General Question

LuckyGuy's avatar

Would this carrot and stick approach work to get more people vaccinated against Covid?

Asked by LuckyGuy (43690points) March 5th, 2021

The carrot: A cash payment when you get the shot.
The stick: A special fee added to your bill if you become positive and need medical attention to cover some of the extra costs involved. Fee would be waived if you were vaccinated.

As an example:
The carrot: $ 100 Covid Vaccine incentive Payment to everyone who takes the time out of their day to schedule and get the shot.
The stick: A $ 300 Covid Cleaning and Convenience Fee added to your medical bill if you are diagnosed with Covid. (Waived if you have been vaccinated)

Now let’s estimate what the payment and fee should be and see if these numbers are reasonable.
First we need to determine the cost of Covid on society.
I’m sure CDC has these numbers but let’s make some assumptions and approximate the costs per person. (Feel free to make your own estimates and correct me if my numbers are way off. I made a spread sheet and can fix it in a second.)
Assume 30% of people would eventually get Covid and lose 1 day of work. Assume 50% are working. At $20/ hr = $160 x .30×0.5 = $24 per person
Assume 10% of those who get it, go to the doctor. At $200 per visit. Cost = $200 x .3 x .10 = $6 per person
Assume 2% of those who get it are hospitalized for 2 days, At $3000 per day estimate = 6000 x .3 x .02 = $36
Assume 0.5% of those who get it die. Life worth $300,000. Cost =300000 x .3 x .005 = $450 per person
Total cost per person= $24 +$6 + $36 + $450 = $516
Assume 25% of people at medical office will refuse vaccine need to pay fee. $300 x 0.3×0.5 = $2.25 per person.

Total cost of Covid in the US = $516 x 330 million people in US = $225 Billion The number is much, much higher in the trillions but let’s stick with this for now.
Cost of $100 Vaccine Incentive payment (carrot) for all US = $100 x 330 million = $33 Billion
Income from Covid Cleaning Fee = 0.7 Billion (Ignore it for now).

It seems we save $225 billion by spending $33 billion. That is 5 to 1 I’m just an engineer with a calculator but this seems like an obvious choice.
I know vaccines are not perfect. I’m sure I missed some things. Please correct me and tell me what I missed.

If you were on the fence or not planning to get the vaccine would you get it if this program was in place?

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54 Answers

hello321's avatar

There is a massive vaccine shortage – not a shortage of people who want it.

LuckyGuy's avatar

@hello321 The shortage will eventually end but there will always be people who won’t want one.
That is their right but they should pay for it.

JLeslie's avatar

I like a carrot idea, not the stick so much. My grocery store gives you a $10 gift card when you get a flu shot. For covid I do think it has to be higher. Right now nothing is needed, because for now we have a vaccine shortage. Eventually, we might need to get creative.

Once lines slow down and appointment stop booking, then they can evaluate what to do. There will be information coming out regarding safety in pregnant and babies born following prior vaccination of the mother, and that might create another small wave of people willing to take the vaccine who weren’t before.

There will be examples of cities very well vaccinated with zero to very few infections (already happening in some places) to sell the notion that the vaccine really helps life get back to normal.

hello321's avatar

@LuckyGuy: “The shortage will eventually end but there will always be people who won’t want one.”

Fine. But with ~8% of the US vaccinated and seemingly everyone else desperate to get it, it feels like an odd time to raise this hypothetical.

LuckyGuy's avatar

@hello321 There are surveys showing a large percentage of Republicans (20–40%) saying they will not get the vaccine. White Democrats have the lowest “no” numbers in the 6–10% range. You can pick your survey, there are plenty, but the numbers are in the 20–25% range.
How are we going to reduce that 25%? Would $100 incentive do it?

stanleybmanly's avatar

@hello321 Until recently, I would have agreed with you, but I am now alarmed at the number of people who openly declare that they will refuse inoculation. While receiving my second shot, I asked the woman administering it whether she had received hers, only to be told that she had no intention of being inoculated under any circumstance. And considering what I have witnessed these past few years, that stunning reply pretty much reflects the age in which we find ourselves.

LuckyGuy's avatar

I did a little more research on my numbers and see that my hospitalization estimate is pretty close. I came up with $11.9 billion.
This healthcare finance article says “Inpatient COVID-19 hospitalizations could cost the U.S. healthcare system between $9.6 billion and $16.9 billion in 2020, according to Avalere.”

stanleybmanly's avatar

@LuckyGuy I don’t think the problem is about lack of incentive or motivation. I wish it were that simple. As stated above, it seems we are up against tendencies far more insidious than mere laziness or procrastination. I mean if the prospect of a gruesome and lingering death is not adequate motivation, what point is there to a hundred dollar bribe?

hello321's avatar

Great. Have at it. My disgust at this question really might just be that it appears to be completely tone-deaf considering the reality that I see. I know 1 person who received the vaccine. We are completely out in MA, with most people 65–74 still unable to get their first dose. The poor and disabled (even over 74) have still been ignored. At 49 years old, my doctor has estimated that I probably won’t see the vaccine until at least June, despite the varying estimates.

If I were to shift my frustration and anger to potential people who will eventually refuse – I say “fuck them”. Let everyone who wants to get vaccinated get their’s, then we use a very large stick to keep the rest of them from taking any part in society. If they want to join society at some point, they can get vaccinated. Until then – no leaving the house, no school, no work, no travel, period.

stanleybmanly's avatar

@hello321 As a practical matter, that one would be tough to enforce. My question would be just how many anti-vaxxers are there among us. As things stand now, adequate protocols are clearly not in place to vaccinate all who are willing. But we will bumble our way to solving this in the same disjointed and multivaried approach as we have to every other aspect of the disease, with the consequence of varied and inconsistent results nationwide. It figures that the one occasion on which a strong willed authoritarian figure would be a positive advantage in tackling a national plight, Trump who is the epitome of the role not only dropped the ball. He hurled it to the ground.

kritiper's avatar

It would help a lot of people, I think, if there were phone numbers to call to set up an appointment instead of having to go ON-LINE to set up the appointment.

hello321's avatar

@stanleybmanly: “As a practical matter, that one would be tough to enforce.”

Seems rather straight-forward to me. Want to travel? Can’t purchase an airline ticket without proof of vaccination. Want to stay in a hotel? Can’t rent a room without proof of vaccination. Want to enter a store? Can’t enter without proof of vaccination. Want to go to school? Proof or no go.

@stanleybmanly: “Trump who is the epitome of the role not only dropped the ball. He hurled it to the ground.”

It would have been nice for the people who ran on their ability and desire to pick up the ball would have… picked up the ball.

stanleybmanly's avatar

It’s kind of late NOW. The protocols for distributing and administering the vaccines SHOULD have been developed while the vaccines THEMSELVES were being devised and tested.

Tropical_Willie's avatar

@hello321 “Until then – no leaving the house, no school, no work, no travel, period.”

Rep/Con will call foul and the have “Rights” like to kill their elderly maybe yours too !

hello321's avatar

@stanleybmanly: “It’s kind of late NOW.”

Nope.

stanleybmanly's avatar

What I mean by “it’s kind of late now” is that while the development and trials were underway, it was incumbent on the FEDERAL government to organize for distribution of the vaccines, rather than willy-nilly pass them around to the whims of local jurisdictions. The Feds alone possess the logistical muscle to pull off such a feat as blanket coverage of the entire country and should have geared up for EXACTLY that goal in the year required for the vaccines fruition.

janbb's avatar

Things are picking up in my state. I’m with @hello321 ; let’s get vaccine into every arm that wants it while demand is greater than supply and then worry about the holdouts.

I do believe there is work being done on both making it more available and the administration more equitable. The two firms working on production of the J&J should help a lot.

si3tech's avatar

In my state we are approaching “herd immunity”. We’ve gone frome 4000 new cases per day
to 500 and less.

hello321's avatar

@si3tech: “In my state we are approaching “herd immunity”. We’ve gone frome 4000 new cases per day to 500 and less.”

I’m no expert, but isn’t herd immunity for C19 estimated to be around 70% – 85%? I’m not sure what state you are from, but considering that the most vaccinated state is only 14% (Alaska), and most states are significantly-less than that, you’re not even close to herd immunity.

Zaku's avatar

Press the “US politics” button on your calculator to get the answer to “would it work?”

KNOWITALL's avatar

@LuckyGuy No, $100 will not change an anti-vaxxers mind, not the ones I know. They don’t take flu shots and some believe it will kill them or has a chip in it. Seriously.

The only thing I can see working is keeping kids out of school who have not been vaccinated, along with their immediate families. Parents lose their free ‘childcare’ during school hours and they’ll come around quick.
Some employers could also require it before coming back into a physical office, but that may violate privacy, not sure.

@hello321
“I know 1 person who received the vaccine. We are completely out in MA, with most people 65–74 still unable to get their first dose. The poor and disabled (even over 74) have still been ignored. At 49 years old, my doctor has estimated that I probably won’t see the vaccine until at least June, despite the varying estimates.”

This is absolutely true for me and my state as well. I’m not pushing for it, until my mom who’s at a much higher risk due to active chemo and radiation, gets it. But I work from home and rarely leave except short, masked trips on the weekends to the store.

gorillapaws's avatar

It is my understanding that punitive measures are ineffective if the person being punished believes the odds of being caught are low, regardless of the severity of the punishment itself. That would mean the carrot is the better choice here. I also like @KNOWITALL’s suggestions about limiting school/work options.

KNOWITALL's avatar

My friend the anti-vaxxer posted this:
And so it begins!!!! CONTROL!! that’s all they want is to control you and scare you into getting this “so called good for you and will stop you from getting sick vaccine”.. I don’t have to go to the movies or the mall or restaurants. We hardly ever do anyways lol. Nothing they can say will want or make me get the vaccine period.

KNOWITALL's avatar

Anti-vaxxer response to a reply from a nurse friend, the post above:
Lol! I know your in the medical field so that’s how your going to think. It’s just not my thing girl. I believe God made our bodies to do what they are supposed to do. I just don’t trust them especially with my kids. I do know ppl who were vaxx injured. If I feel in my spirit it’s not right for me then I’m gonna listen to that.. I totally respect your opinion. Just not my throught process.

Jeruba's avatar

^^ What in the world makes some people think they are so important that anyone would go to that much trouble to CONTROL!! them?

I wonder how those same folks feel about CONTROL!!ing their kids, their spouses, their employees or coworkers, etc. Or does this aversion go only one way?

JLeslie's avatar

@KNOWITALL I’ve been seeing those posts for many months. It’s so obvious they all talk among themselves. All the same lines. Also, “if you have faith you don’t need to be afraid,” and, “I’m healthy, I take vitamins and eat right and exercise, I’m not afraid.”

@Jeruba Lots of those people are spare the rod spoil the children people.

KNOWITALL's avatar

@Jeruba I know, I see it every day here. They give me the eye for wearing a mask, as if I’m the crazy one.

On control, I posted a meme that said ‘Most of you are not worth micro-chipping. Change my mind.’
It did not go over well. I thought it was hilarious.

I just wanted you to see that emotion is tangled up often with anti-vaxxers. They are usually adamant they are correct. So a hundred dollars means nothing.

hello321's avatar

@JLeslie and @KNOWITALL – I’m sure there are a lot of these people who are young and healthy and really don’t feel it’s a threat to them (or that their god will look out for them or whatever). The thing is – they’re actually playing the odds and the odds are in their favor. They probably won’t get sick or even know when they are carrying it.

But the thing about a society is that each of us is but one unit. Some people are brought up with an American “rugged individualism” that is by definition anti-social. It’s not a surprise that they can’t view their actions in the context of the society as a whole.

We’re not going to convince these people to start caring. We need them to meet certain criteria if they are going to be part of this whole thing (society). If they can’t do this, they should be as isolated as they believe they are. This includes harsh restrictions.

JLeslie's avatar

@KNOWITALL A friend of mine wrote on Facebook that her “dog was microchipped and no way a chip fits in the vaccine needle.” She’s a Republican and a Trumper, and a lot of our mutual friends are too. I think she was seriously trying to reassure them.

JLeslie's avatar

@hello321 Most people I know are 50 years old and older. Where I live most people are over 60 and many of them still feel that way. Luckily, there are Republicans who are on board with the vaccine and masks. It seems 50/50 among the Republicans I know.

KNOWITALL's avatar

@JLeslie One of my Dem friends posted sarcastically that with the second chip installed (second shot) the Feds can now track him at will so everyone be on their best behavior. Haha!

KNOWITALL's avatar

@hello Yes, she is maybe 30 years old, you’re right. Not worried one iota.

JLeslie's avatar

@KNOWITALL Oh gosh, I’ll have to use that line. Lol.

LuckyGuy's avatar

@KNOWITALL I’ll bet the same person worried about invisible tracking chips in his vaccine is carrying a cell phone, using Facebook, email, and other social media.

It breaks my heart to see that people are so dumb and gullible.
Maybe they don’t deserve the vaccine. I just want some method in place so we don’t have to pay for their stupidity.

doyendroll's avatar

The carrot you live.

The stick you aren’t allowed inside.

janbb's avatar

Well, one thing I think is that people from states that fully open with no mask mandate should have to quarantine if they travel to a protocol abiding state.

gondwanalon's avatar

To those sad folks who believe that there are computer chips and nanobots in the vaccines (designed to monitor and control) there is no carrot so good or stick too painful to get them to get vaccinated.

KNOWITALL's avatar

@LuckyGuy Yes, but remember a lot of healthcare workers aren’t getting it either, as someone posted above. That alone helps create a mistrust in the public.

Tropical_Willie's avatar

@KNOWITALL In area it is a condition to work at a hospital, no shot no work ! Same as Flu shots.

stanleybmanly's avatar

I suspect the rise of the anti-vaxxer movement merely reflects the growth in overall distrust of our government and suspicions on the integrity and competence of “experts” and authority in general. And when you consider the way this disease was handled, it becomes hard to blame them. When I was a boy, we took pronouncements from our government and its scientists as gospel with resistance to such pronouncements as rare and infrequent. I would like to place the mishandling of our covid crisis directly at the feet of Trump, but that leads to the chicken and egg question of who in their right mind would believe anything emerging from a government headed up by Trump? I don’t know what the answer is, but I do know that if 30% of us are going to refuse inoculation against future outbreaks, we’re in for a grim future indeed.

janbb's avatar

@stanleybmanly The anti-vaxx movement has been around for quite a while pre-Trump. There’s been all that flap about vaccines causing autism which may have started it some years ago..

JLeslie's avatar

I think @janbb is right that the autism vaccine scare did a lot of harm when it came to the public feeling safe about vaccinations.

Plus, the HPV vaccine created opportunity for vaccines to be used in politics by the religious right. Remember Michelle Bachman. Here is another from the past. The right wing antivaxxers from ten years ago sound just like QAnon and there is a lot of crossover in the two groups. Back 20 years ago my friends who were cautious about vaccines were more left and into all natural type of ideas, but none of them were completely against all vaccines like I see the far right in more recent years.

Trump always supported the vaccine. Some of his groupies probably think he didn’t, because it fits the narrative they want to believe.

Anti-vaxxers have a whole bunch of false information they believe and a lot of incomplete information.

KNOWITALL's avatar

@janbb And lots of payouts over the years, over $4billion.

“Young parents, they’ve never seen measles; they don’t see meningitis; they don’t see mumps and the sterility that can result,” said Dr. Cody Meissner, a member of the American Academy of Pediatrics’ committee on infectious disease.

janbb's avatar

Relevant info:

Amount of people hesitant to get Covid-19 vaccine dropping rapidly – CNN Politics

https://apple.news/A0qbR6UfMTKGAaqgMkEf0mw

JLeslie's avatar

@janbb I guess the people who wanted to wait and see were telling the truth. I never understood why media, including people on social media, were so upset some people wanted to wait a few weeks or months to feel more comfortable. It seems pretty rational.

crazyguy's avatar

I think the reward required is access to places and events that the unvaccinated cannot get.

I do not think that US laws will allow any jurisdiction to get away with discriminatory pricing for health care; however, access to places and events is subject to approval by the owners of the businesses.

Restricting access to airplanes, other public transportation, and government facilities like the Congress may be more problematic but can probably be approved on an emergency basis.

RocketGuy's avatar

Americans value freedom (free-dumb?) too much. Money penalty/reward won’t pass. Health insurance will end up eating the cost. But I do like the idea of a vaccine pass, as a reward. That would be something like the Yellow Fever vaccination certificate for traveling into countries that have that requirement to “make sure that travelers also keep the locals healthy”. It has been around for a while. https://www.passporthealthusa.com/2019/08/why-do-i-need-a-yellow-fever-card/

crazyguy's avatar

@RocketGuy During my travels in the 1950s and 1960s, I recall traveling with several vaccination certificates: small pox, yellow fever, cholera/typhoid come to mind. It was not unusual then. In fact, even when the requirement went away, I recall seeing health inspectors at some airports who had nothing to do!

RocketGuy's avatar

I’ve got two smallpox vaccination scars that can be used as indicators, plus a yellow fever certificate. My typhoid vaccine record is on an ordinary vaccine form in the Other box.

crazyguy's avatar

Most posters here had no difficulties with Mask Mandates; it is surprising that requiring people to get vaccinated raises so many objections.

I think we should make vaccination optional; however, allowing the vaccinated to go around without masks and getting into concerts and sporting events will decrease the number of naysayers substantially. Especially if some of them catch the disease while the vaccinated folks don’t.

Response moderated (Spam)
crazyguy's avatar

All, I have just returned from a week in BEAUTIFUL KAUAI! I am so glad the board, and this question in particular, is still alive. Now that the CDC has stated that vaccinated people need not wear masks any longer (based on SCIENCE!) this question can be given a decent burial.

stanleybmanly's avatar

Right along with the 600,000 coffins rewarding our haste to minimize the significance of this outbreak. Besides when have YOU ever trusted the CDC?

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