Shots in the dark.

• Author: Pollock, Robert
• Position: Health Care

The saga of the Vaccines for Children program

IT WAS A RALLY SET AGAINST THE BACKground of the New York City skyline. The Statue of Liberty towered behind President Clinton as he pounded the podium with such force that the presidential seal fell off. It was August 1, and the White House was trying to save a very unpopular health plan. We must pass his plan "this year," Clinton repeated incessantly. "Don't let the fearmongers, don't let the dividers, don't let the people who disseminate false information frighten the United States Congress into walking away from the opportunity of a lifetime."

Why is "this year" the "opportunity of a lifetime"? Maybe because by next year, people will have had an opportunity to witness the first phase of ClintonCare in action. The Vaccines for Children program is scheduled to start October 1, and an administration eager to take credit for at least one successful piece of legislation before the fall elections has been strangely silent about this one.

Such silence stands in marked contrast to the confidence with which Clinton launched his first health-care policy initiative in February 1993, accusing the pharmaceutical industry of "pursuing profits at the expense of our children." Sen. Edward Kennedy (D-Mass.) added his voice: "The laissez-faire attitude of the past administration meant that business too often was not asked to participate in meeting urgent national needs."

The new administration alleged that the divergence between the public good and the private interests of vaccine makers meant that only about half of the nation's preschoolers were properly vaccinated. In 1982, the average cost for a complete set of childhood vaccines was $23.29. In 1992, it was $243.90--a seemingly obvious example of profiteering. Thus, Clinton argued, the industry needed government intervention.

Hillary set up a working group to explore the possibility of price controls if vaccine costs exceeded "voluntary" guidelines. Bill pushed for "universal purchase"--he wanted the federal government to buy and distribute all childhood vaccines produced in the United States. In August 1993, Congress passed a compromise. The Vaccines for Children program would purchase one third of the national supply at a forced discount of half price. The government then would distribute the vaccines free to private physicians who could administer them to Medicaid recipients, the uninsured, the underinsured, and Native Americans.

SOUNDS SIMPLE. BUT FROM THE ORIGINAL rhetoric to the approaching...