length, but Blogger ate it. Oh well. It's really not that important.

But for the record, the treatment center my acquaintance ended up with was state-run and taxpayer-funded.

Thersites said...

Care to know how many taxpayer dollars go to prostitutes in other countries? It's in the tens of millions each year in the contracting/engineering field alone.Yeah, nobody in the private sector EVER uses corporate dough for hookers.

NEXT!

NYMary said...

Philalethes,
You've been reading books again, haven't you? Didn't we talk about this? Ten whacks with Our Mutual Friend if it happens again.... (and that could hurt!)

Phila said...

Polio and smallpox are counterexamples in the sense that they are only required once

Same with almost every vaccine...including flu, where the target pathogen changes from year to year. But even if this weren't true, your point is obscure at best.

But why is the government negotiating contracts for flu vaccine

In my adenovirus example - which provides the context for your question - because it was the military buying it, to deal with a problem that existed primarily among military personnel. That's why it's such a good example; not only is it a microcosm of society as a whole, but it's directed related to national defense issues. On top of which, the disease has spread somewhat into the general population. An H5N1 epidemic could kill 25 million Americans in a matter of months; it worries me more than terrorism does, and I'd rather have more money going to prevent that (not that Bush is actually doing anything to prevent terrorism).

This is idiotic, no reasonable person thinks this way.

Agreed. But many people think that way all the same. I often do freelance work for them. And I'll tell ya...I guarantee they're way, WAY higher up the corporate / governmental ladder than you are. And I can also guarantee that they laugh over the idea that the "dumbshits" (i.e., me and you) are voting to have their pockets picked. It's only a secret to the little guy; hang around boardrooms, and people are laughing.

The question is how best to allocate scare resources so that people who can't afford basic healthcare can get it without collapsing the rest of the system.

Actually, the question is "Why are the resources scarce?" In Canada, there's enough flu vaccine for them to inoculate their at-risk population, and give us the leftovers. Anything they can do, we can do. What irritates me about this argument is that it assumes that America can't do better. It can, of course...but the objections to doing so are faux-moral ones, which just happen to be made by disingenuous parasites who are gleefully robbing the public coffers (like the people I sometimes work for, for instance). Or do you like having your tax dollars go to $400 hammers and $700 toilet seats? Care to know how many taxpayer dollars go to prostitutes in other countries? It's in the tens of millions each year in the contracting/engineering field alone.

No system can support giving the latest and best to most at no cost and having few pick up the cost for everyone else.

We're going to pick up the tab regardless. The question is, do you want to pay for the prevention, or for the cure? My mother ran up nearly a million dollars in medical bills in two months, before dropping dead. She got literally the best treatment there is, free of charge. Multiple MRIs, therapy, you name it. The taxpayers covered it all. That's not going to change; the promise that it will is phony, just like the promises Bush makes to the fundies about delivering on a gay marriage or abortion ban. It's just bait for suckers; as long as they keep moving towards it, the rubes will throw money at 'em. But they'll never actually get there.

In other words, if the government pays for treatment for poor people related to obesity, then to the poor it is cheaper to get the treatment than eat healthy, exercise, etc throughout their lives.

You folks always like to bring up obesity, because it's so easily portrayed as a personal failing inflicted on the public via a culture of victimhood. But I'm not talking about that. I'm talking about preventing epidemic diseases that spread like wildfire; if that's not the government's job, nothing is.

But the flu fiasco proves that it is better than the government at getting medicine to people who need it.

No, it doesn't; again, read my adenovirus example. The PS doesn't get the vaccine to people unless someone pays them. Of those who can't pay, a certain percentage get sick. The more people get sick, the more it costs (and that's not just taxpayers; private industry suffers, too) and the more it puts other people at risk. Sick people weaken the country; the more you have, the weaker you are on every level. Again, if you can't see it as a moral issue, you can look at it as a security issue, or as pure self-interest.

My guess is that your formerly drunk friend pas pulled out of the gutter by a charitable organization ot affiliated with the government? If so, doesn't that also prove the point that the government isn't needed?

Nope. It was state-run, funded by taxpayers like myself. It closed down under Bush I. Now, there is literally nowhere in my county for people in his position to go. If he had that problem now, he'd probably be dead.

Pretty much everything you think you know about this stuff is wrong. And it's not even your fault. These folks know that there's a certain amount of gullibility out there, and a certain hunger for feel-good fairy-tales. All politicians exploit that human weakness, to some extent, and most people buy into it, to some extent. But seriously, friend...I've been around these folks, and I'm not joking: They're laughing at you. They're collecting your chump change, tossing it in the pile, and going off to eat monkey-brain sushi and hire hookers. You're comic relief to these guys.