Male1: Healthcare for pediatricians is very difficult thing to talk about-the cost of vaccines is about for an average practice of about 2500 kids, which is great, which is a small average, maybe below average practice, what is the cost for boys over this time spent acting fully is about $3 million, about $1200.00 a kid. If it is a girl and you give the new Gardisil, it could be another $400.00 a kid over your career. So the money involved in vaccines is huge. There is a program in New York State, thank God, if a person has a Medicaid or a Child Health Program, we get the vaccines for free now, which is a great idea. Some states are giving all of the vaccines to the pediatricians and they either collect it from the insurance company by batch payment or they just give the doctors a fee. Massachusetts which happens to have the highest immunization rate, most of the vaccines are given to the pediatricians. I think the pediatrician should get a little bit of an administration fee, but it does not have to lay out huge numbers. I have actually met with the people in the Department of Health on several occasions and said, why do you not just give me all the vaccines, I will report it to Blue Cross or some fine insurance company and let them on a batch payment give it back, so I do not have to touch these huge dollars putting on credit cards praying that I get paid back.
In the newspaper, which is in front of you, we are not going to mention the doctor’s name, he was knowingly vaccinating for about nine to ten years outdated vaccines. He did not have a lot of vaccines and was on a shelf and got outdated, I spoke to the newspaper reporter and the impression she left with me and I hope I am wrong, he found a way of getting outdated vaccines, obviously from an illegal source and using it to his patients. Why would he do it? Jeopardize a license, unless the money involved had to be enormous.
Estimation, he made $500,000.00 high end, could even be as much as a million. Take the dollar value of these vaccines away from the pediatrician—let me just give the vaccines when it is properly indicated and maybe some of these situations that we are worried about, sue them to make money on a fraudulent, allegedly, who knows if he even gave them that? He may have given sugar and water?
Male2: Well, vaccines at time having just reviewed the recent immunization schedule published by the American Academy of Pediatrics are far different than they were 20 years ago when I was beginning in this area of pediatrics. We have been very successful in the development of vaccines. We have been very successful in new vaccines and in modifying and improving old ones. As a result, the numbers of vaccines we now give children is far, far greater than we ever did before and they are far more expensive. It is unrealistic and not appropriate to expect the pediatrician to front end the cost of those vaccines with the hope of getting reimbursed at some percentage by an insurance company.
If we want to fully immunize our population, we must figure out a more appropriate way for those vaccines to be paid for so that our children and really our adults can be safe and protected from those multiple viruses and bacterias that we now immunize against.
Those countries or state that provide vaccines free of charge, no question, the immunization rate is higher and as a result, the population is healthier and more productive. If you are going to measure value to a society that is the way to look at value to society.
The current process by which individual physicians must lay out the money upfront to buy the vaccines is absurd and one that will only lead to non-compliance or ways of getting around the system which will only hurt children and lower the immunization rate. None of which we want to see happen.
Male: So in other words, the pressure of—I should say the cost that is put on the pediatrician could be greatly reduced if the people who are in the Department of Health or at CDC got together and came up with a system that we deliver the vaccines, but do not pay for the cost of the vaccines and make sure we follow the guidelines correctly and get audited, we are doing it correctly. Maybe we are going to get a smaller administration because the labor intents are recording that. It will be free for everybody involved, is that correct?
Male2: Well, I strongly believe and this is purely my opinion that first, healthcare should be universal and there should be no population who is exposed to a non-insurance situation and I hope that under whatever new administration who gets elected, that we are able to have a universal health system for all of our populace for both children and adults.
Second, there will be specific types of medications perhaps and certainly vaccines would fall under them. That the cost of them would be underwritten by the central government and in my mind that is a wise use of resources, tax dollars, a citizenry pays, either the Medicare or through its own tax dollars and it makes perfect sense because that way, we can guarantee a higher immunization rate and a healthier society. We know that for instance the slippage in vaccinations against pertussis has led to greater pertussis in teenage and adult population. It has decreased quality of life for those adults and even caused some death and certainly illness, much greater than it needed to be. We have seen the reemergence of some measles. We have seen the reemergence of some of the bacterial diseases that are preventable. All of that would go away if we had a uniform mechanism by which payment for those vaccines was guaranteed and therefore administration by the providers, either in the adult, internists for adults or pediatricians would also be a guarantee with an administrative fee for the cost it takes to give that vaccine. That will take some universal healthcare overall and some clear philosophical agreement on the part of our politicians, but it is the way to go.
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