Authentic Vaccines: Ensuring Safety at Vaccination Sites

[BillTre]

The vaccine is free. The drugstore is allowed to charge my health insurance (actually, my pharmaceutical insurance) for the shot itself. If some uninsured comes in, it's still free to them. I don't know who, if anyone, they charge.

If I were setting this up from the higher level of national government, I would want something that would be quick and easy to set (for reasons of pandemic emergency), would provide the institutions doing the injections with a reasonable reimbursement, and distribute that pay in a simple (for the government) manner.
Therefore, it seems likely to me that the organization doing the injects (drug store or other retail places, or health care organizations of some kind, would be "billing" and passing that up in an efficient manner, to where the government could easily pay for it (or at least part of it).
This seems most likely to be send the bill (for compensation) to an insurance company (which are way smaller in number vs. drugstores and hospitals) and the government pays them.
It is also reusing an already established billing mechanism, to serve a slightly different purpose. So it should be easy to get it to work quickly.
I am guessing there are a lot of already established formulae for cost and expense of standard medical billing.

The uninsured would just be billed (with a special code) to an insurance company which would pass it on to the government.
Its all quick to set up and should work for a shared purpose that has life and death implications.
That should cut them some slack in allowing them to do certain things, but an economic entity (company) always wants more money, as a basic selective drive in the economic world (two opposed tensions on the determination of compensation).

Also, $2.59 seems unlikely. It would be hard to even pay the salaries of the stickers at that rate.

I was thinking about that. Off the top of my head, I wasn't sure if it would or not.
As far as I could tell, these not nurses, but something like a nursing assistant or trainee.
These are very easy injections to do. Intra Muscular in the arm. Can't miss that. Not easy to do harm.
Where I went, each injectee dealt with several people (greeters/informers/card checkers (probably a good fraction volunteer), someone telling the next person what station to go to, injector (sub-nurse in my experience), card filling out station/waiting area (probably had a nurse somewhere on site where I was (a central injection site)).
At each step there was one person dealing with the whole crowd, but there were maybe 10 sites doing the injections. So other than the injector labor, the accounting of labor of the other stations would be reduced by ~10.
In the drug store, its a single pharmasist, or a pharmacist aid, doing the injection at about 1/4 of the rate (my flu shot experience).
The people doing the injections may not get much of a wage, being low down on the health care hierarchy.
It might even be training situation. Learn how to deal with people, while you doing a really simple procedure and develop confidence and experience, but not getting much a wage.

However, I don't know what wages in healthcare are like for these kinds of employees.

When I employed a lot of people at a university where I worked, we would budget their labor at: cost of paying them plus 0.5 of the salary to account for all their benefits (on average) bundled together.
That's how we budgeted our labor cost (rate).
The university, however, had very good benefits, so the extra expenses would be less elsewhere.

 

[Vanadium 50]

I don't know if the government is reimbursing the health insurance company or not. However it's set up, it doesn't feel like the "how will we get paid" question is driving the incidence of vaccination.

Neither of my vaccinatrices (is that really a word?) said they were nurses. One seemed too young to be a nurse. Possibly too young to drive. :)

 

[BillTre]

Neither of my vaccinatrices (is that really a word?) said they were nurses. One seemed too young to be a nurse. Possibly too young to drive. :)

I like this version better: vaccinatrix, but I guess you doing plural now.
Seems like its feminine gender, but I'm not sure.

 

[russ_watters]

I was thinking about that. Off the top of my head, I wasn't sure if it would or not.
As far as I could tell, these not nurses, but something like a nursing assistant or trainee.
These are very easy injections to do. Intra Muscular in the arm. Can't miss that. Not easy to do harm.
Where I went, each injectee dealt with several people (greeters/informers/card checkers (probably a good fraction volunteer), someone telling the next person what station to go to, injector (sub-nurse in my experience), card filling out station/waiting area (probably had a nurse somewhere on site where I was (a central injection site)).
At each step there was one person dealing with the whole crowd, but there were maybe 10 sites doing the injections. So other than the injector labor, the accounting of labor of the other stations would be reduced by ~10.
In the drug store, its a single pharmasist, or a pharmacist aid, doing the injection at about 1/4 of the rate (my flu shot experience).
The people doing the injections may not get much of a wage, being low down on the health care hierarchy.
It might even be training situation. Learn how to deal with people, while you doing a really simple procedure and develop confidence and experience, but not getting much a wage.

However, I don't know what wages in healthcare are like for these kinds of employees.

Both of mine were at chain pharmacies. For the first there were two injection stations, a supervisor (who relieved one of the injectresses for a few minutes and acted as a "floater") and a greeter/card checker. For the second there was one injectress and a floater. Though also, someone at the pharmacy counter checked me in. At mass vaccination sites they likely do better than a 2:1 ratio.

There's a questionnaire filled out by the injectress before you get vaccinated which takes a few minutes,* and then the vaccine itself.

I'm guessing the rate is maybe 5 min per vaccination, or 12 per hour per station. That's $31 an hour in revenue for two people. Glassdoor tells me a pharmacy assistant averages about $16 / hr so it would be tough to pay salaries alone at that rate. And none of that has anything to do with the cost of the vaccine itself.

*At my vaccination site the floater took a passport photo for the woman ahead of me which slowed her down by about 30 seconds, but I would think that isn't a common occurrence.

 

[Tom.G]

Actually, there was a new claim you made, that I was questioning: you suggested it would be possible for the government and insurance companies to re-charge us for the vaccine we already bought and used.

Think Deficit Spending and the subsequent interest payments.

As for individuals making a profit, shortly after the vaccine(s) became available there were newspaper reports of people with more money than ethics paying US$250 for a shot. Just so they didn't have to wait for the high-risk folks to get theirs first!

Cheers,
Tom

 

[russ_watters]

No such thing.

Zimbabwe has vaccinated 10,000 people. Zimbabwe being Zimbabwe, these are probably 10,000 people you don't want to mess with.

I've been. Those 10,000 are at least less likely to infect you with COVID than anyone else in the country. Beyond that? ...evidently the guy with the assault rifle near the ATM was on my side, even if the guy driving slowly past it may not have been.

But suppose once they get going, people still want to push fake vaccine. You have exactly the same problem: the government has already paid for it, and you're competing with "free".

How do I know the government has paid for it? And even if I accept that the government has already paid for it -- paid whom?

I do think the OP and @TeethWhitener have a point at least that we may lack imagination for how countries with less than functional governments may be corrupted. They're really, really good at it. When I first saw the thread I was thinking about the US/other developed countries. While it's not impossible that an extremely rich and dumb person or two has been scammed in developed countries for vaccines, it really does take some effort to fall victim to a scam. But my initial read of the OP wasn't for lack of imagination, it was based on the assumption that we live in developed countries and aren't idiots.

 

[bhobba]

It's fairly common for patients at hospitals to be promised that procedures would be covered by insurance only to be told after the fact that they owe much more than previously told because "out-of-network" doctors were used in the procedure. Some studies estimate that as many as one in five ER visits are subjected to surprise medical bills, and they affect millions of Americans per year. (note this practice was recently made illegal by congress, which will take effect in 2022).

As I know only too well. The only way to avoid it in Australia is to go to a public hospital. Even if you do not have insurance, it is free. But if you do not have insurance, the issue is getting in. They may have beds etc. but are running low on money. If you have insurance, the insurance company pays for everything, no ifs or buts, everything. I could go into the difference in 'culture' between private and public in Aus, but that is way off-topic. Health and how to pay for it is a complicated issue.

Thanks
Bill

 

[bhobba]

Neither of my vaccinatrices (is that really a word?) said they were nurses. One seemed too young to be a nurse. Possibly too young to drive. :)

Had that one as well. The doctor said to a very young nurse - nurse give him an insulin shot. She was young and obviously not at ease. The doctor said - I will supervise while you do it, and there were no problems. I found out later junior nurses are not supposed to give injections unless a senior nurse or doctor supervises. Here they are called enrolled nurses. They have done a one-year diploma and complete their bachelors part-time over the next 3-4 years.

Thanks
Bill