People have been criticizing me what they think is my position in favor of mandatory vaccination (whether for Winnie the Flu or other things). That, however, is not my position. Never has been. I can see that folk calling for such have some valid points to make while still disagreeing with the conclusion.
Let me explain in more detail.
People should vaccinate, not just to protect themselves but to protect everyone around them. I’ve gone over that multiple times. This does not, by itself, imply a government mandate but is just damn good advice. Indeed, anyone who can should be vaccinated against pretty much everything for which they are at all likely to come in contact.
Just because something’s a good idea, does not mean that government should force people to comply. Like the joke: “Socialism, an idea so good it has to be forced on people at gunpoint.”
One of the keys there about vaccinating is “who can”. Some people can’t take certain vaccines because they have serious reactions to some component of it. (This is not as common as the Jenny McCarthy’s of the world would have you think and Wakefield lied about the autism thing, but it is, nevertheless a real thing for some people. I do, however, know somebody in that situation, who suffers life-threatening reactions to the Pertussis vaccine.) The only way those people can be protected is to avoid exposure to the disease.
This is where “others around you” comes into play. When someone gets sick, they tend to “share the joy” with folk around them. In some cases that can be someone who can’t vaccinate against that particular illness (my friend when it comes to Pertussis). It can also include children who haven’t yet had their full course of vaccinations, folk who are immunocompromised and get sick easily even if vaccinated (again, personal knowledge of a person in this situation), or folk who are just unlucky and are the ones for whom the vaccine just happened to fail in there case. Nobody but anti-vaxers of the “if your vaccinated, then why should you care if…” type claim that vaccines are 100% effective. Sometimes, for some people, it just doesn’t work. (And for this one I’m the person: measles vaccine failed on me and I ended up getting measles. Not the worst week in my life but right up there.)
Being sick is a cost. Even if you never miss a day of work, or a lose a dollar of pay, it’s still a cost. The key is, if you would pay to get make it go away (something called a “bad” on the first day of my Intro to Microeconomics class back in college–whereas a “good” is something you will pay to acquire) then it’s a cost. I don’t know about you, but I would pay to make the miserable symptoms of being sick go away.
Now, in economics there are internal and external costs. An “internal cost” is one a person directly involved in a transaction incur. If you don’t vaccinate and get sick, the “cost” of being sick is an internal cost, one you imposed on yourself by your choice. The person involved in the “transaction” of not vaccinating incurs that cost. Well, they made their choice and they can live (or not) with it. So far, so good.
Now, external costs. (This is a bit more advanced topic. I don’t think I it was covered in Intro to Microeconomics back in college and it took until I encountered Sowell and Friedman that I really started to “get” it.)
External costs are costs imposed on third parties, not party to the transaction. If you have a barbecue and throw your trash in your neighbor’s yard, he has the cost of cleaning it up as well as the reduced enjoyment he has of his own property until it is cleaned up. That’s a cost you would have imposed on your neighbor who is not a party to the “transaction” of your barbecue. (Now, if you invite him over to the barbecue and throwing trash into his yard is part of the deal, that’s now an internal cost and all is well, at least to that extent; we won’t go into other neighbors whose enjoyment of their own property is reduced because you’ve created an unsightly mess over there.
External costs are often subject to legal remedies. Throw your trash over in a neighbor’s yard and refuse to both clean it up and cease doing it and he can sue you. Break someone’s window while playing softball. And so on.
Now, in these cases it’s generally fairly easy to determine who imposed the “external cost” on whom. There might be some arguing on the magnitude of the cost. (You and your neighbor will likely disagree about the value of the lost enjoyment of his property from your trash.) But in general it’s fairly straightforward.
Now consider someone who’s ill infecting others. If you have a single “Typhoid Mary” infecting a lot of people, that’s one thing. In such cases the person can be identified and censured, perhaps held liable for what they’ve done to others. But what about a lot of people who could be of much reduced likelihood to infect others but choose action or inaction that gives them a higher chance of doing so. In most cases particularly when talking about something like vaccinated or not, each individual has a relatively small “expectation value” of cost imposed. (“Expectation value” is the magnitude of something that can happen multiplied by the probability of its happening. If you got a dime every time a fair flipped coin came up “heads”, the expectation value on a flip would be five cents.) However, when you start talking about larger populations, those small “expectation values” add up, particularly since the combination is not linear.
People who don’t vaccinate, as a group, impose a cost on other people, people who do choose to vaccinate. That’s an external cost, one that those making the decision don’t have to pay and yet which is imposed on people who had no part in the decision.
The point of all that is that the argument about those external costs, imposed on folk who had no say in the decisions that led to them is a valid one. In theory at least, it makes a case for some kind of government action (not a comprehensive list):
- One could hold those who impose the external costs liable for the costs imposed on others and require them to make restitution.
- One would be a kind of insurance/risk sharing. Folk who choose not to vaccinate would pay a small fee for each vaccine of a “standard list” foregone. If they have legitimate medical reasons to avoid that vaccine (documentable allergies to specific components for instance), the fee could perhaps be waived for that specific allergy. This fee would be aggregated and used to compensate those who do choose to vaccinate, or who cannot (including those with those documentable allergies), or are too young to have the full course should they fall ill to an illness against which they are not yet vaccinated.
- One could be simply to mandate vaccination to a standard list (exempting those with specific issues with specific vaccines as above) .
HOWEVER, Each of those has severe problems:
- How do you determine which unvaccinated person infected (imposed external costs on) which other person fell ill despite doing their best to vaccinate? I ran into a “screw you; I can do what” I want type of “Libertarian” when asked if he’d be willing to take responsibility for other people catching the disease he could have been vaccinated against responded “sure, if you can prove that I did it.” That, right there, sums up the problem. How do you “prove” to even a “preponderance of evidence” let alone “beyond a reasonable doubt” that this particular individual was the specific one who infected that particular individual?
- This is not too dissimilar to what Friedman recommended for dealing with polluting industries. Charge an “effluent fee” to cover the “external costs” that their pollutants impose on others. However, the problem I see is that the government does a very bad job of making fees it charges match the actual “cost” of what it’s being charged for. Fees rapidly shift to “money grab” with the value set to “all the traffic will bear” (until it becomes politically unprofitable to raise them higher).
- Government mandates, in addition to the simple moral problem of “how many people are you willing to kill to make this happen” (which all laws come down to in the end), tend to lead to cookie cutter “one size fits all” solutions. Well, people are not the same and one size does not fit all.
Every one of those is s deal breaker as far as I’m concerned. Every. Single. One.
Those can all be summed up in Sowell’s oft used expression: “Just because government can do better than the market in some areas doesn’t mean that it will.” And while I don’t recall Friedman expressing it that way, his book “Free to Choose” is filled with examples of the principle even if not explicitly stated that way.
So, there are valid arguments to be made in favor of something like mandating vaccines, but the problems attendant on them so outweigh them that I still fall on the “no mandatory vaccines” side.
That does not mean that I can’t recognize, and acknowledge the validity of those “pro-mandate” points. Indeed, I must if I’m going to be intellectually honest. So the argument is “well, you do have a point there, yes, but I think these other factors loom larger and take precedence over it.”
Or, as I am wont to say “There is no problem so bad that government can’t make it worse.”