Nov. 13, 2004 - 15:21 MST

THE WONDERING JEW

Bottom Line ?

A column by Ellen Goodman of The Boston Globe in today's Rocky Mountain News is of great interest to me. In part:

'Free Market Flu' should spur health-care reflection

"Toward the end of the campaign, President Bush offered his small variation of JFK's famous line: "Ask not what your country can do for you, ask what you cannot do for your country." "My call to our fellow Americans is, if you're healthy, if you're younger, don't get a flushot this year." I have followed the patriotic edict to go unarmed into his flu season. In fact, unlike certain members of the Congress who shall remain nameless, I have no choice but to follow it."

" If we are lucky, if the flu season is mild and the crick don't rise, this may not be a disaster. But for the moment, we have the Centers for Disease Control and Prevention rationing the last ten million doses and we have New York City independently ordering its own vaccine from Europe."

"In short, every American is getting a chance to see what life's like for people without health care insurance and just how precarious the health-care system really is.

"The strain of flu that is coming our way has been dubbed by one reporter as the Free Market Flu. This shortage is not, after all, a natural phenomenon, like say, a shortage in pomegranates or pineapples. The world did not run out of the chicken eggs whence the vaccine cometh."

"The entire debacle comes from the fact that preventing the flu isn't as profitable as, say, treating erectile dysfunction. The major American drug companies, who continuously tell us that their profits are for our benefit, don't do flu vaccines any more."

"For some years, flu prevention has been outsourced without oversight. Chiron Corp., one of the vaccine manufacturers, had worried the FDA as long ago as 1999, but it was the Brits who blew the whistle on them in October when this year's batch of vaccines was contaminated. We were left dependent -- mon dieu ! -- on a French Company, Aventis Pasteur."

"As James Morone, a political scientist at Brown University and co-auhor of the upcoming Healthy, Wealthy and Fair, says, "When one company in England runs into trouble, the whole thing collapses. Private markets are only as good as the public health system overseeing them." "If there were a sudden run on watches or sofas it wouldn't be a problem, but health care can't work that way."

"Instead of sofas and watches, it might be life and death. About 36,000 people died from the flu last year and that was when vaccine was available.."

"After 9/11 with all the talk of bioterrorism, anthrax and smallpox, there was the beginning of a dialogue about strengthening the public health system. But today we rarely talk about the basics, like vaccines, as a public good."

"Americans have long been told that national health care would mean long lines, rationing and second-class medicine. Despite spending more of our gross national product on health care than any other country,we rank 29th in life expectancy, right between Slovenia and Portugal. And what do we have ? Long lines and rationing. Not to mention lotteries, and a shot in the arm for Canadian tourism."

"Maybe it takes the Free Market Flu to remind us that sometimes we need a public health system as much as we need a fire department or a military. For the moment however, a casino in Las Vegas has generously donated its 5,000 doses to he local health department. A retirement home has given the Denver Santa his shot."

"Meanwhile back home, I think I will tie a patriotic yellow ribbon around a great big pot of chicken soup."

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Some of my opinions and thoughts.

Ellen Goodman, among other things, in her column mentions a Santa in Denver who will possibly have at least ten thousand children on his lap this season, who got his shot through the generosity of a retirement home, where the danger of flu to older and frailer people is great.

We have a grandaughter who was deathly ill with pneumonia last winter -- denied a flu shot as she is classified as "not at risk." Most of those who read Ellen Goodman, I think, could mention many more instances of needs not met for those who will suffer greatly if they get the flu.

It is easy for a layman like me to suggest solutions to this problem, many of which might not be feasible. But FDA has power and could possibly use it to lay the law down and say, "If you wish to sell, in our country, prescription or over the counter medications, -- then you must produce all the serums and vaccines needed in preventitive medicine here. Those items being explicitly of A-one quality and dependability."

Sounds easy, doesn't it ? Imagine the hoo-hah and lawyerese afloat over something like that. AMA frothing at the mouth possibly ?

Old man Kaiser who had a feeling for his employees apparently did not want his employees to put out exhorbitant payments for their health care and started what became Kaiser-Permanente, to make affordable for them necessary health care. But, it seems to me that HMOs and other health care systems have allowed the costs to be added and compounded astronomically, while those of us protected (more or less) have been blissfully unaware of the costs adding to costs.

When I went to Kaiser-Permanente in 1977, a prescription cost $2.00, a visit to a physician $2.00, any procedures - free, x-ray and labs free. Hospitalization - free. Now even though the company I retired from still pays about the same as it has before, prescriptions - the minimum $5.00 others much more, Physician visit now $10.00, procedures - minimum, $25.00, ambulance $50.00. X-rays and labs still free. I have some relatives with the same coverage who pay more than $700.00 a month to Kaiser.

So, like in the oil filter ads of past, "you can pay me now, or you can pay me later," seems to fit.

Is there some way to make health care affordable for us all, other than "Socialized Medicine" ?

Will the FDA insist that all vaccines and serums be produced and guaranteed effective by the drug manufacturers ?

Or will the bean counters and lobbyists prevail once again ? What happens to us all if the flu this year or next year is of the 1918 death toll variety ?

Are we again to be put down by the dread Bottom Line ? . . . . . . . . .

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