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Msgr: Paul V. Garrity: Denying health insurance may prod unvaccinated - Itemlive - Daily Item

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One man can lead a horse to water but 10 men cannot make him drink. This piece of wisdom has never been more true than it is today. 

COVID is wreaking havoc in our nation and around the world. Sixteen months ago, we were powerless as our death tolls kept rising. Vaccines came along and, almost overnight, we had within our power the ability to beat this pandemic and get back to some new sense of normality. This never happened. Instead, we have a pandemic of the unvaccinated. 

Doctors, nurses, mayors and governors have tried to cajole, encourage and invite the unvaccinated to get vaccinated. Natural reticence coupled with political machinations have produced a perfect storm of intransigence that may keep us in masks long after we should have been able to put them to one side. 

The big question before us, then, is how do we incentivize the unvaccinated to come in out of the cold. One route may be through health insurance?   

The insurance industry makes money by calculating the odds of your house burning down and their liability for paying its replacement cost. It is a very simple calculation to make especially in a time when big data provides more actuarial information than ever before. If you set your own home on fire (which we call arson) the insurance company will legitimately deny your claim. This, also, is very easy to understand. 

Correspondingly, people who choose to build a house in a flood plain have a higher risk of losing their homes to water damage than people who live on mountains and hills. Their flood-insurance premiums are appropriately higher than premiums for homes that are in safer locations. Risks come in all shapes and sizes and are the foundation of this very lucrative industry.

With these examples in mind, there may be interesting opportunities to incentivize the unvaccinated. Hospitalizations are very expensive. Intensive-care-unit hospitalizations are enormously expensive. This is why we have health insurance. If a person is hospitalized because of the virus, their health insurance will presumably pick up the cost. (Hospitals cannot refuse to take in sick people.)  However, if the infected person has made a decision not to be vaccinated, does this raise the possibility that the health-insurance provider is no longer responsible for the infected person’s hospital expenses? 

Or maybe the question is whether the insurance company should charge a higher health-insurance premium for people who are choosing not to be vaccinated. (This already happens in some places for people who are smokers.)

There are some people who may not be able to be vaccinated because of age or some pre-existing condition. For everyone else, vaccinations are the proven tool for avoiding serious illness and hospitalization. People who choose not to be vaccinated are at greater risk of contracting coronavirus and at greater risk of hospitalization. They are choosing to take this risk. They are also putting other people at risk.

All insurance is based upon calculating risk. Accident-prone drivers pay higher insurance premiums so that everyone else doesn’t pay for their accidents. Without these higher premiums, we would all be subsidizing careless drivers. This seems very logical. 

If we apply this logic to health care and vaccinations, it seems very reasonable that health-insurance premiums should be a great deal higher for people who could get the coronavirus vaccine but choose not to do so. Why should everyone who is vaccinated be forced to effectively subsidize those who choose not to be vaccinated and whose behavior will result in avoidable hospitalizations?

In the dark days of the past year when hundreds of people were dying on a daily basis, we hoped and prayed for relief. Relief came in the many vaccines that had the potential to eradicate coronavirus. 

Sadly, too many people are choosing not to be vaccinated. Their refusal is now powering a resurgence of the virus with deadly consequences. Healthcare workers are once again on the firing line and are being put in harm’s way unnecessarily. Vaccine refusal is having a domino effect that may exponentially grow worse as the omicron variant continues to spread and we get deeper into the winter.

While mandating vaccines may be impractical and unenforceable, it is clear that more needs to be done to protect the health and safety of everyone. Perhaps the insurance incentive is the answer. 

Ninety percent of coronavirus hospitalizations are unvaccinated individuals. If these people became liable for their hospital expenses, things may begin to change overnight. If insurance companies begin to deny coverage to the unvaccinated, dramatic change may quickly ensue.

Of course, the best motivation in the world is the realization that we care for one another and do not want to harm our families, friends and neighbors. Virtue is its own reward and the virtuous thing is, for everyone who can, to be fully vaccinated as soon as possible. This is both the reasonable and the loving thing to do. 

Msgr. Paul Garrity is a senior priest of the Archdiocese of Boston and former pastor at St. Mary’s Church in Lynn.