Pfizer/BioNTech has applied to the Food and Drug Administration (FDA) for approval of their vaccine in children. This is the first vaccine requesting approval in children ages 5 to 11.

The Wall Street Journal reports the companies had filed data with the FDA showing the vaccine was 90.7% effective in this age group in clinical trials. The companies also say the vaccine was safe and tolerable. A meeting is scheduled Tuesday, October 26^th by the FDA to consider the application by a committee of vaccine experts. The panel, known as The Vaccines and Related Biological Products Advisory Committee, will meet to review the evidence of the vaccine’s safety and effectiveness and vote to recommend whether the FDA should authorize its use.

The vote of the committee is not binding on the FDA, but their recommendation will have a strong influence. The FDA could authorize the vaccine within days.

There are more than 28 million children ages 5 to 11 in the U.S. according to the American Academy of Pediatrics (AAP). Earlier reports by Pfizer/BioNTech in September said the vaccine was well-tolerated and induced strong immune responses in a study of nearly 2,270 children in the 5 to 11 age group. The vaccine induced neutralizing antibody levels in younger children that were comparable to those seen in teenagers and adults ages 16 to 25 who served as a control group in the study.

The study results indicated three children receiving the vaccine became sick with Covid-19, while 16 cases occurred in those who received a placebo. This data calculated the 90.7% efficacy. Concerns about cases of heart inflammation, seen in some teenagers, didn’t materialize as none were seen in this younger age group. Pfizer also tested the vaccine in an even lower age group, as young as six months, with lower dosages. No adverse effects were reported.

The Biden administration has reported plans to distribute the Pfizer vaccine to children at doctors’ offices, pharmacies, and schools if the FDA approves the shot. Since the vaccine must be stored at extremely low temperatures, this could prove a logistical challenge. Moderna and Johnson & Johnson are also studying the use of their Covid-19 vaccines in young children, but at present they are only authorized for people age 18 and older.

Some 64% of people in the U.S. ages 12 and over are fully vaccinated against Covid-19, according to the Centers for Disease Control and Prevention (CDC). Many older people and people with compromised immune systems have recently received booster shots, either Pfizer or Moderna, as well.

Do your young children need to be vaccinated?

This is the critical question every parent of young children needs to ask. Many infectious disease experts say Yes! Children can and do get sick from Covid-19, though typically they experience milder cases than adults. As I wrote recently (Vaccines for Young Children?), the

AAP reports about 125 deaths in children ages 5 to 11 due to Covid-19. This is a very small percentage of the roughly 5.9 million Americans ages 18 or under who have acquitted Covid-19. Yet it is a tragic event in every one of these families.

The decision for parents may be impacted by vaccine requirements of some schools. Most school districts in the country already require students to receive vaccinations for mumps, measles and rubella, as well as polio, diphtheria and chickenpox. Some districts grant exemptions for pre-existing health conditions with a doctor’s approval, or on religious grounds, though abuse of these exemptions in some states have led to local epidemics. The same may happen with Covid-19.

Everywhere you go these days there are signs that say “Help Wanted.” Every restaurant seems to have a shortage of servers. Every large department store has a shortage of cashiers. Every supermarket has a shortage of deli workers – and cashiers. There are about 10.4 million job openings out there but very few are being filled. There’s a backlog of freighters waiting to unload at our ports because there aren’t enough truck drivers. Already they’re predicting Christmas presents will be in short supply. What’s going on?

I’m a surgeon, not an economist, but I don’t buy this is all because of the pandemic. John C. Goodman is a real economist, specializing in healthcare issues, who writes for Forbes. Goodman says the latest jobs report was dismal, despite the claims of the White House. Only 194,000 people were newly employed, a far cry from the 500,000 predicted. He says there are 5 million fewer people employed today than before the Covid pandemic struck and 7.7 million are officially counted as unemployed. But another 6.0 million say they want a job, but are not counted as unemployed because they are not actively seeking work.

This is remarkable given there are record high job openings and employers around the country report difficulty hiring workers, even after offering higher pay! Goodman agrees with me that fear of Covid is not the most important factor. He says federal policies that punish work and reward non work are more important.

It’s all about incentives to work. Income and payroll taxes reduce worker take-home pay and more than thirty federal entitlement programs reduce benefits as family income rises. In other words, many families find they can make more money not working than working.

It is a monumental task to research the complexity of the entitlement programs, but Boston University professor Lawrence Kotlikoff and his colleagues have taken on this task. They have calculated the lifetime incentive effects of all the tax and entitlement programs for families at different ages and income levels. The study finds that workers in their 20s who are in the bottom fifth of the income distribution stand to lose $770 in taxes and reduced benefits if they earn an additional $1000 of income.  That’s a 77% net marginal tax rate and it is higher than for any other income group. The top 1%, for example, faces a net marginal tax rate of 44.5%.

Kotlikoff gives the example of a single mother living in Oregon with three children and earning $37,157 a year. She qualifies for such annual benefits as food stamps ($1,334), Section 8 housing vouchers ($15,015), Obamacare subsidies ($11,372) and other benefits. If she earns $1,000 more, she will violate the Section 8 housing requirement to maintain continuous eligibility. That will cost her a lifetime of housing support with a present value of $184,456!

In another example, a father of four in Wyoming earns $57,432 per year. He receives $23,921 in annual childcare support and a $40,337 Obamacare subsidy. Additional earnings of $1,000 would cause the loss of his entire childcare subsidy, which, extended over future years, has a present value of $149,197.

In a third example, a retired Alaskan couple receives Supplemental Security Income (SSI), which in Alaska automatically qualifies them for adult Medicaid. An additional $1,000 of earnings, however, would cause the couple to lose their eligibility for SSI and Medicaid, with a present value of $39,539.

As if this is not bad enough, according to Goodman, Democrats in Congress want to make it much worse. For example, the newly proposed Child Tax Credit (CTC), which would increase the maximum benefits to $3,000 or $3,600 per child (up from $2,000). The current system has pro-work incentives, but the new proposal would make the full credit available to all low- and middle-income families regardless of earnings or income.

Democrats claim this would reduce child poverty by 34% and deep child poverty by 39% – which assumes families will not change their work behavior. But the authors of a new study estimate that an additional 1.5 million workers will exit the work force, meaning child poverty will fall by only 22% and deep child poverty would not fall at all!

University of Chicago economist Casey Mulligan writes: “The implicit employment and income taxes in the bill would increase marginal tax rates on work by about 7 percentage points. I expect that such a change in the disincentive would reduce full-time equivalent employment by about 4.5%, or about 7 million jobs.”

That’s 7 million fewer people employed than now! Goodman says, “Economics teaches that incentives matter. The more perverse the incentives, the more perverse the results.” Sounds like we need to get used to ordering at the counter and bussing our own tables.

Vermont Senator Bernie Sanders ran for president in 2020 on a platform pushing Medicare for All. During the presidential campaign, I wrote extensively on the evils of Medicare for All. These posts can be viewed by simply searching on the blog site under “Medicare for All.” You might have thought this information was irrelevant now that Joe Biden was elected president – but you would be wrong.

Even The Wall Street Journal editorial board believes Bernie Sanders is calling the shots in this White House. Therefore, Medicare for All is far from dead. The next step in implementation of this radical rewriting of Medicare is the so-called $3.5 Trillion budget bill that most now concede is more like $5.5 Trillion.

The newest push by Democrats is to expand Medicare coverage to include dental, hearing, and vision benefits. This despite the recent report that the Medicare Trust Fund is due to run dry in 2026 (Medicare Going Broke). The WSJ editors say Democrats claim that half of Medicare recipients have no dental insurance, but this is not accurate. Nearly 9 in 10 low-income seniors have access to dental coverage through Medicaid. AARP sponsors dental plans with low premiums, and many graduate dental schools offer charity care for low-income seniors.

Seniors can also get dental, vision, and hearing benefits through privately managed Medicare Advantage plans. Bill Clinton and Republicans in Congress established Medicare Advantage in 1997 to reduce wasteful spending under the program’s traditional fee-for-service payment model and increase competition with the goal of improving care. This program has been widely embraced and now covers 24.1 million seniors, or about 40% of the Medicare population. Competition has also lowered average premiums by 34% since 2017 even as most added benefits. About 74% of Medicare Advantage enrollees have access to dental benefits and 79% to vision care including eye exams and glasses. Some 72% get help paying for hearing aids.

You would think this tremendous success would be welcomed by both Republicans and Democrats – but not so. Democrats dislike Medicare Advantage because it reduces government control over healthcare. Instead, they want to require traditional Medicare plans to cover benefits that seniors are already getting elsewhere – because traditional Medicare is government controlled. No need to worry about wasteful spending.

This will not only raise the cost of Medicare for taxpayers at a time when Medicare is already on the way to bankruptcy, it will also impact the cost of private healthcare. Because Medicare reimburses hospitals below the cost of care, privately insured patients get charged much more to compensate. The expansion of Medicare could result in privately insured Americans paying more for their contact lenses and dental work.

The estimated cost of this expansion of Medicare is $81 billion a year when fully phased in, or more than $800 billion over ten years. To disguise the real cost, Democrats plan to delay phasing in the dental plan until 2028. That saves $60 billion a year and helps squeeze the expansion into their 10-year budget window.

Naturally, Democrats cite polls showing the popularity of this expansion of Medicare benefits. Who wouldn’t agree to “more free stuff” when asked that simple question? But few voters know any of these fiscal or other facts because the press doesn’t report them, apart from WSJ. The same folks don’t know the Medicare Board of Trustees recently reported the fund faces a $578 billion shortfall over the next decade.

The WSJ editors sum up the situation: “All of which proves that when it comes to entitlements, looming bankruptcy is no barrier to expansion. Bernie Sanders wants Medicare for All on the installment plan, and the reconciliation bill is one giant step. The surprise medical bill will come later in rationed care and higher taxes for the middle class.”