One of the largest, and largely invisible, benefits of national health care systems is the ability to carefully target treatment at a population level to maximize benefit. A good example of what I mean is the way that European nations are managing their swine flu vaccines:
[A]cross most of Europe, vaccine to protect against the pandemic flu is mostly given by invitation only to those at highest risk for flu complications.
“That is one of the great advantages of the British health system,” said Dr. Steve Field, president of the Royal College of General Physicians. “We have a list of all the names of patients who qualify to be vaccinated.”
When Britain unrolled its pandemic vaccination program last month, it designed its campaign to ensure that priority groups — including pregnant women, health workers and those with chronic health problems like diabetes, cancer and AIDS — get the shots first.
Instead of advertising that vaccine had arrived and waiting for the lines to form, Britain’s National Health Service sent letters, inviting all those who qualify to make an appointment and get the shots first.
This ensures that the people who are most vulnerable get the vaccine first, reducing the number of severe complications and deaths. This saves the system money by reducing the number of serious flu cases, and it maximizes the number of people who will live through an epidemic, both by reducing complications in the first place and ensuring that resources (money, space, doctors, medication) will be available for those who become seriously ill.
By contrast, in the US we let Goldman Sachs get the vaccine, while high-risk groups still have not received it.
Some will no doubt say that it’s outrageous that European governments are “rationing” the vaccine this way. Personally, I find our method of rationing — letting the rich people get it first — to be far more morally objectionable, not only because it privileges the wealthy, but also because it introduces more risk into the system without providing any systemic benefit. As with the bailouts of the bank system where we privatized profit and socialized risk, America’s method of vaccine distribution privatizes health and socializes death.
Is that who we really want to be?