Should the government pay for flu vaccines for everyone?

[Dred Pirate]

With the covid vaccine being provided by the government free of charge, it got me thinking if we should have a similar process for the flu vaccine. I am not sure what other vaccines the government provides for free. I know in my state the hep B vaccine is provided by the state for newborns, but unsure if any others are. The local health department does provide vaccination, but it is run through your insurance/medicaid - not free per se.

I know there are those that fall into "healthcare for all" and others on the other end of the spectrum that it should be "no government involvement in healthcare" so the question of vaccine availability wouldn't be any different in this question than if you asked if there should be "free knee replacement for all" or "free pneumonia coverage for all", so I added the questions in the middle to differentiate those that don't have a view to one extrememe or the other.

Personally I fall into support of a universal healthcare system - but I realize that isn't happening anytime soon, but would advocate for vaccine availability for all.

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[owlegrad]

Interesting skew so far. Big time yes from me.

 

[Sparda29]

I'm pretty sure right now Medicare covers flu, shingles, and pneumococcal vaccines. But that's just for people on Medicare.

 

[Dred Pirate]

I'm pretty sure right now Medicare covers flu, shingles, and pneumococcal vaccines. But that's just for people on Medicare.

Correct. I am meaning a universal coverage for all people regardless of insurance status. Most vaccines are covered by health insurance currently (all childhood ones have been for my child)

 

[WorthlessOxygen]

I had a hard time choosing between
Yes- and I support a universal healthcare system
And
Yes - but only if a patient in uninsured - otherwise their health insurance has to cover it

I don't really see these as mutually exclusive given that I support universal healthcare but believe that most if not all preventative care should be covered by insurance in our current system.

 

[Seriously Serious]

I personally do not support universal healthcare. However, I'd be willing to compromise on universal ~preventative~ healthcare. If no one has private insurance, the state should be willing to cover the cost. Whether it be vaccines or birth control.

 

[Sparda29]

My problem with the private insurances is the variability among the plans.

Example: I was on the BCBS EPO for the last 2 years and it was about $250 a month but every year there is a $2000 deductible, and I have to pay 20% coinsurance if I use an out of network hospital. Meaning, even though I live in Long Island, if I need a hospital stay or a planned surgery, I would have to go all the way to the Bronx or to the hospital where I work to get the minimal cost.

So I signed up for the PPO but then the cost goes up to $1200 a month and there still is a $2000 deductible. Now, I'm trying to switch back to the EPO.

 

[lord999]

No - Status Quo

You all realize the federal government already HEAVILY subsidizes vaccines both indirectly through research and directly through setting price schedules? And the supposed private sector prices are always indexes to the VFC ones as no insurance company in their right mind would ever pay far outside the VFC scale (they pay more, but it is still subsidized from world pricing).

But remember, in return for the subsidy, that also includes protection against lawsuits. You can't sue a manufacturer for a vaccine, you have to go to the Special Master for vaccine injuries which do legitimately happen on the scales they are used (encephalopathy in a flu vaccine is something I have directly witnessed and was a complete bad luck issue.

I don't believe in "free" vaccines in the same way as I don't think our time are "free", but I would support a "free" to receive if the tax basis changes to account for it. The current tax structure does not, and we are in serious trouble with the Medicare Trust Fund running out (which is what is used to subsidize these vaccines).

I'm not ok changing the status quo unless we are willing to accept higher taxes to fund the Trust or else we bankrupt ourselves through runaway interest on the debt service.

 

[RxPreceptor]

Not right now...I would like to first see govt address/acknowledge citizenship & paying/providing services for those who choose to live here illegally

 

[MatCauthon]

Not right now...I would like to first see govt address/acknowledge citizenship & paying/providing services for those who choose to live here illegally

you want non citizens to receive healthcare before all the uninsured citizens healthcare needs are resolved?

 

[RxPreceptor]

you want non citizens to receive healthcare before all the uninsured citizens healthcare needs are resolved?

Is this really that hard to interpret that I don't believe US citizens should be paying healthcare for non-citizens/illegal immigrants?

 

[owlegrad]

Lol am I the only one who thinks these two aren’t reading each other’s posts properly? Or am I the dumb one?

 

[CetiAlphaFive]

I would vote yes if i knew it wouldn't inevitably result in Tucker Carlson claiming that the flu shot is fake

 

[WorthlessOxygen]

Lol am I the only one who thinks these two aren’t reading each other’s posts properly? Or am I the dumb one?

I get what they're both saying but those posts are worded awkwardly enough that it took a couple reads for me to understand

 

[BidingMyTime]

Not right now...I would like to first see govt address/acknowledge citizenship & paying/providing services for those who choose to live here illegally

Is this really that hard to interpret that I don't believe US citizens should be paying healthcare for non-citizens/illegal immigrants?

Yes, it is very hard to interpret your words. You literally said you want to see govt paying/providing services for those who choose to live here illegally, before providing free flu shots. I also thought that was a weird thing to say.

As for OP's question, if you had asked me a year and half ago, I would have said NO. Covid, & the idiocy of people (especially my former libertarian friends) however, has shown me the limitations of my libertarian ways, I now say yes, we need single payer.

 

[owlegrad]

Yes, it is very hard to interpret your words. You literally said you want to see govt paying/providing services for those who choose to live here illegally, before providing free flu shots. I also thought that was a weird thing to say.

As for OP's question, if you had asked me a year and half ago, I would have said NO. Covid, & the idiocy of people (especially my former libertarian friends) however, has shown me the limitations of my libertarian ways, I now say yes, we need single payer.

To be fair, it seemed clear to me that what he meant by “government address” was that he doesn’t want the government to give benefits to immigrants. But I can certainly see why people have a hard time getting that from his post.

 

[RxPreceptor]

Yes, it is very hard to interpret your words. You literally said you want to see govt paying/providing services for those who choose to live here illegally, before providing free flu shots. I also thought that was a weird thing to say.

As for OP's question, if you had asked me a year and half ago, I would have said NO. Covid, & the idiocy of people (especially my former libertarian friends) however, has shown me the limitations of my libertarian ways, I now say yes, we need single payer.

Not right now...I would like to first see govt address/acknowledge citizenship & paying/providing services for those who choose to live here illegally

verb - address paying/providing services for those who choose to live here illegally
AND/&
verb - address citizenship

ok let's just say "re-evaluate" instead of "address"

#English
Bold hardly shows up when typing on this website

 

[CetiAlphaFive]

Yes, it is very hard to interpret your words. You literally said you want to see govt paying/providing services for those who choose to live here illegally, before providing free flu shots. I also thought that was a weird thing to say.

As for OP's question, if you had asked me a year and half ago, I would have said NO. Covid, & the idiocy of people (especially my former libertarian friends) however, has shown me the limitations of my libertarian ways, I now say yes, we need single payer.

Agreed. The pandemic has pushed me to the left in a significant way on a lot of issues.

 

[CetiAlphaFive]

verb - address paying/providing services for those who choose to live here illegally
AND/&
verb - address citizenship

ok let's just say "re-evaluate" instead of "address"

#English
Bold hardly shows up when typing on this website

The syntax and grouping of the words is what makes it confusing.

 

[owlegrad]

verb - address paying/providing services for those who choose to live here illegally
AND/&
verb - address citizenship

ok let's just say "re-evaluate" instead of "address"

#English
Bold hardly shows up when typing on this website

Seems very bold to me. We have different templates so it could be different depending which version you are on.

 

[WorthlessOxygen]

Seems very bold to me. We have different templates so it could be different depending which version you are on.

Do you use one of the dark modes?

 

[owlegrad]

Do you use one of the dark modes?

No I use the default.

 

[WorthlessOxygen]

No I use the default.

Bold is very subtle in the dark modes. One of my biggest complaints about them

 

[owlegrad]

Agreed. The pandemic has pushed me to the left in a significant way on a lot of issues.

Like what? If you don’t mind sharing of course.

 

[sadface]

Is this survey biased by retail pharmacists sick of trying to figure out flu shot billing 🤔

 

[RxPreceptor]

Bold is very subtle in the dark modes. One of my biggest complaints about them

dark mode as well. Yeah maybe bold appears subtle due to the white font...like colorless imprints/engravings on white tablets FFS

 

[owlegrad]

Well I hate to totally derail the thread (too late I guess lol) but do you have an example of bold text that looks good/clear/bold in a dark mode website and I’ll see if the Dev team can prove it for SDN?

 

[lord999]

Well I hate to totally the thread (too late I guess lol) but do you have an example of bold text that looks good/clear/bold in a dark mode website and I’ll see if the Dev team can prove it for SDN?

Serif Didione or a thinner font works well. It’s a well known typography problem.

 

[Dred Pirate]

As for OP's question, if you had asked me a year and half ago, I would have said NO. Covid, & the idiocy of people (especially my former libertarian friends) however, has shown me the limitations of my libertarian ways, I now say yes, we need single payer.

You sound like you have taken a similiar path as I have as I grew older and more wise. I used to despise the thought of universal healthcare - and voted Libertarian often. I still believe in personal responsibility, but understand what is better for the country as a whole.

 

[lord999]

You sound like you have taken a similiar path as I have as I grew older and more wise. I used to despise the thought of universal healthcare - and voted Libertarian often. I still believe in personal responsibility, but understand what is better for the country as a whole.

I went the other way. I went into graduate school being very much a pro of universal healthcare, until I actually dealt with it both at a practitioner and at an administrative level which a single point a failure becomes damning when run by a bunch of sociopaths (think the UK system under Boris Johnson right now who clearly doesn't give a damn about it). I dislike the American donut hole where the working class has poor to no coverage, but I actually favor the US employment based insurance system over most single payer systems (I consider the German hybrid the best compromise and an improvement over the US system, but its not a single payer system).

I also have faith in the enduring power of human stupidity. I have no problem with dumb people screwing themselves or mismanaging their communities to the ground. You can and should usually choose to live among people who aren't that stupid. You can't outlaw it, you just manage it. Perhaps we're going to get to Mexico's or South Africa's enclave style living for the middle class due to this (where their societies clearly don't give any consideration to the poor's livelihoods or security and the middle class pays a premium to hire in their private security enclosed properties), but on the other hand, you can't save everyone. It's actually debatable if you can truly save anyone who won't help themselves. Medical Nemesis was the book that converted me from the idea of paternalistic intervention to a DIY responsibility. You build programs to extend helping hands to those who want it and will work for change, and then make policy and economic arrangements to trap the rest in the cycle of minimum expectations to the degree that they are pacified into disastisfied silence like most retail pharmacists these days.

You get what you pay for. I'd rather be in the position that I can pay for my own care to what I feel the limits are than take whatever low standard the government gives you. And this is coming from someone who pays out enough to hit annual out of pocket maximums on the Civil Service Insurance ($12k a year) and can take itemized deductions on it. Under socialized medicine, you take what you are allowed, but in this system, you can pay for better and in our position, we can.

 

[CetiAlphaFive]

Like what? If you don’t mind sharing of course

Like what? If you don’t mind sharing of course.

I now:
Support universal healthcare.
Some form of extended universal income under certain circumstances.
Armed violence against certain political groups

 

[SlitLampExam]

Universal health care systems are run by politicians. As a result, it is always underfunded. You can be for or against universal health care but know it is underfunded. Sometimes, you cannot buy your care if there is a universal health care system.

As far as flu shots, it's free with no deductible with Medicare and also my private insurance as well as Medicaid.

In India, sometimes free is looked at with suspicion but things you have to pay for, even if low priced, is looked with less suspicion. Disclaimer: I am not Indian. I have only visited India briefly as a tourist.

 

[confettiflyer]

Yes, because most of the costs are incurred by Medicare beneficiaries, so my gut says universal flu shots will save $$ over time. I’ve done zero research for that statement.

Also, fewer sick days and lost productivity by working age people out sick will increase federal income tax receipts.

Overall net gain, financially. I’ll let someone else calculate QALY, etc etc…

 

[lord999]

Yes, because most of the costs are incurred by Medicare beneficiaries, so my gut says universal flu shots will save $$ over time. I’ve done zero research for that statement.

Also, fewer sick days and lost productivity by working age people out sick will increase federal income tax receipts.

Overall net gain, financially. I’ll let someone else calculate QALY, etc etc…

Nope. QALY yes, people do gain QALY with better access to care, but it's a definite no on costs. We know this from USRDS (dialysis), HIV, and mental health policies that Medicare/Medicaid basically pick up everything as increasing life expectancy doesn't necessarily mean increased financial value to society.

There's an old reason for this. Recall what the point of health care is in the US and why it's employer-sponsored, it was to keep the working population healthy. Don't take my word for this, read The Social Transformation of American Medicine and other history of medicine books on payment. The horizon expectation of private care insurance that is employer sponsored is to drag the worker through employment with as much productivity as possible until retirement. After retirement, it's the government's problem.

The VA version of this phenomenon of better care actually costs more is actually problematic from a taxpayer standpoint.

Project MUSE - Current and Future Demographics of the Veteran Population, 2014–2024

muse.jhu.edu

So, what happens is that better health care from the 1990s when we went to a primary care model keeps veterans alive longer. Without increases in veteran worker productivity or more years of work, that's actually translated into higher costs for the taxpayer. The heartless observation is why do we have such good healthcare when it actually costs us more in the long run if there are no productivity gains in work/taxaction on veterans? My answer, which is quite a number of us is, it's part of the social obligation and if veterans healthcare is perceived to be too substandard, no one is going to risk their life on the line. It's why police and firefighter widows and orphans benefits are so generous, because they are positively correlated with better productivity and performance from the first responders. But, if we go back to the old Born on the Forth of July VA, we'll save money both by not spending more and letting veterans die earlier. And yes, a previous Secretary of Health, Education, and Welfare (today's HHS), Donna Shalala, had the math drawn up which is still used today for valuing health services (the Marthe Gold panel).

Honestly though, healthcare is a reflection of worker productivity. If you have unproductive workers, we don't get paid as our preservation of productivity isn't worth much. But if you have really productive workers, we take our reflected gains. We definitely do this for pediatric care because we get more and better workers out of the deal (SCHIP came about from those observations as well as why medical neonatology has unusually high procedural RBRVU's). Unless the US leverages the better health into more work from the average person, then there is no financial gain for better healthcare, only better quality.