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Singapore: If you’re unvaccinated, you pay for your own healthcare

Safe bet: If you did an opinion poll on this here in Ireland, you’d comfortably see a majority in favour of it:

Singapore has a substantially lower rate of vaccination than Ireland – about 85% of adults are double jabbed there, compared to 90% here. Every country, internationally, reports a similar pattern: That unvaccinated people take up ICU beds at a rate that is proportionally far greater than those people who have been vaccinated. Vaccine sceptics point – correctly – to data which shows convincingly that vaccine immunity wanes. But that data also shows that protection against severe illnesses lasts much longer than protection against infection.

And so, whether you agree or not, it is not surprising at all that Governments – who do not much like having health services straining under the burden of stretched capacity – should want as many people vaccinated as possible. From their point of view, more vaccines equals more hospital capacity, equals less of a crisis, and more votes (though the votes thing, it should be said, is not a consideration in Singapore).

The question then becomes what measures a Government can take to encourage vaccination. In Ireland, for example, the Government has embedded and encouraged discrimination against those who have not been vaccinated, in order to try and get the vaccine rates up. At Gript, we have long argued that this is illegitimate and wrong. But the evidence from public opinion is that it is very popular.

What about this, from Singapore, then?

There should be little doubt in anybody’s mind, first of all, that the policy will probably be effective. After all, medical care is one of those things that is astonishingly expensive. Most of us, in western countries, do not ever get exposed to it, because of our socialised healthcare systems. But ask an American without health insurance what their care costs, and you’ll find horror tales of people paying the equivalent of mortgages for a two week stay in hospital. People will want to avoid that, at least after a few examples have been made. But lots of policies might be effective. You could eliminate speeding in the morning by introducing the death penalty for it. People would certainly, in that instance, slow down. We still wouldn’t do that, though, would we?

The problem, as ever, is the precedent that is being set. Across the world, we are embedding the notion that the public have a duty to the health service to be healthy, and that a sick person should be judged, firstly and foremostly, on how responsible they are for their own condition. Which poses a question: Should a drunk driver, who crashes their car, be forced to pay for their own medical treatment?

Such a person, after all, has contributed far more to their own condition than an unvaccinated person with Covid 19. The unvaccinated person simply turned down a prophylactic. The drunk driver actively took a decision that risked his or her life, and that of others.

And what about smokers? Again, the unvaccinated person is much less responsible, objectively, for their ill health than a smoker is. A smoker is actively taking something that will make them sick. An unvaccinated person is simply declining to lower their risk profile.

There’s another question, too: Why should the unvaccinated, or any other group who might be targeted like this, pay tax? If a service is no longer universal, and you no longer stand to benefit from it, then what moral obligation remains to pay for it?

This stuff is popular for two reasons: First, human beings, however much we protest to the contrary, are naturally vindictive, and have a natural sense of our own moral superiority. The “I would never end up in that situation” response we all have, on some level, to the afflicted: Perhaps you feel it about drug addicts, or people who die doing stupid things, or criminals. You see this on a widespread basis about the unvaccinated on social media: A kind of smugness and satisfaction that accompanies stories about high profile unvaccinated people ending up in hospital. We do enjoy a good morality tale, and the idea that people suffer the consequences of their own actions.

There’s no reason, however, that Governments, having tapped into that impulse, cannot use it on a more widespread basis.

The second reason that it is popular is the notion – completely unproven – that unvaccinated people are a threat to the vaccinated community. This makes no sense, and has never made any sense, and yet, is one of the most widely held beliefs in Ireland. We know that the vaccine does not prevent transmission. Even if it were shown that the vaccine substantially reduced transmission, that would still not be enough to justify the belief that unvaccinated people were a threat to the vaccinated. It is a belief which has been conjured up, and kept alive, by politicians and the media, for the reasons outlined above.

On that basis, people might argue that the unvaccinated are a special case, because smokers, after all, do not threaten non smokers. But that’s not true either – because the main problem with the unvaccinated, we keep hearing, is that they take up hospital beds, not that they threaten others. The threat to others is always a secondary justification. If it was real, it would be the first thing people mentioned.

No.

What we are doing here, across the west, is willingly handing Government an argument that it will be tempted to use time, and time again: That Government is not to blame for inadequate healthcare, and it is, in fact, some section of irresponsible members of the public, who must be blamed and held to account for their actions.

It is an incredibly dangerous precedent, which appeals to the very worst in human nature, and is designed to turn people against each other. Any responsible leader, writer, or activist, observing this, should be, in the words of William F. Buckley, “standing athwart history, yelling stop”.

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