Long queues, waiting lists, and inefficiency are said to be the hallmark of public health services. That seemed true of private service in the US when it came to getting vaccinated for yellow fever. Well, at least the part about long queues and waiting lists! And to top that, it was also incredibly expensive. A single shot of yellow fever vaccine that I was told would cost $200 in the US, cost me nothing in Brazil. Gratis! Free! Zero centavos!
Yellow fever vaccination, I was cautioned, is absolutely necessary if you are going to the Amazonas in Brazil. I was given a list of hospitals and services in and around Cambridge where I could get vaccinated. Call after call to these facilities proved futile because they had no dates available before my travel. Most of them provided the service only twice a week. Finally, one facility gave me a date one week away. “That will be $200 please,” said the person at the health facility. Of that, $55 was for the nurse practitioner or doctor and $145 for the yellow fever vaccine. Having no choice, I quickly said yes.
However, when I told a Brazilian journalist and friend who was visiting Boston, about my efforts to get the yellow fever vaccination, he nearly fell off his chair. “$200? Really???” He asked me not to waste my money. “Just wait till you get to Brazil. It is free there.” I could not quite believe that. I am not a Brazilian citizen. Why would it be free? He was insistent, and so I cancelled my appointment.
And it was true. I walked into the faded old building of Instituto Pasteur on Avenida Paulista, one of the main thoroughfares of Sao Paulo at 7.30 pm with a friend. She explained that I was from India and needed the vaccine. I showed a photocopy of my passport and my Harvard ID card. That was it. I was registered and sent to the nurse practitioner to get the injection. Chatting with me all the while about my trip to Brazil, she gave me a painless intramuscular jab on the upper arm and we were done. Took all of ten minutes. Did not cost me a centavo! Free, efficient, and extremely friendly service!
The institute provides rabies and yellow fever vaccine free of cost from 8 am till 7.30 pm, seven days a week, to anyone who needs it. Incidentally, all the yellow fever vaccine used in Brazil is manufactured by BioManguinhos, a publicly funded vaccine and immunobiologicals manufacturer, which also supplies the vaccine to over 70 countries through the UNICEF.
Of course, public health does not always work this well. But if public health systems worked this well, would anyone seek private healthcare?