Today's Opinions, Tomorrow's Reality 

Death by Hubris
The High Price of Rationed Medicine

By David G. Young

Washington, DC, February 1, 2005 --  

When the British inspectors found widespread contamination last fall of a plant producing the bulk of America's flu vaccine, American government officials and health care providers went into reactionary overdrive. Do-gooder authorities put the remaining vaccine supply into a Soviet-style rationing program, creating predictably disastrous results.

Old ladies stood in line for hours only to be turned away when supplies ran out. Younger Americans were refused access, being told by the powers-that-be that they were not worthy of the precious vaccine. Most Americans gave up on getting a flu shot. And by the end of January, some of the same do-gooder officials who hoarded the vaccine in the first place, realized that 5 million does were languishing in government custody.1 It is now a virtual certainty that millions of does held by the U.S. Center for Disease Control will be wasted, like bread rotting in a Soviet warehouse while peasants starve.

Like the Soviet central planners of yesterday, American officials sought to promote the good of the whole at the expense of individuals. What resulted was a complete fiasco, with deadly consequences. Long-term studies show that about 25 out of 100,000 Americans -- mostly those with weakened immune systems -- die each year from influenza and related pneumonia.2 If 5 million doses of the vaccine remain unused, and this season's vaccine proves 90 percent effective, this corresponds to 1,125 lives that could have been saved.

This will likely be the legacy of America's public health authorities' efforts. Over a thousand Americans will needlessly suffer premature deaths due to their actions -- about a third of the number killed on September 11th, 2001. If the flu season continues to be mild and fewer die as a result, it will be only due to blind luck. Given the failure of the centralized planners, Americans can do little more than pray.

There is no point in quibbling about how the rationing program could have been handled better. The world has over 100 years of experience to show that centralized planning results in inefficient distribution and vast waste. The Soviet Union did not bury us. It collapsed from its own rot.

The idea of a market-driven distribution system may be offensive to civic-minded public health officials, but it works. Back in September and October, millions of Americans were more than willing to pay top dollar for access to the limited doses of the vaccine. People flew to Canada and the Caribbean to circumvent America's rationing system. Had the vaccine been sold to consumers on the open market, few if any of the 5 million does sitting in government custody would have been wasted.

Of course, supplying the vaccine to the highest bidder does not necessarily target the people at greatest need. But the rationing plan has proven abysmal on this measure. In early January, a CDC survey showed that only 35 percent of high-risk Americans had received flu shots, and that 23 percent of them reported they were unable to get one.3 Had a market-based distribution system been in place, there is no doubt that these people would have been able to get the vaccine they sought -- so long as they were willing to pay for it.

It does not take a rocket scientist to realize these facts. Ample evidence exists that markets distribute scarce resources much more efficiently than government entities. That America's public health officials sought to override this reality is inexcusable. As a result of their hubris, hundreds of Americans are bound to pay the ultimate price.


1. Washington Post, Vaccine Shortage Turns to Surplus, January 22, 2005

2. U.S. Center for Disease Control, Pneumonia and Influenza Death Rates -- United States, 1979-1994, July 21, 1995

3. The Virginian-Pilot, Flu shots offered outside high-risk groups, January 4, 2005