Hacker News Reader

A concern of mine is where the insurance companies will get their guidelines, i.e., who pays. Also, being willing to pay out of pocket is not a panacea, as you can still be turned down.

Indeed,

"Nineteen states have laws or regulations that only let pharmacists administer vaccines recommended by ACIP, according to the American Pharmacists Association.

In those states, pharmacies may not be able to dole out shots even for people who fit the FDA’s narrowed range until the committee makes its recommendation."

https://apnews.com/article/covid-19-vaccine-insurance-covera...

I'd expect insurance companies realize that paying for vaccines is a lot cheaper than paying for measles, mumps, covid, and the flu. They are in business to make a profit, not to pinch pennies at the cost of pounds.

Not to mention that common vaccines are not very expensive, even if you're paying out of pocket.

Not if you get to stop paying for treatments if they get sick!

Why would they? Why would anyone buy insurance that didn't pay for treatments of illness?

I get frequent emails from both my employer and my insurance plan reminding me to get flu shots, annual physicals, etc. because it's cheaper for them if I stay healthy vs. having to pay (potentially a lot) for treatment of preventable illness or health problems.

Because you have no choice. In the US, I noticed a trend that companies are starting to offer one choice for Insurance, the cheapest for them.

There's always self insurance. These days that's likely cheaper.

Same reason people buy baby formula that's poisonous: they don't know or are desperate.

Because you don't buy insurance, you're essentially assigned it. There is no insurance marketplace. And no, healthcare.gov does not count.

These companies act in lockstep and the service is socialized - you pay for everyone else. Its the most shitty approach imaginable to healthcare.

You get all the greed and ass fucking of private healthcare, with all the choice (or lack thereof) of huge socialized medicine. And, cherry on top, the private sector has WAY less rules than the public sector.

I'm not seeing it. My private employer's plan and my son's healthcare.gov plan and every plan of everyone I know covers vaccines.

Right. And have you actually taken a step back and thought about why that is?

My health insurance in Germany - "public", but we get to choose which of about 150 Krankenkassen (sickness funds) we want to go with - comes about as close as it legally can to bribing us to get vaccinated, both seasonal (flu and covid) and boosters for the ones you should have gotten as a kid.

Your health insurance here is also responsible for paying your sick leave, so they are SUPER motivated for you not to get the flu or covid.

Divergence from the CDC guidelines could also enable (scientifically meritless) lawsuits from patients against their doctors, no? What a sorry state of affairs.

Why are insurance companies involved here at all?

That requires a lengthy US history lesson, which you can read elsewhere.

Rhetorical question I suppose... I don't think Health Insurance should cover typical things. When I've gone to the hospital with kids or as someone nearing 40 its more expensive with insurance than without, not including the 30k in payments through employment we already endure. I don't care to subsidize the boomers.

I'm glad people are finally saying their true position is 'I don't care, let old people/disabled people die'. We're really starting to see the real American values system.

The boomer generation is also well known as the “me” generation, so it’s something they should expect, to be quite honest. They are the ones who raised us.

'It's someone else's fault I'm cool with letting people die, I have no agency in the matter'. Keep telling yourself that.

Sow -> Reap

If it costs me let 'em die. But also, I'll pretend it's their fault I suck so I don't feel bad.

I wouldn't be mad if you fumbled the handoff, but you ate the damn football.

> The physicians in my life - including my spouse - have essentially all abandoned the CDC and FDA as a source of decision-making

Same here.

And personally, as someone who isn't in the medical field in any way, what's been done to these agencies has removed pretty much all trust I have in their recommendations. They look like they are being run by political hacks for political purposes now, and actively disregard things like evidence and truth.

> The physicians in my life - including my spouse - have essentially all abandoned the CDC and FDA as a source of decision-making on vaccines and pharmaceuticals, except for what is required by law.

The risk in this implicitly will be that some vaccines may be declared illegal, or not permitted in some other licencing model, which means physicians will be at risk of their professional registration to make them available.

I could imagine a similar risk in the prescribing of Mifepristone/Misoprostol. Not to actually declare 'day after' pill illegal, but withdraw licence to use the drugs, and put doctors at risk if they go ahead.

This is already happening with covid vaccinations, in that only some age groups are getting approval. The decision is not being made according to safety, but justified with economics. I don't recall the FDA doing that before.

> This is already happening with covid vaccinations, in that only some age groups are getting approval. The decision is not being made according to safety, but justified with economics. I don't recall the FDA doing that before.

Incorrect.

A lot of scientists believe the Covid vaccinations should never have been approved in healthy young children. Omitting the Covid vaccine from the childhood schedule, in fact, is the position of the WHO, and many European countries, including the UK [1], Germany [2] and France [3]. The USA was an outlier [4].

[1] https://www.nhs.uk/vaccinations/covid-19-vaccine/

[2] https://www.bundesgesundheitsministerium.de/en/coronavirus/f...

[3] https://www.lemonde.fr/en/health/article/2023/02/25/covid-19...

[4] https://archive.ph/aD00n (NYT link)

Wrong. Regardless of your links there, that's not the justification that FDA used.

I would have my kids get the vaccine in two seconds. I write-off all these EU concerns as capitulation to public pressure, which has no scientific basis. The same thing happened with the COVID vaccine requirement in California public schools.

It's not just the EU. Nearly every first-world country has done the same. The US was the fringe player in this debate.

The Covid vaccines for children (and especially infants) were approved with essentially no proof of effectiveness because bad outcomes from Covid are so incredibly rare in these age groups. They would have needed to run gigantic trials in order to have any hope of catching any signal, and that was deemed expensive and/or impractical. Instead, the trials used use (poor) proxies for effectiveness, such as antibody titres. In some cases, even these proxies barely showed a signal.

Subsequently, there have been real signals of bad side-effects from the vaccine in children (i.e. myocarditis, particularly in young boys), that make the risk/reward trade-off incredibly cloudy. A great many people don't know this, because the issue has become political on both sides of the debate.

The chance of harm to children from the Covid vaccine is small, but so is the benefit. Unfortunately, one side of the US political spectrum only knows the former part of that statement, and the other side only knows the latter. Both are half the story.

The economic excuse seems like a fig leaf over the true motivation to deny the vaccine to children, which is baseless fear of side effects.

Plus, I think it's just completely outside of the legal authority of the FDA. There have been many cancer drugs that have been approved because they are safe and a (little bit) effective, but completely cost ineffective, and I always remember the FDA saying that they can't make decisions based on costs, that's up to other people.

That the FDA didn't even use the supposed safety concerns also pints to the scientific weakness of those concerns. All the scientists are being forced out of the FDA and they are not being consulted by leadership on scientific decisions, and even in that situation the fake science safety concerns were not cited in the decision.

I worry that the pharmaceutical companies won't have the funding to develop vaccines for new variants of existing diseases (like the yearly Covid-19 and flu variants), or even for "new" diseases (e.g. there's a dog vaccine for Lyme disease, but not one for humans). IIUC (please correct me if I'm wrong), vaccine development is expensive, and relies on government subsidies--which certainly won't be coming from the US in the near future. And even provision of existing vaccines depends on there being a market, where the US has been the most reliable such market--again, correct me if I'm wrong (I'm hoping I am!).

I, for one, will be happy to see Covid make a vigorous comeback in the US. Theories need to be tested.

We're probably past herd immunity at this point.

Yeah, just like how no one gets other forms of the flu these days... herd immunity...

Because everyone knows viruses don't mutate.

They tend to get weaker.

COVID is endemic.