I’m honestly not sure what the editors of the LA Times are arguing in favor of in their latest editorial. I do know what they’re arguing against: inoculating the rich first. They say they want to prioritize “by need” and here’s their conclusion:
Any healthcare rationing decision is going to be politically fraught, especially when the government is playing a role in the decision-making. The best approach is to ensure that emergency triage, and leaving some people to die in this pandemic, remains a hard-fought but strictly theoretical matter.
If we can’t do that by rapidly increasing our supply and distribution of medical equipment, emergency physicians and specialists, then we do it by holding down the surge. That’s why Americans can tolerate a temporary infringement on personal liberty. That’s why we stay at home instead of going to the movies or to the beach, and why owners of restaurants, bars and other retail businesses have closed their doors: to prevent hospitals from being overwhelmed by critically ill patients, and to not have to take a ventilator away from a patient whose life could be saved.
The economic and social costs are huge. But we pay them in order to reject the process of assigning a different value to different human beings, and to reject the affront to human dignity that such calculations entail.
Before that there’s a lot of hand-wringing about the poor, disenfranchised, and people of color being short-changed.
An old client of mine used to talk about “too many oars in the water” by which he meant trying to accomplish too many conflicting goals at the same time. I think the LA Times has too many oars in the water. Let’s just give one example. A bit fewer than half of all practicing physicians, that’s a half million people, earn enough to put them among the top 1% of income earners, a category referred to as “the rich” by some. Said another way you can’t prioritize health care workers without prioritizing the rich at the same time.
My own view is that the highest priority for using the limited supplies of vaccine should be with those for whom it will do the most good. That means the first priority should be given to frontline health care workers. I also think that, for example, the State of Florida, has erred in prioritizing the elderly. Although they’re more at risk of dying from COVID-19 should they contract it IMO there are just too many of them to prioritize and there are other ways open to reduce the likelihood of contracting the virus than using the limited supplies of vaccine on them. I would inoculate people who work in long-term care facilities (who are disproportionately “people of color” by the way) and shut those facilities as tight as a drum. We don’t even have enough vaccine at this point to inoculate all the health care workers and people who work in long-term care facilities. We can talk about other priorities later. By the way, the elderly have higher wealth than the non-elderly as well. You can’t prioritize the elderly without prioritizing the rich.
I hate to advocate sticks before carrots but it should be made clear to frontline health care workers and people who work in long-term care facilities that they are free to accept or reject inoculation but they’re not free to keep their jobs unless they’re either already contracted COVID-19 and recovered or been inoculated.
Ideas for carrots, anyone?
Meanwhile, complicated rules are just plain foolish. The simpler the better. Setting up elaborate point systems borders on the insane.