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Opinion | Delta Air Lines' vaccine penalty is a bad idea. Here's a better one. - The Washington Post

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Delta Air Lines’ decision to require unvaccinated employees to pay a $200 monthly surcharge for health insurance sounds, at first blush, like a good idea. About 3 in 10 U.S. adults have yet to receive a single dose of a coronavirus vaccine. Lotteries and other bribes haven’t worked. Tales of dying Americans haven’t worked. Why not hit in the wallet all those who refuse to get vaccinated against the coronavirus?

But for all the good reasons to raise the effective price of going unvaccinated, policies like Delta’s could end up costing all of us in the long run.

To understand the potential harm, you don’t need to be a conservative commentator like Ben Shapiro, obsessing that if exhausted or exasperated doctors refuse to treat covid patients they could target obese patients next.

For one thing, there is precious little evidence to suggest that higher insurance premiums for the unvaccinated would work as hoped. Consider: The Affordable Care Act allows insurers to charge up to 50 percent more for smokers’ premiums. A 2016 study published in the journal Health Affairs discovered, however, that this higher pricing not only didn’t make it more likely that people would quit smoking but also reduced the likelihood that those affected would sign up for insurance.

Such policies potentially open the door to other punitive measures. Jonathan Meer, an economist at Texas A&M University, has argued that insurance companies should refuse to pay covid-related bills of patients who avoid vaccination (excluding, of course, those with valid medical reasons for going unvaccinated). Those costs aren’t cheap: Delta’s memo announcing the policy pointed out that the average bill for a hospitalized covid patient is $50,000.

If it ultimately costs several hundred thousand dollars to save the life of a patient who has chosen to remain unvaccinated, the argument holds, that should be on them. As Meer put it, “Insurers, led by government programs, should declare that medically-able, eligible people who choose not to be vaccinated are responsible for the full financial cost of COVID-related hospitalizations.”

Let’s be clear: This sort of sentiment is good for little more than letting off steam. The laws governing health insurance do not currently allow for such a carve-out, and changing things would require Congress to step in.

There are also reasons to be uncomfortable that such proposals are being widely discussed. “I’m worried that making an exception for covid or someone’s vaccine status starts us down a slippery slope,” says Sabrina Corlette, co-director of the Center on Health Insurance Reforms at Georgetown University. Denying health insurance coverage for preexisting conditions, even seemingly minor ones, ended only with the passage of the Affordable Care Act. “It was a long, hard-fought battle to end the practice,” she says.

Lots of things in day-to-day life are risky, Corlette notes. “Should we charge people more if they work with toxic chemicals in their day job?”

Many Americans seem to understand that people shouldn’t be singled out by an optional health status. A recent poll by Eagle Hill Consulting Research found that almost 6 out of 10 oppose the idea of charging unvaccinated Americans higher insurance premiums. “Even employees who are vaccinated might oppose higher rates, as they could worry this could lead to more health-care costs placed on employees,” says Eagle Hill CEO and President Melissa Jezior.

That’s not an unreasonable fear. In the ongoing battle over who will pay our ever-increasing medical bills, consumers all too often get tagged as “it.”

If you believe, like I do, that health care is a basic human right, narrowing access to care is a step backward. Costs should not be conditional on someone behaving in a medically approved way.

None of this is to excuse those who choose to be unvaccinated. In some ways the unvaccinated are freeloaders, benefiting from the risk reduced by those of us who got jabbed even as they raise the risk to the immunocompromised and others around them. These days, the unvaccinated account for the vast majority of the pandemic strain on our health-care system. Every eligible American needs to get vaccinated.

But we don’t need to give employers and the medical industrial complex another excuse to raise people’s bills, no matter how worthy the end goal. If Delta or other companies are concerned about unvaccinated employees, they should tackle the issue in the most direct way possible: mandate that all their employees get jabbed. They’ve got the power to require vaccination, and no extra premiums are needed.

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Opinion | Delta Air Lines' vaccine penalty is a bad idea. Here's a better one. - The Washington Post
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