Last Thursday, Ian Millhiser, a senior correspondent at Vox, published a controversial tweet arguing that the government should tax unvaccinated people at 99% as a means to coerce them into getting the jab.
While the exact figure Millhiser attached to his tax proposal is (probably) hyperbolic, I suspect the sentiment underlying it is not. People like him seem to think it would be ethical to inflict financial harm upon those making healthcare choices with which they disagree.
Applying their logic to public health generally, would it not be consistent to levy a similar tax on the medically obese?
Obesity, after all, is associated with a 12% to 25% increased risk of all-cause mortality compared to people in the normal body mass index range. Given that COVID-19 has an approximate mortality rate of 1.8% in the United States, a figure inflated by the susceptibility of the elderly to the virus, it is fair to say that the two conditions represent comparable threats to human health, especially for the middle-aged and younger populations.
The similarities between the two conditions go beyond simple increases to one’s probability of dying. Recently, there has been much talk about “long COVID,” which is a condition that refers to lingering effects, such as brain fog or fatigue, that remain well after one initially contracts the disease. Around 25% of those who get COVID-19 experience long-term symptoms. Nearly every obese person also experiences drawn-out health complications and is otherwise physically impaired by virtue of their condition.
At the moment, obesity and the coronavirus are public health concerns of comparable magnitudes. That established, does it make sense to impose heavy fines on people in hopes of making them healthy? With regards to obesity, the answer is obviously no. Likewise, financially penalizing those who choose to remain unvaccinated is also irrational when applying the same logic.
Consider that the obesity or vaccination status of another person is no threat to anybody but that person. With obesity, this is apparent as sitting next to a fat person isn’t going to make you fat. Similarly, someone being unvaccinated doesn’t negate the protection your vaccination provides. In both cases, the personal decisions of those around you, no matter how misguided or unwise, have no bearing on your well-being. It is therefore illogical to use the hammer of the state to beat them into submission.
Such measures would almost certainly be regressive in effect, which should concern the leftists who are pushing them. Racial minorities and the impoverished are overrepresented both among the obese and the unvaccinated. Taking punitive measures against noncompliant people to pursue lofty public health goals would, in both cases, lead to a disproportionate amount of resources being taken from society’s least fortunate — hardly a progressive proposal.
A better strategy may be to provide positive financial incentives to encourage vaccination. There is some evidence from the developing world to suggest that offering conditional cash transfers to vaccine-hesitant populations improves vaccination rates. With New York City pioneering a program that will give people $100 to get vaccinated, we will soon see if these results are generalizable to the U.S.
No sane policymaker would ever suggest taxing fat people into oblivion as a way to make them skinny. Following this, it would be both nonsensical and socially harmful to use monetary penalties to coax hesitant people into getting vaccinated.
