Marginal Utility

by Tom Bozzo

In today's Capital Times, Judith Davidoff offers this misleading lede:

While social conservatives were expected to fight the mandatory vaccination of young girls against a sexually transmitted virus that causes cervical cancer, the loudest opposition in Wisconsin is coming from a more unlikely source: pediatricians.

A state Senate co-sponsor of legislation to require the HPV vaccine says:

Echoed [Robert] Wirch: "Cervical cancer is a preventable cancer, and we should do everything we can to get rid of this terrible cancer."

But the pediatric community is balking.

If not for those meddling pediatricians!

WTF?! said I, father of a two-year-old daughter... fourteen paragraphs into the story, it turns out that the pediatricians are not actually opposed to requiring the vaccine per se:

The objections are not about the vaccine itself, [James] Conway [of the Wisconsin Chapter of the American Academy of Pediatricians] stressed: "I don't think anybody from the medical side of things would dispute that the preliminary data and the design behind how they actually developed this vaccine is a terrific step forward for medicine."

It is about the implementation, he said.

While insurance companies are pledging to pay for the costly vaccine, Conway questions who will cover the vaccine for the underinsured and uninsured. He said the federal program that covers vaccinations for children without insurance can now barely pay for the other vaccines that have come on the market in recent years.

Now, according to the story, even at the stiff monopoly price of the vaccine (about $360, per the story), the cost of treating cervical cancer runs to the tune of more than 10 million annual doses of the vaccine. The economic case for vaccination looks clear enough. (Something Gov. Doyle might consider before throwing around more questionable tax expenditures.) A smart policymaker would cough up the money to make the AAP (fully) happy.

The George Bush/Heritage Foundation method? Not so much. The fundamental of the Bush "plan" is that the vaccination decision should be made on individual assessments of willingness to pay the $360 in a world (ideally, in that view) of high-deductible insurance that covers little routine care. Some people — probably concentrated in high-risk, low-income demographic groups — will choose "wrong" and society will pay for avoidable cervical cancer cases around mid-century.

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Herein lies the rub of the Edwards-Blogger business. Any of the major Democratic contenders are smart enough to pass on the opinions of certain "sensible" economists and consign health care a la the WPE back to the right-wing think [sic] tanks. Then again, so were John F. Kerry and John Edwards, and they lost to the WPE and the MEVPE (*) in part because their campaign was fatally slow in the face of the right-wing noise machine's onslaught. People with better policy ideas than George W. Bush or the Republican '08 field are a dime a dozen; people who can win a campaign which, as John Rogers rightly observes, will be a "f***ing knife fight" are not.

(An additional curiosity is that this particular kerfluffle seems to have been an attack on the rapid-response mechanism itself. Amanda Marcotte being the Edwards campaign's blogger-in-chief and Melissa McEwan the netroots coordinator, they'd have presumably coordinated the response had the targets been anyone else on Edwards's staff. As Waveflux observed in Shakes's comments, the progressive blogs stepped into the breach and arguably saved the Edwards campaign from the influence of the "elite punditocracy" with its civility-over-substance bias and showed the value of campaigns having key netroots staff whose bloggerly charisma actually motivates the netroots.)

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(*) Most Evil Vice Preznit Ever.

Labels: Bushonomics, Health Care, John Edwards, Journamalism