The Frustration Of The Vaccinated
In all the discussion over how to convince unvaccinated Americans to get vaccinated, I have noticed one suggestion popping up repeatedly -- but always down in the comments, never proposed by any pundit or politician (that I am aware of, at least). It's a simple and elegant answer to the problem, although I have no idea whether it could actually be legally implemented or not. Or if it should, for that matter. The idea? If you choose not to get vaccinated, then your health insurance company should inform you that you will not be covered if you get it and are hospitalized. Your insurance would still work for all other ailments and treatments, but not for COVID-19.
As I said, it's an elegant solution to the problem, because it shifts the risk precisely where it should be placed. Don't want the shot? Then you're on your own if you get it. You would risk bankrupting your family by your "freedom" and your choice. After all, why should the rest of us have to pay for your dangerous behavior?
There is at least tangential political precedent. When California passed a helmet law which mandated that motorcycle riders always had to wear helmets, the reasoning was simple. A lot of motorcycle riders didn't have health insurance back then, so if they were in an accident and got horrendously injured, they did so using the public health system -- paid for by taxpayers. So the law was sold to the public as: "We're tired of paying for these people's recklessness." Getting in a crash with a safety helmet meant far fewer (and far less severe) head injuries. Which saved everybody a lot of money. Helmets were mandated, and you got a ticket if you were caught riding without one. A whole lot of motorcycle enthusiasts were angry about the new law, but since the rest of us were footing the bill, they were overruled.
That is the feeling a lot of people are getting now, when we see on the news each night some poor guy in a hospital bed begging his relatives: "I wish I had gotten vaccinated, please go get the shot if you don't want to wind up like me -- and trust me, you don't want this." That's all fine and good, and an important message to get out, but why should all the other people with the same company's health insurance have to pay for your care? Or the taxpayers, for public health cases?
Legally, I have no idea how or even if this could happen. Obamacare mandates minimum levels of coverage for all health insurance, so perhaps a loophole to allow this would have to pass Congress? That would be a political landmine, which is probably why I haven't heard any politician suggest this plan (yet).
It also would admittedly open up a very slippery slope. If people don't want to pay for care given to someone who risks their life by refusing to get vaccinated, the same exact logic could be used to deny people coverage for illnesses or injuries caused by intravenous drug use. Or smoking cigarettes. Or drinking. Once you start making a list of "things society frowns upon" for insurance purposes, it'd be pretty easy to get carried away in a Puritan sort of frenzy.
So it'll probably never happen, and perhaps it shouldn't happen. Perhaps this is why the only people propounding the idea are those outside the realm of the media and politics. But the frustration is still out there, and it seems to be growing. This fourth wave may not have been totally preventable, but it could have been a lot less pervasive if vaccination rates among the public were 20 or 30 percentage points higher than they now are. The unvaccinated among us are forcing all of us to get to herd immunity the hard way -- not through a free and widely available vaccine, but through a whole lot of people gaining natural immunity by getting sick. It's pretty obvious who the culprits are -- just look at a map of where the most people are still unvaccinated, and that map is pretty much identical to where the Delta mutation is wreaking havoc.
We were all thinking, at the beginning of the summer, that life was returning to normal. We thought we were coming out the other side of the pandemic. Now that we're in the dog days of August, we're not just frustrated that it's happening all over again, we're getting annoyed at those who forced the rest of us backwards. And wanting them to pay monetarily seems like the most common reaction, at least that I've seen.
[Program Note: Sorry for the somewhat-abbreviated column today, I am busy dealing with an external issue (car repair). It seems likely, at this point, that there will be no new column tomorrow (or possibly Thursday), as it is looking like I will be busy all day dealing with repairs. I apologize for the interruption of service in advance, but did want to warn everyone.]
-- Chris Weigant
Follow Chris on Twitter: @ChrisWeigant
We were all thinking, at the beginning of the summer, that life was returning to normal. We thought we were coming out the other side of the pandemic.
I wasn't thinking that. No, not me.
Am I the only one around here who is following the World Health Organization?
Will this idea - of health insurance not covering the unvaccinated if they get sick with COVID-19 - work? And, work to do what? I don't get it.
I hate to be the bearer of bad news but, none of us are on track to coming out on the other side of the pandemic anytime soon. And, by 'us' I mean ALL of us. Not all Americans and Canadians but ALL of us all over the world.
It may be hard to fathom but there are many, many countries that do not have even 10 percent of their populations vaccinated ... once! Many are at less then 5%! There are healthcare workers who are tirelessly working to save lives and who are dying today because they do not have access to COVID-19 vaccines.
The WHO has called for a moratorium on third so-called booster shots at least through September until the goal of at least 10 percent of the populations of all countries are fully vaccinated.
Why would the WHO call for such a thing? Because, it is a fact that we will only come out on the other side of this pandemic when ALL countries come out on the other side of this pandemic. The longer the iniquitous distribution of COVID-19 vaccines continues, the more likely that variants of much more concern than Delta will emerge to the point where we will all need shots of new vaccines.
So, back to my question. How will eliminating insurance coverage for COVID-19 make people who choose, on grounds other than medical, not to get the vaccine change their minds about this?
Would not the use of compassion, empathy, understanding and education be a much more effective way to encourage people to get their shots?
Subjecting those who don't get vaccinated with a horrible death combined with financial ruin to their families doesn't strike me as the best solution. It reminds me of the Gospel story of the rich man in hell who asks an angel to go warn his brothers not to end up like him and is told, "They already have the Law and the Prophets."
A much better proposal has been made that requires no legislative action. Just let the airlines come together and say that they will not be selling tickets to the unvaccinated. That would be a much stronger incentive and would work by giving people a powerful incentive to get vaccinated and stay well. That's much better than letting people learn a lesson they'll never forget after they get sick.
As much as I agree that its wrong for we, the sane, to have to deal with the consequences of the ignorance of Trumpanzies and the like, this approach would roll us down a slippery slope (e.g. smoking, overeating etc.)
Furthermore I don't see a legal way to implement this per Obamacare's minimum insurance requirements.
BUT,
what would stop the insurance companies from making this so? They already require a blood test to ensure that they're insuring lower-risk non-smokers.
Talking Point:
Republicans are always talking about letting businesses run without excessive governmental interference. Why shouldn't insurance companies get to decide who they want to insure?
[1]
Elizabeth, you probably are the only one down here in Weigantia who is paying any attention to the WHO. As such, you are providing us a service and I hope you to keep contributing in this manner!
I don't know that I would use the word iniquitous* regarding vax distribution. Do you think it's politically REALISTIC for governments to ship off doses before they've covered their own countries needs? I can't see it.
And I don't believe that most everyone in the world has to get vaxxed for the richer countries to return to "normal." If herd immunity is achieved in a given local environment, people locally will still catch Covid (which, like influenza, will be with humanity forever.) But not in the numbers that crash our health-care system and have all the other effects that we've experienced.
One of the very few things that I liked about Dubya was his anti-HIV work in Africa. I could definitely get behind a similar concept involving the entire developed world.
*in·iq·ui·tous
adjective
grossly unfair and morally wrong. For example, "an iniquitous tax."
[2]
Whoops, andygaus seems to have posted my idea first,
A much better proposal has been made that requires no legislative action. Just let the airlines come together and say that they will not be selling tickets to the unvaccinated. That would be a much stronger incentive and would work by giving people a powerful incentive to get vaccinated and stay well.
Good job, Amigo!
Iniquitous distribution of vaccines = morally wrong and not in the self-interest of rich countries. Ahem.
So, what makes anyone assume that the unvaccinated have airfare, anyways. Hmmmm?
That was a little joke.
I[m more than a little upset with you, Caddy.
And, i"m a little bit drunk.
What did I do? Said it wasn't immoral or unjust for governments to take care of their people first? In some utopia the political pressure to not do may be absent. But not on planet Earth, Darling.
For the record, I'm not drunk. Nor stoned, dammit.
Drunk texting
verb
What Miss Canada is doing
You're beyond hope.
I don't really mean that
I love you, Caddy.
Love you too, Baby doll!
AND,
I hold in my mind's eye a vision of you and I...
sipping Coffee or wine outside a sidewalk Cafe in Vancouver. With a fabulous view. And maybe some shrooms
EM-1
You are not the only Weigant-ite following the WHO. WHO COVID forecasts have been accurate - and roughly in line with other competent Health Organizations.
That said, I have misgivings about their concept of "equitable distribution" of COVID vaccine. Is this good medicine? Is a 10% vaccination rate going to have a significant impact on the spread of the disease within the targeted populations? I haven't seen any WHO forecasts concerning effectiveness of a 10% vaccination goal.
The 3rd World is not homogeneous. Can the WHO get vaccine into 10% of the targeted arms, or is a substantial fraction of the allocation going to rot in warehouses for 1)lack of transportation networks, 2) trained and organized field teams and 3) militant to violent anti-vax groups within some targeted nations?
There is a 4th point that needs to be considered. Is the vaccine going to the needy, or is most of it going to end up in the arms of social and political elites?
As is usually the case, the devil is in the details. The WHO needs to publish the relevant details.
TS,
The third world is far more competent at vaccinating its populations than you seem to give them credit for.
These countries have a great record when it comes to vaccinating their citizens. They just need the bloody vaccines!!!
There is massive waste of vaccines in North America due to inefficient vaccination programs, given the extremely short shelf life of these vaccines. Case in point - when I arrived for my appointment for my second shot (Moderna, my first was Pfizer) at a local pharmacy, I arrived 10 minutes early. The pharmacist looked at me and the clock and said, great! you're here early! let's get you in here now before the vaccines expire!!! I said what the frak?! I kid you not.
If you are looking for relevant details, check out the WHO website.
Oh, and the 10% goal by the end of September is not the end goal. They are working to get to a 40 percent vaccination rate in ALL countries by the end of the year, and so on ...
The point is that all countries need the vaccines NOW and there is no good evidence for third booster shots - that's just the first world being very, very greedy not to mention working against its own self-interest. Again. Surprise, surprise ...
Caddy[17],
Sounds like a wonderful dream ... :)
Medicovidcare For All!
I like it!
Heh.
I do know how you feel, Don. It may be time, at long last, for a change of tactics.
Maybe I just don't read enough, but one thing I've never seen anyone suggest as a way to convince people to get vaccinated is to offer a refundable tax credit for those who are fully vaccinated. Make it function similarly to the current child tax credit from the American Rescue Plan, so it effectively puts money in the pockets of those who were responsible enough to get the shots. Maybe have the credit apply for every month that you are vaccinated, and apply retroactively to, say, May or June when vaccine eligibility was expanded to all adults, that way those who chose to get vaccinated early on get more benefit than those who have resisted and delayed.
@bleyd,
that's actually an excellent idea. one of the biggest criticisms of incentives is that they don't apply retroactively to those who behaved responsibly right away without needing any additional incentives.
JL
A refundable tax credit might be a good incentive if there is also a concerted effort at the very local and community level to get the message out about how effective and safe the vaccines are etc. etc. etc.
The messangers need to be community leaders who are respected by most everyone.
This must be underway already in some areas - I'd like to know how it's going ...
It's so sad to see how many unvaccinated people are dying every single day ... if they had just followed sensible public health measures they may still be with us, vaccinated or no.
well, the bipartisan infrastructure bill passed the senate, and the reconciliation bill is on its way. my hope is that a few republicans decide to jump on board the reconciliation bill too.
I thought that reconciliation bill passed this morning, no?
EM-19
I'm reacting to the WHO press conference from Aug 5.
https://www.who.int/docs/default-source/coronaviruse/transcripts/media_briefing_on_covid-19_4_august_2021_transcript.pdf?sfvrsn=f077e3b1_1
The scarcity of vaccines is best addressed as a triage problem. Triage is how medicine allocates scarce medical resources. I don't see any reference to triage principles in the hard copy of the press conference. Is WHO intending to apply the triage protocol to allocation of vaccine? If they are, I'm board. If they aren't I'm against it.
I think the press conference may be a bit ahead of the WHO planning process.
TS,
Let me revisit that presser and get back to you ...
Okay, TS ... first off, what exactly do you mean when you say 'triage protocol'?
EM-34
Triage is the allocation of limited medical resources based on anticipated outcomes. Commonly applied when medical needs outpace medical resources. The goal of triage is to save as many lives as possible. Those in need are divided into 3 groups.
Those for whom immediate care may make a positive difference in outcome. Treat first.
Those who are unlikely to live, regardless of what care they receive. Treat next, as possible.
Those who are likely to live, regardless of what care they receive: Treat last.
Liz and Caddy
From the moment in which God made his last distribution of Manna from heaven, there has never been a single useful item beneficial to human existence, the creation/distribution of which was NOT "iniquitous", if you define that word in the same sense as "unfair".
As long as humans are doomed to have to live "by the sweat of our brows", goodies will be "iniquitously" created/distributed, because we choose to sweat at different rates.
TS,
So, what we are essentially talking about then, in terms of COVID-19 vaccination, is the need for prioritization in the context of a scarcity of vaccines. I think the fundamentals of triage protocols and vaccination prioritization are similar but, there are some critical differences.
If we are to come out of the acute phase of this pandemic, sooner rather than later or at all, then we need to get serious and make some tough decisions about the prioritization of the right populations in the right order in ALL countries to ensure vaccines have the greatest possible impact, globally.
What the WHO is urgently recommending from a global health perspective is the prioritization of populations based on risk of severe disease, hospitalization and death. Health workers on the front lines are the top priority followed by older populations and other vulnerable groups.
Because there is still a scarcity of COVID-19 vaccines, the WHO Director General, at the end of May, called for global support for a 'Sprint to September' to enable ALL countries to vaccinate at least 10 percent of their populations by the end of September and at least 40 percent by the end of the year and 70 percent by the middle of 2022. If those goals are reached, then the world will have come a long way toward vaccinating health workers on the front lines, older populations and other vulnerable groups and then work down through the age ranges IN ALL COUNTRIES. This is the only way we get out of the pandemic and end the tragic health, financial and social consequences - we have to get there together!
With regard to that 10% goal, we are more than half way to the target date and most decidedly NOT on track. When the DG issued this challenge back in May, rich countries had administered 50 doses per 100 people and now this has increased to 100 doses per 100 people in rich countries. Meanwhile, as the DG said in the August 4 presser, low income countries have only been able to administer less than 2 doses per 100 people due to a lack of supply of vaccines. That needs to change, and FAST!
And, as the DG also said, the course of the pandemic depends on the leadership of the G20 countries and the support of a handful of countries and companies who control the global supply of vaccines.
EM [31]
Passed 50-49 along party lines this morning from what I read
CRS,
I'm gonna keep using that fine word, just for you! :)
By the way, I missed you Sunday night ...
Bleyd,
Yeah. But, that vote was just to go forward in the process. It wasn't the end game, in other words ... or so I have gathered.
EM [40]
Right. All the details, including the real total price tag and where that money goes and comes from still need to be worked out. But getting Sinema and Manchin to agree to the concept is important. Something is most likely going to get done, it's just a matter of haggling to find what's necessary to placate Manchin and Sinema.
Yeah, I agree.
Caddy,
The equitable distribution of COVID-19 vaccines NOW is very much in the self-interest of rich countries. Because, if transmision of this virus is allowed to continue for much longer there will be an increasing risk of new variants emerging in one corner of the world that are resistant to current vaccines and infecting people in the opposite corner of the world, if you catch my drift ...
[27] Bleyd wrote:
"Maybe I just don't read enough, but one thing I've never seen anyone suggest as a way to convince people to get vaccinated is to offer a refundable tax credit for those who are fully vaccinated. Make it function similarly to the current child tax credit from the American Rescue Plan, so it effectively puts money in the pockets of those who were responsible enough to get the shots. Maybe have the credit apply for every month that you are vaccinated, and apply retroactively to, say, May or June when vaccine eligibility was expanded to all adults, that way those who chose to get vaccinated early on get more benefit than those who have resisted and delayed."
I think this is an excellent idea also. It would certainly be one of the few programs that would actually help me, since I have no children and do not benefit from the child care credit. It is astonishing how little help is actually geared toward people without children.
EM-37
Right populations is nice way of saying elites.
So the goal of 10% vaccination is preservation of essential bare bones services while the virus rips thru 90% of the nonessential herd. Keep the lights and water on, bury the dead and, not to put too fine a point on it, keep public order (government, armed forces and police) until naturally acquired herd immunity among the non-elites kicks in. Pretty grim, but not that different from the worst of European Colonization in so much of the third world. Or the worst of indigenous tyrants post colonization. It's a low bar, but desperate times lead to desperate solutions.
TS,
Oh My God ... you couldn't be more off base if you tried!
Quite obviously, you have NOT been following the WHO.
We're done here.
i've been following the WHO.
Heh.
You know what's really funny ... reporters at the weekly WHO virtual press conferences referring to the WHO as the Who. Hehehehehehehehehe
EM-46
OMG indeed. I believe the WHO has best of intentions, but they will be working with some of the World’s most oppressive governments. Foreign aid from developed nations has had a strong tendency to benefit government officials, military and police of recipient nations. Ordinary citizens have generally gotten little if any benefit. Vaccine is just another form of foreign aid. I expect the bulk of the vaccine is likely to go into the arms of government officials, the armed forces and police. Maintaining order is job one for oppressive states.The rest of the population will have to rely on acquiring immunity the old fashioned way….person to person transmission of the virus and the right set of genes. How can WHO control this type of abuse? The only practical solution I can think of is to flood recipient nations with vaccine that is too cheap to meter. That will take time. WHO should focus on doing what they can to dramatically increase vaccine production and distribution.
WHO should focus on doing what they can to dramatically increase vaccine production and distribution.
They are.