Should the unvaccinated have to pay their own medical bills?

Not for the first time, the pandemic has raised new questions about how to balance individual liberty with public health. The latest is whether people who choose to go unvaccinated against COVID-19 should be made to pay their full hospital expenses if they get sick.

Jonathan Meer, an economics professor, makes the argument at MarketWatch: "Under our system of risk-sharing, it's all of us, whether through government programs like Medicare and Medicaid or through private insurers," he writes. "When someone who refuses to get the vaccine gets seriously ill, their bills currently are paid by taxpayers or others in their insurance group."

Meer bases his argument on economic incentives, as befits his profession, but many of the people advocating for this appear at least partially motivated by animus against Donald Trump's supporters. But anything targeting the unvaccinated would also have a disparate effect on racial minorities with low-vaccination rates, especially black Americans, as much as any GOP voting law. That is not a defense of white conservative vaccine hesitancy, it is just an acknowledgement of reality.

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Higher insurance premiums for the unvaccinated might make sense, but making them assume the full cost of hospitalization is probably unworkable. But the question does raise interesting thought experiments about what kind of behaviors the government would be able to regulate or forbid under Medicare-for-all. Some Republicans are interested in passing laws or regulations to prevent local governments and even private companies from experimenting with their own ways to encourage safe COVID practices. President Biden has said he thinks this is inconsistent with the standard GOP critique of government overreach, and he may be right, even in an era where conservatives are rightly reappraising whether supporting free markets entails an uncritical defense of whatever private businesses want to do.

What both of these excesses have in common is that they confuse stigmatizing the other side of the red-blue divide and piling mandates upon mandates with protecting the populace from the virus.