San Antonio Express-News (Sunday)
A SHOT IN THE ARM
The Smart Money S.A.: Money for getting the COVID-19 vaccine? Yes, please.
Mostly when we discuss reasons to get or not get the COVID-19 vaccine, it’s about the frictions between individual health, public health, trust in science and personal freedom. We mostly don’t talk about the money side of the equation.
But — and I bet you can guess where I’m going with this — I think we should also be talking about the money.
Focusing on the money side became easier Aug. 23 with full FDA approval of the PfizerBioNTech vaccine for COVID and the anticipated FDA approval of the Moderna vaccine within the month. Since December, COVID vaccines have been given under “emergency use authorization.” With full approval, employers feel more comfortable requiring their employees to get vaccinated, using a combination of financial carrots and sticks.
In San Antonio, the first major non-health care employer mandating employee vaccinations I heard about was my kids’ school district. San Antonio ISD is requiring its employees to be vaccinated by Oct. 15. The school district had been waiting on the FDA to settle the science, which happened Aug. 23.
Gov. Greg Abbott and Texas Attorney General Ken Paxton shot back, announcing a ban on employer vaccine mandates and a lawsuit against SAISD and Superintendent Pedro Martinez.
In response, Martinez issued a statement: “We have not wavered since we implemented our mask and vaccine mandates. In fact, we are more committed than ever. Our focus remains on protecting the health of those in our care and the stability of student learning. We are staying the course.”
SAISD did not mention either financial carrots or sticks to go with its mandate. But when your employer creates a mandate, the money side is implied. Money is always part of the deal of being employed.
On the national scene, following the FDA’s full approval, Delta Airlines announced that all employees insured by the company must get a COVID vaccine by Nov. 1 or pay a $200 health care surcharge per month. In announcing the surcharge, Delta CEO Ed Bastian quoted an expected cost of $50,000 for the company per hospitalized employee.
This financial penalty, linked directly to expected costs to the company, makes sense to me. You can have your freedom to remain unvaccinated, but you’re putting the finances of the company at risk, so pay your share
The “cost of Regeneron treatment vs. cost of vaccine” problem is just the latest in a long American tradition of paying a lot for medical interventions instead of paying less upfront for preventive care.
of expected health care costs.
Perhaps the best employer mandate so far has been the one proposed by Houston ISD. As we learned from Mary Poppins long ago, a spoonful of sugar helps the medicine go down. The school board approved a $500 bonus payment per employee for getting the vaccine. As the largest school district in Texas, its leadership surely will result in similar proposals.
HISD is awaiting approval by the Texas Education Agency, which did not respond to my query whether it would OK the proposal.
Other school districts since have announced their own monetary incentives.
Back in San Antonio, Southside ISD plans to offer $200 to each vaccinated employee. Somerset ISD plans a similar incentive for employees.
Financial officers at two other regional school districts, speaking on condition of anonymity, said they did not believe their districts were planning any financial action — neither carrots nor sticks — to encourage employees to get vaccinated.
For my part, I’d raise the bonus to $1,000 and see what price people put on their freedom to get sick. But that’s just me.
Finally, when it comes to money and vaccines, I can’t resist mentioning Regeneron treatments. Abbott, who received this treatment after testing positive for the virus, touts that the state is offering free infusions of monoclonal antibodies in a nonhospital setting, also under an FDA emergency use authorization.
I am not the first person to talk about the maddening structure of health care in the U.S., in which we eschew cheap and basic preventive care in favor of expensive procedures and hightech interventions. We favor surgery over physical therapy. We financially reward dialysis treatment over access to nutritionists and safe spaces to exercise.
The “cost of Regeneron treatment vs. cost of vaccine” problem is just the latest in a long American tradition of paying a lot of money for medical interventions instead of paying less upfront for preventive care.
“Free” Regeneron for Texans does not take into account the cost of the in-clinic intravenous treatment and the technicians needed for this procedure, or the risks associated with this type of intervention.
I’m glad we have this treatment to prevent hospitalization of people testing positive for the virus. But it is a weird thing for the governor of Texas to highlight after fighting mask mandates (essentially free!) and vaccine mandates (very cheap!). It’s a very high-tech, high-impact, high-cost approach to COVID — not to mention the higher burden of side effects — when we have better preventive measures.
Anyway, now that we have fully FDA-approved vaccines, I hope we can get more rational about the money side of COVID prevention and treatment as well.