Friday, July 17, 2009


Oh, we're going to hear about this from Michelle Bachmann or Glenn Beck any minute now:

Health Care Bill Will Fund State Vaccine Teams to Conduct ‘Interventions’ in Private Homes

There is a knock at the front door. Peeking through the window, a mother sees a man and a woman, both in uniform. They are agents of health-care reform.

"Excuse me, ma'am," says the man. "Our records show that your eleven-year-old daughter has not been immunized for genital warts."

"And your four-year-old still needs the chicken-pox vaccine," says the woman.

"He will not be allowed to start kindergarten unless he gets that shot, you know," says the man -- smiling from ear to ear....

Is this a scene from the over-heated imagination of an addlepated conspiracy theorist? Or is it something akin to what is actually envisioned by the health-care reform bill approved this week by the Senate Health, Education, Labor and Pension Committee.

The committee’s official summary of the bill says: "Authorizes a demonstration program to improve immunization coverage. Under this program, CDC will provide grants to states to improve immunization coverage of children, adolescents, and adults through the use of evidence-based interventions. States may use funds to implement interventions that are recommended by the Community Preventive Services Task Force, such as reminders or recalls for patients or providers, or home visits."

Home visits? What exactly is the state going to do when it sends people to "implement interventions" in private homes designed "to improve immunization coverage of children"? ...

Um, I assume it would be something like what's already being done in the case of, say, tuberculosis by public health workers -- there's monitoring of patients to ensure that they don't abandon treatment programs midstream. Here in New York, for instance,

Directly Observed Therapy (DOT) is the standard of care for tuberculosis (TB) treatment. In directly observed therapy, a trained health care worker monitors the patient taking each dose of anti-tuberculosis medication. When TB patients receive all medications as prescribed under a program of DOT, both patients and community benefit....

The New York City Department of Health and Mental Hygiene (NYC DOHMH ) provides DOT in its clinics, as well as in patients' homes and workplaces whenever necessary....

More than 90% of patients diagnosed with TB and treated in New York City since 1994 complete therapy, compared with fewer than 50% in the late 1980s, before DOT became the standard of care.

And I assume the program would be chronically underfunded, and subject to cutbacks at the first sign of an economic downturn (even if it can be shown to save money by decreasing spending on treatment of prevented diseases).

Is this appropriate for vaccines? Maybe, maybe not -- that's why I assume what's being authorized is a demonstration program. But in any case, it's not going to be done by people "in uniform," unless what you mean is a nurse's uniform, or a white lab coat.

Clearly, we've had this sort of thing for TB in New York City for more than a decade, and there's no evidence that anyone, even Giuliani, has ever set up concentration camps for non-compliers. And yet this is already freaking out Pammy Atlas, the Freepers, and other wingnut conspiracy junkies. Can Bachmann and Beck be far behind?

No comments: