Conservatives often decry the “nanny state” that showers benefits on citizens and tries to guide them on how to behave. Yet we now have a nationwide effort to incentivize vaccine-resistors—who are largely conservative—to get inoculated against Covid-19 by offering them cash and goodies. The nanny state now includes vaccine bribes to persuade people to do what they should have done—get vaccinated—without any financial incentive.
From a public health perspective, it makes sense for states to run lotteries, provide free admission to zoos and amusement parks, and hand out savings bonds, gift cards and other freebies to people who get vaccinated. While it might not seem like the best use of taxpayer funds, higher vaccination rates save lives and the economic costs associated with losing productive citizens. Every inch closer to herd immunity we get further enables the normal functioning of the economy and the return of 8 million jobs still missing.
Sisters Guadalupe Flores, 15, right, and Estela Flores, 13, left, from East Los Angeles, get vaccinated with the Pfizer's COVID-19 vaccine by licensed vocational nurse Rita Orozco, far left, at the Esteban E. Torres High School in Los Angeles, May 27, 2021. Vaccinated Californians will be eligible for $116.5 million in prize money. Gov. Gavin Newsom announced the massive pot of money on Thursday as part of an effort to encourage more people to get their shots. (AP Photo/Damian Dovarganes) ·ASSOCIATED PRESS
But how did it come to this? Why do governments have to pay citizens to do what’s right for themselves, right for their communities, and right for the country? This is obviously not the same United States that eradicated polio in the 20th century through near-universal vaccination. Slightly more than half of eligible Americans have gotten at least one Covid vaccine dose, and some of the unvaccinated face practical or logistical barriers. But many of the unvaxed are unmotivated or outright hostile to the idea of vaccines. It now seems likely we will never eliminate Covid, in part because of low vaccination rates. Antipathy to public health is now its own public health problem.
A chance for a windfall
There are two types of vaccine bribes. The first is a universal bribe, available to anybody who got a vaccine at any point in time, such as the Ohio “vax-a-million” program. These are the most defensible. They’re obviously meant to give vaccine resistors a reason to get jabbed, but they don’t discriminate between people who lined up early, when there were no incentives other than vaccination itself, and latecomers enticed by the chance for a windfall. All can win, and there are signs the scheme is actually working.
More troubling are targeted bribes that award prizes only to vaccine latecomers, with nothing for those who lined up early. Delaware, for example, is offering cash prizes and other rewards to people vaccinated between May 25 and June 29. New York offered a $5 million lottery prize to anybody vaxed during a five-day period in May, and may roll out other limited programs. Illinois has been giving free amusement park admission to people who come to the park for a shot—but not even a discount for anybody who got a shot earlier.
In this April 14, 2021, file photo, a Northwell Health nurse vaccinates a Local 28 Sheet Metal Worker with the first dose of the COVID-19 Pfizer vaccine at Belmont Park in Elmont, N.Y. (AP Photo/Mary Altaffer, File) ·ASSOCIATED PRESS
As an incentive system, this pastiche of come-ons would be a disaster if you structured it this way from the beginning. If you told Americans there’d be no financial reward for getting a vaccine early, but a chance at winning $1 million if you waited, some would still get the early shots but many would wait, producing exactly the wrong policy outcome. If we had another pandemic sometime soon with a similar vaccine rollout, it’s possible some people, conditioned to wait for the reward, would put off getting vaccinated, slowing the recovery. Maybe Covid is a one-off and this won’t happen. Still, clever-seeming ideas often backfire.
Expecting to get paid
There’s also the embarrassing spectacle of some Americans basically expecting to be paid to take a vaccine that could save their life, while Covid ravages countries such as India and Brazil and many others where vaccines are scarce. A recent UCLA survey found that one-third of respondents who are not yet vaccinated would be more likely to get the shots if paid $100. In that poll, Democrats responded more favorably to the allure of financial incentives than Republicans, but that may only be because Democrats are more willing to get vaxed. A Marist poll from mid-May found that 41% of Republicans refuse to get vaccinated, compared with just 4% of Democrats.
This is modern America, where a gimme-gimme, me-first culture blocks sensible taxation, affordable universal health care, reasonable gun laws to reduce obscene levels of violence, and other civic improvements that are the norm in most developed nations. The reasons are familiar: worsening wealth inequality, plunging trust in government that can’t seem to solve big problems, a plague of disinformation on the Internet, partisan careerism.
President Biden is trying to change some of this, with the most activist agenda since the 1960s, at least, including large social-welfare reforms meant to reduce wealth inequality and the nation’s first organized effort to curtail climate change. There’s entrenched built-in resistance, and we can see now it begins with people who need to be bribed to get vaccinated for their own good. Maybe the solution is to include million-dollar lotteries in every measure that faces any political resistance at all.
