On December 16, 2020

Incentivize to immunize

By Philip Finkelstein

Editor’s note: This commentary is by Philip Finkelstein, of Charlotte, Vermont, who is a technical writer and business analyst. After attending the University of British Columbia, where he received a BA in political science, he served as a blog contributor for Citizens’ Climate Lobby. 

Americans value their freedom—so much so, that refusing to wear a mask during a pandemic has become a misguided expression of one’s commitment to that freedom. With Covid-19 cases spiking to all-time highs as winter rolls in, the health care system is already overloaded in much of the country. Pandemic fatigue after months of quasi-quarantining is certainly not helping the situation. In such an environment, freedom and protection have found themselves at odds.

Yet, there is hope. Vaccine candidates from Pfizer and Moderna, both claiming 90%-95% efficacy, are poised to receive emergency-use authorization from the FDA in mid-December. Rollout of the vaccines will commence immediately following approval — but many logistical hurdles stand against widespread distribution of the vaccine in what will be the largest mass-vaccination effort in American history. These hurdles include the manufacturing of hundreds of millions of doses, transportation around the globe, and maintaining storage temperatures throughout the supply chain.

However, the real issue may not lie within the logistics of the supply chain, but the “consumers” themselves. According to the most recent Gallup poll, only 63% of Americans say that they are willing to get vaccinated. Concern over the speed of development, hyper-politicization, and general aversion to vaccines explain the hesitancy. Regardless of reasoning, a 63% immunization threshold stands in the way of expediting herd immunity. Although older citizens — the most vulnerable to the virus — are among the most willing to get vaccinated, a large swathe of Americans unwilling to vaccinate will allow Covid-19 to fester within the populace for longer than necessary. This could provide opportunity for the virus to mutate, perhaps even leading to negation of the vaccine’s effect.

Forcing Americans to take the vaccine is out of the question. For one thing, paternalism of this kind is in direct conflict with that aforementioned freedom held so dearly — making a mandate political suicide. Persuasion, however, is a different matter. Policymakers need to incentivize vaccination. Currently, the government is funding unemployment and stimulus to keep the economy going. The federal pandemic response is dumping money into the health care system to deal with the surge in cases. A new stimulus package is being debated in Congress to further this endeavor, and will likely be passed in some form sooner or later. All of this amounts to a strategy that will cost more, take longer, and prove less effective.

Think about it. We are treating the disease, not curing it. Why not tackle the root of the problem? If very few Americans were contracting this deadly virus in the first place, the government funding flowing through the economy would no longer be required. Hence, stimulus benefits to an individual should be contingent on taking the vaccine. Simply put: pay people to get the shots. Freedom talks, but so does money, especially when in desperate need of it, as are many Americans in this pandemic. The vaccination plan can generate the stimulus through this incentive payment, all the while cutting off the virus at the source, rather than letting it germinate within the “freest” among us.

I have to imagine that the percentage of Americans willing to get vaccinated would rise dramatically if doing so was fiscally rewarded to the tune of $1,200 (the amount on the first round of stimulus checks). The economists can crunch the numbers regarding specifics, but presumably paying out some decently sized incentive would save a lot of money over the long run because initial prevention would eliminate the need for treatment. Hospitals, schools, restaurants, businesses, travel — they could all get back to normal faster without fearing the sick.

In the same vein, it is time we start disincentivizing unhealthy behaviors. Covid-19 revealed some of our fatal flaws as human beings. Americans were already suffering from an epidemic when the virus hit, with an obesity rate exceeding 40%. This disadvantaged many immune systems in their fight against the virus. Smoking and air pollution obviously do not help. Americans should never have their freedom taken away, but incentivizing them to make the right choices is well within the scope of the American ethos. A sin tax on cigarettes and junk food in basically a reverse subsidy for anything healthy. The sin tax revenue generated can then go toward treating those afflicted by ailments arising from their unhealthy decisions. Americanism is all about liberty and choice. Do not deprive us of that — just nudge us in the right direction.

A free society should grant the individual final say — certain choices just need to come with an extra cost, or, in the case of the vaccine, reward. Let Americans decide how much they value their freedom. That is capitalism at its finest. A healthy society is better for the economy. A health care system that serves to heal us and prevent us from getting sick will be far more efficient than one that only works to treat us once we are already knocking on death’s door. Save money … and lives. Whatever you value more, incentivizing immunization and healthy choices is a win. In this way, we can all live our lives to the fullest and freest.

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