Unvaccinated Covid coverage exclusion?

The Sandbox Covid19
21

I think it’s an incredibly bad idea to deny people health insurance just because they take risks with their health.

What’s the cut off? If they smoke? If they don’t exercise enough? If they are overweight?

At the extreme, people who actually commit suicide are mostly suffering from depression, which is a mental illness and basically bad luck to have. At the other extreme, everyone makes some bad choices. And we all start with different information, different social pressure, different limitations of time and ability…

I’m not opposed to underwriting insurance in general, but i don’t think it works very well for health insurance. A lot of the risk is persistent from year to year and it’s beyond the control of the person. But i guess I’m drifting off topic, and into universal healthcare…

Anyway, once some covid vaccines are officially approved by the FDA i think we should start restricting the unvaccinated from certain crowded public places. (As well as trying to make vaccinations easier.) But i don’t think we should deny them healthcare.

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22

FDA will add warnings to Pfizer and Moderna vaccine fact sheets (msn.com)

likely connection between pfizer and moderna to heart inflamation in young adults. the risk of dying from COVID is pretty low for this group, so I could see skipping the vaccine.

But if Snik has his way, if they do wind up with a severe case of COVID after not taking the vaccine, just let them die with no health insurance.

23

Wait, really, the FDA hasn’t approved any vaccines yet?

24

Nothing permanently approved. Approved for emergency use, or conditionally approved, or something like that

25

“Emergency authorization” for everything currently in use.

26

exactly, which means, these vaccines are being tested on everyone who agrees to take them, and snik wants to deny medical coverage to people who don’t trust that these vaccines that haven’t even been FDA approved aren’t going to harm them.

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27

Well, if it harms them at least they will have health insurance to pay for their treatment…

28

well yes, but that’s not an argument to take away insurance from people who choose to opt out of the vaccine. seems like a way to punish them, by making sure they die if they dare to not comply and also wind up with a bad case of covid.

29

I don’t like people free riding. Relying on others to get vaccinated to get to herd immunity is a free rider problem in my mind, I’d like to make it a less attractive option.

It’s laughable that vaccines that have been given to half the country at this point are being painted as unsafe. If there were serious side effects they would be apparent by now. The risk of heart inflammation is higher if you get Covid (and are young) than if you get the vaccine.

Society is going to pay a much higher price to treat what will be endemic American Covid epidemics than if everyone was vaccinated. I guess for the US that’s preferable to creating stronger incentives to be vaccinated.

30

are you saying that Canada is planning to institute your plan to deny coverage to unvaccinated people if they contract COVID?

31

Seems like around 45% of Americans are vaccinated. My understanding is supply isn’t an issue in the US so the remaining 55% seem like they don’t want a vaccine.

Canada is around 75% for first dose. Due to initial supply constraints we’re catching up on second doses, very likely we’ll exceed 75% fully vaccinated in a few months.

If I was running either country yes I would implement something along these lines.

32

my question was if Canada would institute such a policy, not whether you would. your post implied that Canada would, but the US wouldn’t

33

This is patently false, based on CDC data, even when they misinterpreted it.

34

Ok, do you have a link?

35

95 per cent of cases of myocarditis and pericarditis (swelling in the lining around the heart) reported in the U.S. after vaccination were mild, treatable with medication like Advil and resolved completely with no lasting symptoms. …

In fact, the condition is far more common after getting COVID-19 than after getting the vaccine, she said.

36

There was an early alarmist study about heart disease and covid, which didn’t stand up over time. But the data now seems to be “covid doesn’t cause heart disease any more than other viruses, and people generally recover from that damage.”

But of course, all severe viral diseases carry a non-negligible risk of heart damage. I didn’t find any compelling data about how that risk compares to the risk of the vaccine either way. I guess I’ll take Snik’s reference until/unless I find something better.

More importantly, the risk from the vaccine seems very low, and even when it happens, it usually gets better on its own. It seems more like a “doctors should be aware this might happen” thing than a “you should worry about this” thing.

In another year (probably less) the Novavax vaccine will be approved. That’s a traditional vaccine made of an antigen and an adjuvant (none of the RNA or adenovirus stuff) and it seems to be just as effective as the RNA vaccines while having fewer side effects. So maybe that will be the one recommended for kids.

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37

I don’t like free-riders, either. But randomly punishing those who happen to get sick seems like bad policy. In addition to being heartless, it incents people who get sick to continue spreading their illness instead of being treated (by doctors who are pretty decent at infection control). I also suspect that a random severe punishment of the unlucky is less effective at changing behavior than a certain punishment of everyone who chooses to avoid vaccination.

So charge a higher premium. Or go after some the most dangerous (in terms of spreading to others) groups – withhold some medicare/medicaid funding from hospitals and nursing homes that don’t require their staff to be vaccinated. Require people who enter schools and colleges to be vaccinated (almost all colleges get federal funds, or federally-backed student loans, that could be withheld), create a vaccine passport and require it for airline travel… There are lots of “sticks” that could be applied to increase the rate of vaccination that wouldn’t leave sick people untended.

But we probably ought to wait until there’s actual FDA approval for some vaccines, first. I expect that to come this fall, at least for people over 18. The rules require 6 months of follow-up data

Pfizer applied in May

Moderna in June

Novavax may skip looking for a EUA (the FDA may not feel the need for more) and just seek full approval. It’s expected to file soon, either way.

38

This is quite the assumption.

The COVID Data Tracker Vaccination Demographic Trends tab shows vaccination trends by age group. As of June 24, 87.5% of people ages 65 or older have received at least one dose of vaccine and 77.4% are fully vaccinated. Over half (65.7%) of people ages 18 or older have received at least one dose of vaccine and 56.2% are fully vaccinated. For people ages 12 or older, 62.8% have received at least one dose of vaccine and 53.3% are fully vaccinated.

You’re right that about 45% of Americans are fully vaccinated, so far, but about 2/3 of U.S. adults have had at least one vaccine dose, and about 63% of all eligible people have had one dose.

We should focus on those who are adults, because children don’t really have much choice one way or the other.

So far, we’ve got evidence that at most about 1/3 of American adults don’t want to get the vaccine. I don’t assume that’s true, because there are lots of people who have accessibility problems in getting the vaccine, as mentioned in one of the links above.

It would be interesting to see the vaccination %age uptake for those on Medicaid, because I would think that would be among the group of people with the biggest healthcare accessibility issues, in terms of geographic location, ability to get time off from work, or even having transportation access to somewhere with vaccines.

Going to take a few snapshots of the CDC vaccination data, just for convenience.

Here’s the age breakout:

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I will note that those age 65-74 have higher takeup than those over age 75. This can reflect mobility issues for the very old… as well, they may be more likely to have health issues that preclude them getting a vaccine.

Breakout by sex is boring (about 5 percentage point difference, and that could be partly age-related…as women do live longer)

Racial breakout has numbers that don’t tie up with age breakout or overall %ages… because they have only 60-70% of the racial info on those vaccinated. If the racial data were more often collected in some states, then there would be a bias to the results just due to geographic differences, so I wouldn’t rely on these data for anything.

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39

I noticed that in my state’s data, too. And also that the gap is larger for “fully vaccinated” than for “at least one dose”. I attributed most of that difference in gap to mobility issues.

Also, in my state, while there had been more vaccine uptake among those 65-74 than those 50-64, the gap between partially and fully vaccinated is now smaller for the younger cohort. Again, I suspect mobility issues among the older people.

The Novavax vaccine is looking to be at least as effective as the mRNA vaccines with fewer side effects, and I’m hoping that when it gets approved it might make it easier for those who can’t afford a day off work for “feel crummy from vaccine” to get vaccinated.

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40

This seems like a far more workable and humane option. Similar to what’s frequently (though not universally) done for smoking.

Also, I worked for a company that had a seat belt benefit on their accidental death coverage. If you died as a result of a car accident and you were wearing a seat belt then your beneficiaries got extra money. It’s not really “insurable” in that beneficiaries don’t need more if you had your seatbelt on. But it falls into the carrot category of carrot vs stick.

I suppose life insurers could pay extra if you die from Covid when vaccinated and/or it could be added to critical illness coverage but only for vaccinated folks.

Accidental Death and Critical Illness are already products that fail the “insurability” test, yet are actual products offered by real insurers and purchased by real people. So they’re reasonable places to add uninsurable carrots.