A premium on vaccination avoidance?

Paul Raven @ 25-01-2011

A provocative and interesting piece has been doing the rounds wherein a doctor suggests that those parents who decline to have their kids vaccinated against infectious illnesses should be obliged to pay higher insurance premiums as a result [via BoingBoing and many others].

Refusing to vaccinate a child is dangerous not just for that child but for entire communities. It’s precisely this point a colleague of mine was considering when he had the idea that parents who refuse to vaccinate their kids should pay substantially higher health insurance premiums.

It makes sense. Insurance, after all, is just a pool of money into which we all pay. In determining how much we or our employers pay, risk is taken into account.

The perfect analogy is smoking. If you smoke — and want to turn your lungs black and spend a greater portion of that pot of money on your possible chronic lung disease or any cancers you’ll get — then you may have to pay more.

Why shouldn’t we impose the same logic on parents who refuse to vaccinate their children?

It’s definitely logical, and there’s an appeal to market forces in there that I suspect has better odds of turning the tide of anti-vaccination paranoia than attempting to pateinetly explain the science to people who cannot (or simply will not) understand it.

The problem, of course, is what happens when the anti-vaccination faction refuses to pay insurance at all; I’m not sure how the law on these matters works in the US, but I’m pretty sure the consitutional obsession with freedom means that folk can’t be forced to contribute against their will. I’m also guessing that this a fracture that will occur along class and political lines… and those lines are looking pretty fractured already, at least from the outside looking in. So as logical as this idea looks on the surface, it’s probably indicative of greater social schism to come, rather than being a workable solution to a current problem.

But the overarching question here is “can we permit and manage science denialism in large societies using market forces?” Or, to put it another way, “believe what you want, but if you want to live here, there is a premium on dissent against scientific orthodoxy”. Phrased like that, you can see why some people describe science as a form of hegemonic belief system… though those that do tend to be devoted to hegemonic belief systems of their own – ones with much less basis in, y’know, reality, evidence, that kind of stuff. And I can’t see them cheerfully ponying up their antivax premiums any time soon, can you? Geographical separation looks increasingly like the only way this is going to shake down.