Monday, November 02, 2009

Even the Victorians understood the need for public health

There's a new anti-healthcare reform talking point stalking the USA. That the swine flu vaccine experience proves that a government run healthcare system can't work. This meme was working around the blogosphere in the last couple of weeks and hits the big time today -- Bill Kristol:

After all, we're seeing a big government health care program in operation right now--the Obama administration's effort to deal with the swine flu problem. No, come to think of it, it's now the swine flu emergency. Last week, President Obama so legally designated it. How's that test case in government-run emergency care going?

Turn on your local news to find out. You'll see false reassurances, broken promises, rationing which doesn't provide the promised rations, queues lengthening while supplies run out, and lots of bureaucrats explaining just why things aren't working quite as their centrally planned plans had planned.

At the all-Obama-hating-all-the-time blog of Commentary magazine, Jennifer Rubin identifies "swine flu Moms" as the successor to soccer moms who likewise will rebel against the Obama plan on the basis of their swine flu vaccination experiences.

Which may be the most abysmal talking point yet. Consider the alternatives to a public vaccination program. The government could just get completely out of the business of procuring vaccines and let the invisible hand decide how much vaccine is produced and who gets access to it. Which raises problems so obvious it's amazing to have to spell them out. Contagious disease vaccination campaigns only work when lots of people get the vaccine -- especially for a quickly mutating virus like flu. And "lots of people" includes people with not much money, or no doctor, or with lack of time to go a doctor's office -- but who still breathe the same air as Bill Kristol and Jennifer Rubin. A long time ago, governments of very different political stripes decided that there was a basis for them being involved in public health programs. Apparently the deal is off.

And if you don't like the trip through successively smaller waiting rooms that is a visit to the doctor's office now (Seinfeld joke) just imagine what it would be like with a mob there convinced that they're the ones who need the vaccine more than anybody else.

Another perspective: the US swine flu vaccinations are being run by state and local governments, who vary in their access to the vaccine, their capacity to deliver it, their criteria for deciding who gets it, and their procedures for enforcing those criteria. We could simplify by putting the federal government in charge of the whole thing and then it would be uniform procedures throughout the country. But then the accusation would be that Obama is "federalizing" healthcare -- and that's before the crazies would get working on the idea of the federal government giving everyone injections. Especially if the government decided to manufacture the vaccine itself -- given the production problems that have arisen with letting private firms do it.

So anyway, the point is that if you don't like the current approach to swine flu vaccination, the alternative is more free market provision of it, or more government provision of it. Which do Kristol and Rubin prefer?

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