Republican members of Congress say they intend to dismantle a federal program that distributes free vaccine to millions of children in view of a new report from congressional auditors who found that the program was misconceived and mismanaged.
Even congressional Democrats say the program known as Vaccines for Children - which had its share of skeptics when it was unveiled in 1993 - must be radically changed or it will not survive.
President Clinton and his wife, Hillary Rodham Clinton, have cited the vaccine program as a prime example of what the government should be doing to promote public health.
But the report prepared by the General Accounting Office says the administration incorrectly assumed that vaccine costs were the major barrier to immunization and underestimated the complexity of delivering vaccine to doctors and clinics around the country.
After reading the report from the GAO, Sen. Dale Bumpers, D-Ark., said in an interview: “I would be perfectly willing to abolish the Vaccines for Children program and start all over again. It’s been an unmitigated disaster from its inception. It proceeded on an absolutely false assumption, that cost was the big barrier to immunizations. We have study after study that shows cost is not a barrier.”
Bumpers and his wife, Betty, have been trying to increase the immunization of children since he was governor of Arkansas in the early 1970s.
The audit by the GAO, the investigative arm of Congress, was requested by Bumpers and by Reps. Scott L. Klug, R-Wis., and Ron Wyden, D-Ore.
In an interview, Klug said: “Immunizing children is an important national priority, but I don’t think you need a government vaccinepurchasing program to do it. This is the most bizarrely managed, poorly conceived government entitlement program there has ever been.”
Clinton persuaded Congress to establish the program in 1993 by arguing that vaccine manufacturers were pursuing “profits at the expense of our children.”
The program provides free vaccine against such diseases as measles, mumps, polio and whooping cough to children 18 and younger who are eligible for Medicaid, have no health insurance or have private insurance that does not cover vaccine. The government expects to spend $457 million on the program this year.
The program replaced an assortment of federal and state initiatives that provided vaccines under Medicaid, the Public Health Service Act and various state laws.
Under Clinton’s original proposal, devised soon after he took office in January 1993, vaccines would have been treated as a public utility, with a guaranteed market and negotiated prices. The federal government would have purchased all childhood vaccine and distributed it at no charge to all children, regardless of family income.
Congress adopted a scaled-down version of this proposal, creating an entitlement to free vaccine for about 60 percent of all youngsters. The government says that the cost to parents for vaccines to have a child fully immunized is at least $265.After a year-long study, the GAO said it “did not find sufficient evidence to conclude that the cost of vaccine for parents has been a major barrier to immunization.”