You Can't Both Be For Universal Health Care And Against Treating Unvaccinated People
Many, and perhaps most, people have done something in their life to increase their health risk; an equitable health care system has to ignore that
There’s been a mini-boomlet of people, understandably frustrated with low vaccine rates and anti-vax rhetoric, arguing that unvaccinated people who end up going to the hospital with COVID shouldn’t get care. In some ways, this is entirely predictable, just one more manifestation of the polarization of the country. People openly fantasize about blue states “defunding” the red ones, and liberals have been complaining for awhile about the news media trying to learn the views of conservative voters. When President Trump got elected, liberals were especially upset of any sort of analysis that said that Trump voters were economically anxious.
And, of course, on the other side of that polarization stands the Republican rhetoric of “makers and takers”, which basically blames poor people (and Democratic Party constituents) for their own problems and says the people who are doing well in our economy should get to keep their wealth and not share it.
So we live in a country where everyone is polarized and the typical attitude of the partisan towards needy people on the other side of the political divide is “screw ‘em”. And that has creeped into our health care rhetoric. It’s a problem.
We obviously don’t have universal health care in this country, but we have aspects of it. Emergency rooms, for instance, are governed by a federal statute and have to treat everyone and apply fair triage rules. And not too long ago, Democrats and liberals were calling for a truly universal health care system. Here’s the thing, though: universal health systems basically have to work on a principle of no-fault insurance.
The basic notion of no-fault insurance is that our traditional rules of compensation for harm, enforced in courts, involve (1) requiring people who are at fault for causing harm to another person to compensate them (this is what negligence law and intentional torts are all about); (2) generally prohibiting people from recovering for harm that is their own fault, or at least reducing their compensation (contributory/comparative negligence law); and (3) leaving people whose harm is suffered by bad luck to pay for their own care.
The problem is that while these rules make a lot of sense from the standpoint of assigning blame, they leave a lot of people uncompensated for the harm they suffered. In addition, categories (2) and (3) tend to grow over time, as powerful people who fall into category (1) use their power to lobby policymakers and judges to reduce the scope of liability. The solution to these problems, well established, is no fault insurance. In a no fault system, you don’t worry so much about whose fault something is; you just pay for the treatment. For instance, workers’ compensation not only pays for accidents that are clearly your employer’s fault; it also pays for accidents that are the result of pure bad luck on the job even when your employer did everything right to prevent accidents. It’s no fault- the notion is that it’s more important to make sure everyone’s accidents are paid for than it is to condemn negligent employers through liability judgments.
Health care basically has to be no fault. First, if it were based on fault, health providers, whether they be insurance companies or hospitals, would have enormous incentives to try and argue as much health care as possible was the fault of the patient, so as to avoid having to pay for it. Second, human health is really complicated and is subject to a million different causal relationships; it’s fairly straightforward to trace a wide variety of diseases and injuries to patient error of some sort. And third, the overused activist term “equity” has some real bite here: you have to think about what sorts of people are going to be found to be responsible for their health conditions. If you guessed poor people, people without a lot of power, minorities, people with drug problems or who live in food deserts and consume a lot of junk food, etc., you guessed right.
On this third point, one thing you can absolutely guarantee is that no hospital is going to be turning away any wealthy unvaccinated COVID patients. It’s going to be poor and working class people, people who may have been duped into their anti-vax stance or who weren’t able to conveniently get the vaccine. Meanwhile, rich anti-vaxxers have no such excuses and, again, believe me, they will get hospital beds.
But beyond the practical issues, this is one of those issues that makes me fear for the social fabric. We are all in this together, and the same logic that compels me to want everyone to get vaccinated (that we have an obligation to take care of our fellow human beings) also compels me to support health care for the unvaccinated. There’s a lot of people, left and right, who think that the judgments that they personally make about other people’s character are the most important thing in the world and should be heeded by our policymakers. But that’s the express superhighway towards complete societal balkanization. We need to love our neighbors and not judge them. A wise preacher once taught his flock that.
Oh, and Merry Christmas.
I feel like you're missing a crucial part of the argument:
Most people don't want unvaccinated people to not be treated, they would prefer if other people had priority over the unvaccinated. (Specifically, people unvaccinated by choice, not because they're immunocomprimised). This would presumably be done by keeping a set amount of hospital beds for vaccinated people, because it's not like they're going to kick out people on life support out if the hospital is full.
People support this policy because they're afraid that vaccinated citizens will die (or already have died) from not being able to enter a hospital, because said hospital is filled with the unvaccinated. And, for the most part, I agree. The idea of someone dying to appendicitis because of the selfishness of anti-vaxxers really sickens me. I'm not sure how much of a problem this actually is, but I wouldn't shed a tear if such a policy was implemented. That being said, I would be convinced otherwise if there was concrete data showing this isn't a problem.
Merry Christmas to you too :)