The US has the worst healthcare system among all industrialized nations. Life expectancy in the US
is lower, especially when it comes to maternal and child mortality. On average, Canadians live
three years longer than we do. These outcomes are not from a lack of money. We spend twice as on
healthcare as the next highest paying country. The amount of federal tax dollars spent per capita on
healthcare alone is more than Canada or any other country spends.
 
There are many ways of lowering our healthcare costs, such as universalizing our healthcare
system, regulating healthcare into a non-profit/low profit service, and negotiating competitive
prices for medication, but the single biggest way to lower healthcare cost is to invest in preventive,
primary care.
 
Graduating more primary care providers (doctors, nurse practitioners, nurses, and physician
assistants) with main objective of disease screening in order to detect early symptoms when
treatment is most effective. It is at this first personal patient and healthcare provider encounter that
promoting healthy lifestyles and balanced diet discussions would be most effective.
 
Besides screening, primary care providers are on the front lines of preventing illnesses. They have
many tools at their disposal to improve our personal health and the health of the community, but in
terms of both cost and effectiveness, vaccines are one of the pillars of primary care medicine.
 
It was recognized as early as 1777 when General George Washington had his troops inoculated
against smallpox at Valley Forge. Up until then, smallpox killed more American “rebels” than all
British-led troops combined. (Inoculations, while effective, were not as safe as vaccines, which
wouldn’t be invented until 1796 by the English physician Edward Jenner). Today, there are dozens
of vaccines which are credited with saving the lives of millions of Americans from prolonged
hospitalizations, crippling and devastating diseases, and reduce the risk of untimely death.
 
Depending upon the targeted virus and the proper number of doses, most vaccines can prevent an
individual from becoming infected. Think of it as a “get out of jail free” shot for that disease. This
is especially true for measles, the most contagious and deadly disease in America today. Vaccines
for coronaviruses, such as COVID, may be slightly less effective for preventing a person from
getting sick, but they’re highly effective in preventing serious illnesses that lead to hospitalizations
and long-term complications. Here, vaccines are more like seatbelts—they don’t prevent car
crashes but protect you from more serious injury and death when it occurs.
 
Vaccines have been thoroughly studied over many years with hundreds of thousands of people and
have been found to be remarkably safe. The vast majority of side effects, if any, are muscle aches,
fatigue, and a low-grade fever that could last up to 48 hours. More serious side effects exist
depending on the vaccination, but they are exceedingly rare. Newer vaccines, including
improvements on existing vaccines, are even safer. This includes scores of studies about autism,
none of which has ever found an association with vaccines. [Note: one study by British physician
Andrew Wakefield that purported to show a connection was later discredited when it was
discovered that he fabricated the data to help a lawyer win a lawsuit.]
 

The number of pathogens (viruses and bacteria) range in the hundreds of billions, but the deadliest
infections are highly contagious and can cause secondary infections by compromising our immune
systems. The measles virus is one of those pathogens. One in five people infected with measles will
need to be hospitalized. The first measles-related death in 2025 was an 8-year-old girl who
succumbed to a secondary infection of bacterial pneumonia. In the book “The Great Influenza” by
John M. Barry, over 50% of the people infected with the “Spanish Flu” of 1918 died of respiratory
failure due to bacterial pneumonia.
 
Because of misinformation, fewer people are getting vaccinated and more measles outbreaks and
subsequent hospitalizations are happening. This is not only putting more of a strain on our already
fragile healthcare system, but it’s contributing to the rising cost of healthcare for all of us. 92% of
the measles cases in 2025 were from adults and children who received no measles vaccinations. An
additional 6.5% received less than the full number of vaccinations required to avoid getting the
disease, accounting for the 98.5% of measles cases reported. Considering the true cost of
vaccinating a child is less than a dollar, hospitalizations for measles and measles complications can
run from tens of thousands to millions of dollars, depending upon the severity of the
complications—and that doesn’t consider the human toll on the patient and family.
 
The importance of getting the vaccines recommended by our primary care providers cannot be
overstated. It’s our protection from illness, hospitalizations, and higher healthcare costs. It’s
something we can all do to lower the cost of healthcare that doesn’t require an act of Congress.
Dr. James Fieseher MD is a retired physician living in Dover.