The United States has the worst health care system among all industrialized nations. Life expectancy in the U.S. 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 much on health care as the next highest paying country. The amount of federal tax dollars spent per capita on health care alone is more than Canada or any other country spends.
There are many ways of lowering our health care costs, such as universalizing our health care system, regulating health care into a non-profit or low profit service and negotiating competitive prices for medication — but the single biggest way to lower health care 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 health care 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 (Inoculations, while effective, were not as safe as vaccines, which wouldn’t be invented until 1796 by the English physician Edward Jenner). Up until then, smallpox killed more American “rebels” than all British-led troops combined. Today, there are dozens of vaccines which are credited with saving the lives of millions of Americans from prolonged hospitalizations 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 (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 health care system, but it’s contributing to the rising cost of health care for all of us.
Ninety-two percent 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 health care costs. It’s something we can all do to lower the cost of health care that doesn’t require an act of Congress.
Dr. James Fieseher is a retired physician living in Dover.