Rationalizing the flu vaccine shortage SNAFU this Fall, Vice President Dick Cheney said that the real problem was that making flu vaccine was insufficiently profitable. What he did not explain is why anyone should profit from the human tragedy of disease and death? The flu vaccine crisis is just one further case in point of the utter impropriety of an economic system based on profiteering from human misery and suffering.
Our Government Knew
Our government KNEW it had a flu-vaccine production and distribution problem - and has known for years.
Our government KNEW that the Chiron plant in England was operating under substandard conditions but failed to secure additional providers in case the plant was shut down.
As if the flu vaccine shortfall weren't bad enough, it has been reported that some of those drug distributors who obtained supplies of the vaccine engaged in price-gouging, raking in windfall profits, exploiting the fears and anxieties of those most at risk. According to one report, more than half of those US hospitals responding to a survey in October said they had been offered flu vaccines at inflated prices. How can that be legal? How can that be tolerated?
As there is and will continue to be unpredictability in demand for flu vaccine, owing to the annually variabile severity and infectivity of virus strains, it is the responsibility of a decent, caring government to shoulder the financial burden of that uncertainty. A decent, humane government would ensure adequate supplies of essential medication are available when needed. If that means making more than is expected to be necessary, with the public shouldering the extra cost, do so! Certainly that is less costly and more beneficial socially than initiating illegal, immoral, unnecessary wars. People before profit!
And that's not all. There's the Vioxx fiasco: did or did not Merck managers conspire to withhold, disguise or misrepresent evidence that the drug had deleterious side effects from/to prescribing physicians and/or the public?
What about the charge in a recent Journal of the American Medical Association editorial that oversight of prescription drugs already on the market relies largely on drug manufacturers' investigating reports of adverse reactions to their own products? Why on Earth would the foxes be put in charge of security for the chicken coop?
It’s not just Vioxx
What about the issue of the advisability of prescribing anti-depressants for children? That issue was raised prominently in the United Kingdom well before it was widely considered in this country.
What about the recently revealed side effects and multi-drug interactions of cholesterol-lowering drugs: Bayacol, Lipator, Zocor, or Crestor?
An item in the 23 November Newsday, reports that median approval times for standard drugs dropped from 27 months in 1993 to 14 months in 2001, while the percentage of drugs recalled rose from 1.56% during 1993-6 to 5.35% over 1997-2001. Are drugs being rushed to market without adequate vetting and testing? So it would certainly seem.
Was and is our government more interested in the welfare of the drug companies than its own citizens, more interested in concentrating wealth in the hands of a few than serving the needs of its community? It has been alleged that the FDA has become an advocate for the drug industry rather than its watchdog. What is the truth?
The purpose of a democratic government
Is not democracy, by definition - of, by, and for (all) the PEOPLE? It is NOT to enrich the few at the expense of the many. Rather it is, or ought to be, the job of democratic government to protect and provide for those of its citizens incapable, for whatever reason, of providing for themselves.
Reasonable people understand that:
- medical science is continuing to evolve,
- there are inevitably risks with the utilization of any drug, new or tried,
- the reactions of different individuals to any particular drug may differ, sometimes catastrophically.
... but taking all available, appropriate measures
- to protect the most vulnerable against seasonally predictable disease outbreak,
- to assure that testing and reporting procedures for new drugs are in the hands of objective appraisers not those very producers who stand to lose if approvals are delayed, and
- to protect those afflicted by medical conditions from the risks imposed by hasty approval and marketing of inadequately vetted medications,
These are fundamental expectations of a rational, humane health care system. Why doesn't America have such?
The development and testing of new drugs inevitably results in uncertainty both in their efficacy and the attendant risk of adverse reactions. But the public, both the prescribing physicians and their patients, must be provided with the information necessary to make rational decisions, not have that information withheld, disguised or misrepresented by the producers who stand to lose profits from unfavorable experience or unsatisfactory results of tests with the drugs.
It appears America's health care system is again failing to take the necessary measures adequately to provide both the supply and safety of at least some medications, seemingly for the sake of producers' profits. More than in any other country in the world, is adequate, effective health care in America subordinated to private, corporate profit? As proudly we proclaim the superiority of our health care technology, are America's healthcare resources principally employed, not to meet the most urgent health needs of the citizenry, but to boost the profits of drug companies, equipment manufacturers and healthcare professionals? Do profits come before people?
In a civilized, humane country, the provision of adequate supplies and reliable safety of appropriate medications required for the well-being of the populace would never be left to the vagaries of the marketplace. Time and time again markets have shown themselves NOT to result in the general good but in the private and personal benefit for the few. To leave the welfare, the well-being, of the country in the hands of marketers and profiteers is criminally absurd.
Too many people's lives and welfare are put at risk for the benefit of corporations, their stockholders and beneficiaries. It is no excuse that private companies are allowed to close a necessary production line following a year in which that line was insufficiently profitable when a public need is at stake. It is no excuse that the bottom line would be adversely affected if the truth of a drug's safety were known. In most corporate charters the proviso is established that the corporation shall function for the public good. Companies that fail the test of providing for the general good should have their licenses, their charters revoked! Does this happen? Why not?
The fundamental issue in these cases is the chronically demonstrated inability of our profit-driven health care system to meet essential societal needs. So long as the private sector handles the manufacturing and distribution of vital medications while government passively pleads and clucks from the sidelines ... so long as monitoring and reporting the efficacy of marketed medications is left in the hands of the marketers ... social needs will be left unfulfilled, and the public will be put at unnecessary risk by manufactured shortages and unexpected adverse drug reactions.
Do No Harm
First, do no harm? Over and over again the free-market system has demonstrated that it doesn't work in medicine. Supply is provided for unnecessary, inessential, high profit, high profile, luxury items and procedures for those who few who can afford them, rather than what is needed by those with essential medical requirements but limited financial resources. The problem is that ability to pay, the source of profit, is no, repeat no, measure of need.
Profit, not need, directs supply
Demand as measured by potential profitability, not need, powers the engines of supply. Health care, if nothing else in this country, ought to be provided equitably, in abundance, on an as-needed basis, with sufficent excess capacity to cover unanticipated glitches. For example, in the Canadian system, the federal government orders the bulk of the anticipated need for flu vaccine each year and then distributes the doses to the provinces as required. This hybrid market system provides a guarantee both of return for the manufacturers and a sufficiency of supply. The American free-market system has failed utterly to keep pace with necessity both of providing essential medication and necessary monitoring of, and information on, drug safety for prescribing physicians and their patients.
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