New Hampshire residents have always been pretty sensible about getting ourselves vaccinated, certainly better than those scared-of-modernity goofballs in Vermont because we know a good deal when we see it. And you can’t get a much better deal than avoiding deadly diseases with an occasional injection.
About $24 million is collected annually from health insurers and other payers to give free vaccines to New Hampshire residents under the age of 19. To see what a bargain that is, go to your local cemetery and check out how many tombstones exist for young children before vaccines became widely available after World War II.
We can’t rest on our laurels, however. Anti-vax publicity chasers are angling for positions in Trump’s administration and their attitude is leaking down into Concord. Consider a proposed State House bill that would eliminate a non-profit organization that helps make sure free vaccines are available to our kids, the New Hampshire Vaccine Association.
The association, created by the legislature in 2002, is basically an actuarial group that simplifies the process of buying vaccines and getting them to doctors and hospitals so they can be given free to anybody under age 19 in the state. It’s a pretty straightforward arrangement; 11 similar groups exist in states around the country.
They don’t decide what vaccines we need. That’s a long process that, as the state Department of Health and Human Services explained to me, starts with an annual review of routine childhood immunizations recommended by the Advisory Committee on Immunization Practices, part of the Centers for Disease Control. You may remember that committee from days when COVID-19 was raging, as they very publicly debated about which vaccines to recommend and when to authorize them.
There are a lot of people involved in the decision about vaccines, monitoring infectious diseases around the world – like many people, I’m nervously watching bird flu – as well as research and studies about the effectiveness and safety of new vaccines. It involves a lot of science, a lot of risk/reward analysis, and some subjective choices that leave room for argument.
Once DHHS knows which vaccines are recommended it uses data from providers such as clinics, hospitals, doctors and schools about how many people asked for which vaccines the prior year. This lets it project how much of each immunization will be needed in the year ahead. Each month, DHHS places orders with the CDC to maintain a 120-day supply of all recommended immunizations.
The money part is the Vaccine Association’s job. They collect payments from health plans, insurers and other payers and pass it on to the state, which uses it to buy the vaccines.
“It’s similar to a high-risk-pool mechanism,” said Patrick Miller, executive director of the NHVA and a partner at Helms & Co. in Concord, which manages the Association’s daily operations. “The carriers can buy vaccines through CDC discounts. On the provider side, it reduces work, reduces administrative work.”
As of the last fiscal year they raised about $24 million. Setting the rate to charge payers works a lot like setting the property tax rate for each town.
“The rate is on a per-covered-life basis. If an insurance company has, say, 300 children under the age of 19 … we would essentially multiply that number by the rate, which at the moment is a little bit above $12,” said Miller.
Their latest annual report says operating expenses were slightly under 1% of their total, which seems reasonable. As established in the originating legislation (RSA126-Q), the association is overseen by a board of directors, who are appointed by various officials.
All in all, it’s a straightforward way to get preventative medicine to as many young people as possible with as little expense as possible, which presumably is why lawmakers created the system in the first place.
So why would anybody want to eliminate it? The text of the bill is still being written so I don’t know the details – perhaps it suggests a better alternative – and I was unable to connect with the prime sponsor, Michael Granger, R-Milton Mills, so I don’t know his thinking.
I assume the incentive is some mix of “government shouldn’t do anything” and “vaccines are bad.” If so, that’s bad because both of those ideas are dead wrong.
Being able to supercharge our immune systems against specific diseases is one of the great accomplishments of the human species. If anything, New Hampshire should expand the free-vaccine program. Why stop at 19, for example? Getting sick at age 25 or 35 is bad, too – if nothing else it removes a worker from their job for a time and right now we need all the workers we can get.
In years past I would assume this pointless bill would be scuttled in committee – a similar one died a session or two ago – but you don’t know anymore. Let’s hope New Hampshire’s practicality still holds sway. We don’t want to be like those Vermont goofballs.
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