By Dan Pool, editor
Before the New Year’s holiday, I heard of several people with the flu. My immediate thought was “oh &*$%, we haven’t gotten our flu shots.”
Normally my family gets flu shots as a regular part of winter – the number of press releases we run from the health districts prompts me to insist on the whole family getting shots.
Our Progress insurance, through Aetna, has a program where we can get free flu shots at CVS. My wife got her shot for free and was on her way in a matter of minutes last week.
I showed up an hour later, seeing the same very nice pharmacy assistant but my insurance card wouldn’t go through for the free shot. To the local store’s credit, they were much more patient than I would have been with the people they were on the phone with trying to find out why I wasn’t being allowed the free shot. The local pharmacist said the excuses from whoever was on the other end of the phone included my personal information was not correct in one instance and that I wasn’t even on the plan at all in another.
I went ahead and paid for the shot, around $18. Considering health-karma, I figured if I walked out, I’d have full-blown H1N1 by the time I got home – (and I know it takes two weeks for the shot to build up your immunity). But, you don’t anger the health gods when it comes to flu shots.
Of my kids, one daughter went to another pharmacy who would give the shots to 13-year-olds without prescriptions, (but not 12-year-olds) -- as long as we paid for it. We got a prescription sent over to CVS and the 12-year-old got her shot there, also for free.
While this is one isolated case involving one family, it shows well the dysfunction in the healthcare/insurance industry. Critics often talk about the complexities and peculiarities of medical treatment in this country as a chief flaw. If fast food restaurants can ensure identical dining experiences at thousands of locations, why is healthcare drastically different when comes to what’s provided for what price?
Except for payroll and newsprint, insurance is our biggest expense at the Progress. We spend a fortune on it and the price keeps rising. To handle the rising costs, every year the Progress drops down to a little worse insurance package. Obamacare doesn’t really figure into this either good or bad at this point. Maybe the price rose a little more than normal in the latest proposals, but really we see the same rising dollar amounts every year. On the good side, when the private insurance finally gets more than we can afford, the “marketplace” will provide a safety net for us.
If there was an advertiser who spent as much with this newspaper as we spend for insurance and I found out they had an issue over a $20 want ad, I would drive to their house to straighten things out. But with healthcare, consumers are always over the barrel. There is no negotiating power because it’s something you have to have and few options for small companies.
On a larger scale, the inefficiency with giving something preventative, like flu shots, is intolerable. Everyone benefits when flu shots are given, both financially and for health reasons.
Consider that only around 40 percent of the U.S. population gets a flu vaccine. The vaccines are only good for one year. Whatever is not used is discarded.
The private companies re-formulate their vaccines to match the current strains of virus each year working through the CDC. There is a lot of research that goes down the drain every year with unused flu shots.
Influenza is the most troublesome, vaccine-preventable disease in America. On an average year, 200,000 people will be hospitalized due to flu related issues; 36,000 will die. Numerous studies have shown that while not guaranteed to keep you well, the yearly influenza vaccination is very effective at reducing the likelihood of you getting the flu.
The Congressional Office of Technology Assessment estimated that direct costs of treating influenza run $1 to $3 billion each year. And the indirect costs of missed work and disruptions to business range somewhere in the neighborhood of $100 billion per year based on several online articles.
The country as a whole and the insurance companies would be better off if they just gave flu shots to everyone who wanted them –sure the vaccine producers would have to be paid, but obviously there is more money going down the drain every time a shot is not given.
Higher number of doses administered would greatly lower the per-dose costs; the country would save substantially on medical costs by lowering the number of flu cases and businesses would operate better with fewer absences – not to mention the great benefit to those suffering from the flu.
But this is not likely to happen. And that is just one example of how our healthcare system needs an overhaul.