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Its clear we'd rather go to war than fix our health care problems

By Andrew Pollack on 10/09/2004 at 01:38 PM EDT

In the U.S., about 50% of the expected vaccine this year has become unavailable. Its a known fact that each year in our country, more than 36,000 people die as a result of complications from the flu. These are the youngest children, the most elderly, and those who are immune compromised like cancer patients.

As a direct result of our total mismanagement of the flu vaccine production and distribution, more people will die in our country than were killed by the attack on September 11th. There is no question that this is the case. More people will miss work, more people will contract the illness, more people with the illness means more people will spread it, and more people will die.

Of course, this issue leaves many people dead, but nobody to bomb. We don't have a country to invade, and we don't have photo opportunities on the flight decks of multi-billion dollar aircraft.

Way back in third grade, I remember a teacher telling us to think of money not as a "number" but in terms of what it could buy. Is a dollar a number 1, or is it a loaf of bread. What is the cost of an ensured delivery of something so important?

Thousands of lives will be lost this year, when they could have been spared at the cost of 1 day of fighting Iraq.

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Not quite so simpleBy Richard Schwartz on 10/09/2004 at 10:20 PM EDT
I'll likely be foregoing my vaccine this year (I'm just in a moderate risk
group), but I can't see connecting this to spending priorities.

First of all, a successful production and distribution cycle is no guarantee of
successful immunization. The vaccine is customized every year, based on the
CDC's "best guess determination" of what virus strains will be present this

Secondly, the whole process is deliberately a last-minute thing, with little
margin for error. The longer they wait to make the determination, the better
information they'll have, the better chance the customized vaccine will turn
out to be effective.

Third, production is left to the private sector. Chiron, the company whose
production was shut down by the UK equivalent of the FDA, was assuring the
government just a few weeks ago that there would be no problem meeting their
quota. Vaccine production was profitable for Chiron, and my understanding is
that it is for the other suppliers as well. Having more suppliers would cut
profit margins, which might lead to more frequent quality problems as more
corners are cut, and would not necessarily increase the short-term
manufacturing capcity as each supplier would plan for less capacity. And it
doesn't seem to me that throwing more money at it or federalizing production
would make production problems any less likely.

Exactly that simple...By Andrew Pollack on 10/10/2004 at 03:57 PM EDT
Rich, it really is that simple.

The poor control over this process is a side of the poor control over the whole
industry we have in the U.S.

In the U.K., where this particular Chiron plant is located, the logical step of
not allocating more than 20% of the vaccine production to a single firm means
they aren't in the same kind of trouble we are here.

Our hands off approach to drug companies leads us to have the terms of our
purchases dictated to us. This is just dead wrong. Drugs, unlike consumer
products, are by definition an effective monopoly. It is time to re-align the
playing field a bit. If Pfizer, for example, wants the right to maintain a
monopoly on sales of its drugs its going to have to spend time also doing
public service work. The alternative is to cap profits on monopoly drugs,
removing the cap only when the drug company willingly allows generics to be

If you invest in research, produce a drug, and gain a patent -- sure, you have
some limited right to profit from that investment. You do not have an
unlimited right to profit from the illness of others however. Not when your
research is derived from other research done at universities, done in public
studies, done with volunteers. The fact that your research was entirely your
own is a falicy.

Time to bring back some reason into the discussion.

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