Blog by Sumana Harihareswara, Changeset founder

07 Oct 2004, 18:45 p.m.

This Will Hurt

Hi, reader. I wrote this in 2004 and it's now more than five years old. So it may be very out of date; the world, and I, have changed a lot since I wrote it! I'm keeping this up for historical archive purposes, but the me of today may 100% disagree with what I said then. I rarely edit posts after publishing them, but if I do, I usually leave a note in italics to mark the edit and the reason. If this post is particularly offensive or breaches someone's privacy, please contact me.

If you are healthy, and you aren't the caretaker for a baby or a sickly older person (etc.), then please don't get the flu shot, because there is a shortage this year. Or unless you are selfish! Argh. Is that harsh? The article profiles healthy youngish people who know there's a shortage, who know that healthy people need the vaccine less than children and the elderly (a healthy person who catches the flu might fall ill for a week; kids and old people die). And they take it anyway. How can that not be recklessly selfish?

I am pretty mad at Chiron, and at the market failure in general. There are some commodities that we can leave to the market, which gets supplies to demanders in the aggregate and in the long run. It is all right if there is a short-term shortage of Beanie Babies; I don't care if a five-year-old loses out one Christmas in the name of efficiency or profit. And then there are services that the government distributes to make sure they get distributed systematically and fairly. Some people believe that the only legitimate role of government is to protect its citizens from each other and from invaders. But our government has taken on a larger role. ( "... in order to form a more perfect union, establish justice, insure domestic tranquility, provide for the common defense, promote the general welfare, and secure the blessings of liberty to ourselves and our posterity...") The police and military defend us, yes, and public schools teach us, parks provide space for recreation, the FCC licenses the privilege of using public airwaves, and so on.

Should health care in general be one of those services? If not, what about this specific commodity of vaccination against deadly diseases? Several biotech companies used to provide the shot for the US market; this year it was two, now one. Should we diversify our vendor list? Should we keep closer tabs on contamination in vaccine factories through government regulation and inspection? Should we make sure our vaccine providers make the vaccines in the US, where we can watch them better? (The offending Chiron plant is in England.) Should we specifically tailor tort reform to encourage vaccine manufacturers?

Should we be leaving this to private companies at all? Epidemics are national emergencies; if feasible, should the CDC make the vaccine itself instead of depending on businesses? (Analogy: sending the National Guard to fill sandbags, preventing a flood.) "[W]e haven't yet discovered a better form of social organisation than private property for solving several important classes of optimisation problem"; is this one of them?

Last year's shortage and this year's debacle-in-progress have me joining lawmakers in pondering what we need to do for next winter and all the winters thereafter. Epidemics affect everyone; shouldn't we avoid them like the plague?

A healthy 30-year-old refuses to talk to the Chronicle about why she's standing in line for the flu shot at Walgreens. I want to tax more or divert taxes from other projects to make sure Claire, Ada, Joel, Frances, Shweta, Rosalie, and my other friends and relations get a fair shot against the flu. Who's being selfish?