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Opening Arguments

Cheap shots

The state has announced a sensible policy on immunizations based on the fact that there isn't an unlimited pile of money available to pay for them -- starting now, it will no longer allow county health departments to provide low-cost immunizations to children who have insurance. But the panic is already settling in. This is a move that "some fear will lead to fewer children receiving critical vaccinations."

But the policy could have an unintended consequence. Some insurance policies have a high deductible, leading to bills in the hundreds of dollars to get vaccinations in a doctor's office.

A pre-kindergarten visit, for instance, can run about $600 for vaccines. By contrast, county health departments typically charge only a nominal fee for shots.

Dr. Mary McAteer, a Carmel pediatrician, has seen high deductibles drive more private-pay patients to the health department. Some families realize that their insurance will only cover one shot; they go to the health department for the others.

The health department was a great resource for those people that were underinsured," McAteer said. "When they don't get to go there, it's going to be a huge impact. They're going to have to make some big decisions."

Whatever happened to the notion that government aid should be reserved for the neediest, with the rest of us paying our own way? Silly question, I know. It's so much easier just to keep handing out the tax-funded freebies than to ask people to make those "big decisions."

Comments

William Larsen
Thu, 06/09/2011 - 10:58am

What is the definition of needy? What is the definition of insurance? There are high deductible insurance policies that cover catastrophic bills >$2,000 while not covering shots, Dr. visits, etc. Then there are those who make more than those who chose to protect themselves by buying catastrophic health insurance, but those higher income people do not elect insurance.

My problem with this all or nothing, is it is not based on need at all. The sole discriminator is "does the person have insurance?" The question should be based on ability to pay. But even the ability to pay is non quantifiable. Seniors have low incomes, but then they are retired and supposed to be living off a combination of income and principal. Income in this regard is not a good measure of needy. The same can be said of working class people. A person who has saved all their lives and has a savings account earning basically 0% has little income from that and when combined with a low wage could be considered needy, but in reality be very well off.

Government freebies are a problem. They attempt to define something that is difficult at best to do. Maybe a combination of asset and income is the best criteria to determine need, not whether a person has insurance.

littlejohn
Thu, 06/09/2011 - 4:52pm

Actually, vaccinating the poor is a very wise investment. If you don't get that, Google "herd immunity."

Harl Delos
Thu, 06/09/2011 - 7:28pm

For years, people who were willing to pay for the vaccination got the Salk vaccine, but they were still able to spread polio to other people. It wasn't until we got everybody to line up in the gym to receive sugar cubes with the Sabin vaccine and we GAVE THE DOSES AWAY FOR FREE that we made polio extinct.

It was cheaper to treat everybody than it is to live with the consequences of having 10% of the population spreading the disease. The same is true for those pre-K immunizations.

If you think about it, who suffers if they don't get immunized? It's the kids themselves, who don't have the wealth or earning capacity to pay for these things themselves, and who don't have the ability to make important decisions, anyhow.

William Larsen
Thu, 06/09/2011 - 8:21pm

Harl, you are correct. For a long time I have held the belief that when Medicare started, the concept started with the wrong age group. Instead of doing preventative medicine from birth to some age, let us say 12, we started with age 65 and over. Pretty hard to do preventative maintenance on an aging body that many had life styles that corrupted it.

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