The New Hampshire House, shown here during convening day in January, earlier this month voted in favor of repealing the New Hampshire Vaccine Association. (Photo by Ethan DeWitt/New Hampshire Bulletin)
Up until a couple of weeks ago, I had never heard of the nonprofit New Hampshire Vaccine Association, which was created by statute in 2002. But late last month, a commentary written by Dr. Patrick Ho, president of the New Hampshire Medical Society, landed in my inbox. On Feb. 27, the Bulletin published his piece: “HB 524 would repeal the New Hampshire Vaccine Association. But what does the NHVA actually do?”
Dr. Ho wrote what I think is the best kind of commentary: clear, thoughtful, and illuminating. In just over 600 words, he shares the background of this entity that maybe voters or even lawmakers don’t know much about — the NHVA — and explains what it does. The argument for or against its existence doesn’t matter nearly as much as clarifying the purpose it serves (the purchase of vaccines at the lowest possible cost) and how it fits into our existing public health system (affordable preventative health care for children). Importantly, Dr. Ho underscores what it does not do: “This NHVA does not set vaccine policies or recommendations.”
If we’re going to get rid of something, we should at the very least understand its purpose. Better still is knowing what we’re going to do instead of the thing we’re getting rid of, but that is absolutely not the forte of the party currently in power in Concord and Washington. “Smaller government” is their mantra, and “private sector” is their answer — to nearly everything. But in practice, in the absence of a plan or even “the concept of a plan,” “private sector” sure feels like another way of saying “dunno don’t care.”
Toward the end Dr. Ho’s piece, the certain result of repeal — the “dunno” vote — is rendered in the clearest possible terms: “Eliminating the NHVA would not eliminate vaccines, or even change policies relating to vaccines. This would, however, take the option out of the hands of lower-income families who would otherwise be able to vaccinate their children for free.”
So, to summarize: If you hate vaccines and very much want them to go away, this is not the bill for you. If, however, you merely hate the idea of families having access to vaccines regardless of their income, then, yes, House Bill 524 is right up your alley.
As the Bulletin reported last week, House Republicans did indeed decide that the NHVA is providing entirely too much important health care access to Granite Staters — and at no cost in state dollars, according to the bill’s fiscal note. But it’s really not fair to say “House Republicans” voted to eliminate the association, because while 188 of them backed repeal, 16 of them voted with Democrats. Among them was Rep. David Nagel, who is also a doctor. Here’s what Nagel said when asked why he voted against the bill: “I gotta live with myself.”
It’s demolition time in New Hampshire, and as any home-flipper will tell you demolition is a necessary stage of revitalization. But if you don’t have a renovation plan, then all you’re doing is wildly swinging away and breaking stuff you should have preserved. And that’s what it feels like the House is doing.
I began this piece with an admission — that until very recently I was unfamiliar with the New Hampshire Vaccine Association. But I think there’s a reason why I didn’t know much about it: For more than two decades, it has served the families of the state quietly and well.
Health care providers and insurers agree. And Dr. Nagel believes in the importance of the NHVA so deeply that he defied his own party and as a result lost his spot on the House Health, Human Services, and Elderly Affairs Committee. Past Republicans must have believed in it, too, because it’s survived a lot of Republican legislative majorities over 23 years – including the slash-and-dash reign of House Speaker Bill O’Brien in the early 2010s.
What it may not be able to survive is this modern nonsense era, where a large chunk of the American political right is under the impression that having an opinion is the same thing as possessing experience, knowledge, and expertise.
Deputy Speaker Steven Smith admitted as much, albeit backwardly, in defending Republican leadership’s decision to remove Nagel from his committee. “Our hope is that people think more and recognize that our opinion isn’t always necessarily correct,” Smith said. “Rep. Nagel was unwilling to embrace that idea.”
First, aren’t the nondoctors who make up Republican House leadership the ones who don’t understand that their low opinion of the NHVA — shaped by what exactly? — may not be “correct”? Second, I don’t think we’re in a great place, democracy-wise, if opinions co-opted from fringe right-wing crusades carry the same weight as perspectives underpinned by a medical degree and decades of practice. But maybe that’s just me.
Within the confines of internal party politics, I do get where Smith is coming from. If you want to wield the power the election provided, you’ve got to keep the caucus in line. But it also speaks to the enormous, willful, and dangerous disconnect between politics and governing that is being inflicted on the nation right now. Eliminating the NHVA is not good governing; it is misguided retribution. The right has spent years creating new American boogeymen — migrants, “wokeness,” science, education, public health, etc. — and what we’re seeing nationally and in New Hampshire is the slipshod elimination of conjured enemies, damn the cost in dollars, degradation, and death.
It is destruction for destruction’s sake, and the crushing price of that undertaking will be paid by all, in one way or another, now and for decades to come.