Disability Law

CNNMoney has published a disturbing article explaining why more and more family physicians are refusing to give vaccine shots. The answer is that the health insurance companies won't reimburse the doctors for the full cost of administering the vaccines. If a doctor is going to lose money on every vaccination, that doctor is eventually going to quit doing vaccinations. And while there are alternatives, such as free clinics and public hospitals, the sad truth is that many parents will just skip the vaccination rather than go to the extra trouble. This is bad news for the children. Here are excerpts from the article:

Parents who bring their kids to Dr. G. Andrew McIntosh for the chicken pox vaccine are out of luck. The family physician, who has a solo practice in Uniontown, Ohio, doesn't offer that shot because he can't afford it. Most insurers won't sufficiently cover the cost.

"It doesn't do me any good. I am losing money on [them]," he said. The chicken pox vaccine runs about $115, but insurers only cover between $68 to $83 of that. McIntosh has also cut back on a handful of other critical childhood vaccines for the same reason -- including the measles, mumps and rubella, known as the MMR vaccine.

It costs him about $58 to buy an MMR shot, he said, while insurers pay about about $40. So McIntosh keeps a lot less of the MMR on hand. If a patient needs the shot and he doesn't have it, he sends them to a nearby public health clinic.

"I'm not happy to do that," he said. "The clinic is far, the service isn't great and my patients aren't happy to go there." "I've lost a fair number of kids [at the practice] because I've had to send them elsewhere for their shots," he said.

It's not clear exactly how widespread vaccine cutbacks are, but in a recent industry survey, 5% of pediatricians and 11% of physicians indicated that they're seriously considering no longer offering immunizations. Currently there are about 350,000 pediatricians and family physicians in the U.S.

"These are fantastically alarming numbers," said Dr. Richard Lander, a Livingston N.J.-based pediatrician who chairs a committee on administration and practices at the American Academy of Pediatricians. "It's an example of how health care is being driven by managed care in the United States," Lander said.

Doctors have to absorb any costs that insurance doesn't cover because in most states insurance contracts prohibit providers from charging patients the difference.

Public health experts are particularly worried about doctors dropping vaccinations. Dr. Lance Rodewald, head of the Immunization Services Division at the Centers for Disease Control and Prevention, points to the consequences this trend has had on public health in the past.

"Between 1989 to 1991, a number of doctors stopped providing vaccinations to children because of financing issues," he said. Instead, doctors referred patients to public health clinics for shots like the MMR. But many parents failed to follow up on those shots, Rodewald said, and their toddlers were never immunized. The result: The situation led to 55,000 cases of measles, 11,000 hospitalizations and 123 toddler deaths. The CDC found that more than half of the children who had contracted the measles had not been vaccinated, even though many of them had seen a health care provider.