Don't put your faith in a central Tamiflu stockpile

Countries around the world are stockpiling Tamiflu, in anticipation of a possible avian flu pandemic. This is better than doing nothing, but Tamiflu is unlikely to protect most of us, should a pandemic arrive. Here are a few reasons why:

1. Tamiflu must be taken within the first two days of symptoms. Your chance of getting some Tamiflu that quickly, in a pandemic, will not be great (of course you could buy some on your own).

2. Tamiflu, if taken preventively, can prevent you from getting sick in the first place. But you would need two tablets each day. Only essential medical personnel, and select politicians, are likely to receive such treatments.

3. You show up at the emergency room with avian flu, and then they have to decide where you stand on the priority list. Will the hospital fear a lawsuit? How long will this take? Will it require federal or regulatory clearance?

4. Given the crush of the infected, will you be afraid to show up at the emergency room in the first place? Maybe you just have the common cold. See point #1.

5. Many Tamiflu supplies will be exhausted on false alarms, such as colds and other flus.

6. A Tamiflu stockpile is only good for a few years. If avian flu does not come soon, do you expect the stockpile to be replenished? Or would avian flu become the new "swine flu", never to be uttered by politicians again? The avian flu threat will likely be with us for at least ten years, in the form of a bird "flu reservoir" for possible mutation.

7. There is some chance that the virus will develop Tamiflu immunity over time, especially if Tamiflu is applied indiscriminately at the early stages of a pandemic.

8. Let's say the virus arrives first in California. Will Tamiflu supplies all be sent that way at first? Will they ever later be shipped back to Kansas? How much of the stockpile -- an inevitable political football -- will be available at any point in time?

Did I mention that the U.S. won't be getting any more new Tamiflu for at least two years? Right now we only have 4.3 million courses.

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For greatest efficiency, lowest cost and maximum choice, ALL hospitals and health insurance schemes should be privately owned and run -- with government-paid vouchers for the very poor and minimal regulation. Both Australia and Sweden have large private sector health systems with government reimbursement for privately-provided services so can a purely private system with some level of government reimbursement or insurance for the poor be so hard to do?

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