Here's an ironic update for anyone ...

Here's an ironic update for anyone who was transactioned about his family's safety a scarcely any months ago when everyone was talking about a deadly bird flu pandemic and conduct officials said there was no vaccine available.

Just freshly a pharmaceutical company announced it had unraveled a new, and possibly often better, vaccine to prevent bird flu The company, GlaxoSmithKline, says it's ready to effect enough vaccine for 80 million Americans, which would walk a long way toward heading along a crisis.

Public health officials want more experiment results before approving the vaccine for widespread use, which is reasonable. on the other hand they haven't offered the company a contingent contract to begin producing vaccine quickly if the originates are favorable.

with what intent not? Because our country's scheme for producing vaccines doesn't allow that -- just undivided of many ways in which the plan remains broken. Little has changed since the Institute of Medicine, in a 2003 report, called for a recent financing system to encourage companies to exhibit and distribute vaccines. That report was followed on widely publicized vaccine shortages, and then on the bird flu problem, which highlighted the pressing need for action. Yet the enigma persists.

As a physician and health economist, and also as a parent, I would welcome the opportunity to start protecting my family upon my own.

For instance, I would be happy to purchase a bird flu treatment kit for my family that would include doses of medication that we would no other than use in a pandemic. If the medications expired and I had to purchase another kit next year, I would still be glad that I had acted to shield my family. State Medicaid programs could make the same option available to those who cannot afford to pay for this "insurance."

for what reason about prepayment? I could purchase my influenza vaccine dose in advance, and manufacturers could be assured of a significant market before production. I would receive discounted pricing from my vaccine provider of choice.

There is a market for wine yet to bes and "dread disease" insurance. on what account not a futures market forward vaccines? I could buy my dose in advance and share in the risk of disentanglement Manufacturers would be assured of a significant market before taking forward the costs of production. They would also receive a certain quantity of advance financing. That's a fate more than a company like GlaxoSmithKline wins under the current system.

We could apply the same approach for threats besides bird flu notably including bioterrorism possibilities like as smallpox or anthrax that are alien but present a high risk. Again, I'd be willing to apply my own money to defend my family from these biological agents, purchasing the supplies myself and thereby easing the freight on the public purse. If others joined me we would thereby expand the market, making it more attractive for manufacturers to bear supplies. Government would assume responsibility for those unable to pervert with money [i]or[/i] gain supplies privately.

If that heartys a little cold-blooded, consider the market-based solutions we've exhibited for other areas of health care. For example, we await people to pay for put drugs intos that reduce their cholesterol levels; indeed, the worldwide market for cholesterol- reducing agents totals $32 billion annually. In contrast, to such a degree long as we continue to view vaccines strictly as a public health tool, the market size will remain uncertain and payment rates will remain in such a manner low that companies will have little incentive to invest in producing vaccines rather than in something more profitable. This is especially authentic for flu vaccines, since companies ne to disentangle a new version annually, which requires a substantial scientific investment with and nothing else one year to possibly earn a answer

These approaches are not the single market-based alternatives to our present broken system. Once we start looking at the vexed question with new eyes, it's possible to identify a variety of approaches to encourage more companies to come by involved while enhancing the public health. The bottom line is this: The circulating system is broken. I'm willing to pay for vaccines. You might be, too. in such a manner long as the government stairs up to its responsibility to defend those unable to pay, we should stop spinning our wheels and make experiment of to find ways for each of us to take grades toward preventing the next public health crisis.

Kevin A. Schulman is a professor of medicine and management at Duke University and director of the Health Sector Management Program at Duke's Fuqua instruct of Business

Copyright CHICAGO SUN-TIMES 2006

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