Tuesday, January 12, 2010

A Free Market Approach To Parental Refusal To Vaccinate

In a recent study reported to physicians by Medscape (the original article appeared in  the January issue of the Archives of Pediatrics & Adolescent Medicine), approximately 5% of the children who were studied did not have varicella vaccination because of parental refusal. The study found that  the children whose parents refused to have their children immunized were at  "high risk" of varicella infection compared to children who were vaccinated.

Today, a parent's refusal to vaccinate with a medically proved effective and safe vaccine has no societal consequences for the parent other than the guilt which he or she may shoulder from severe complications of varicella infection in his or her child. Other parents, and their children who become infected as a consequence of each refuser's decision (such as children with immune disorders or leukemia who cannot be vaccinated) unfairly bear all of the financial and personal liability flowing from the original refuser's decision, a decision in which they did not participate.

A straightforward marketplace approach to the parents' vaccination decision making could be relatively simple. After being provided with relevant information, a parent who denies his or her child the protection of vaccination (or does not present the child for vaccination) becomes liable for all economic and "pain and suffering" consequences of all downstream infections which can be traced back to that child by public health authorities.  Guaranteed freedom of choice, the refuser could insure against such liability, or could post a bond which he or she purchases. 

Adoption of this approach would reduce the cost of health care because it would prevent the refusing parent from shifting the cost of the decision to payers and other parents.  The refusing parent could reduce his or her exposure to liability through insurance, bringing the opportunity for new business to insurers. Attorneys actuaries, public health officials could be engaged in the "fight against preventable disease".  It's a "win-win".

3 comments:

jk said...

That's a great idea. Any chance you can call the White House and have it added to the Health Care Reform? Yeah...didn't think so.

DrTaras said...

Great idea, but you stated "becomes liable for all economic and "pain and suffering" consequences of all downstream infections which can be traced back to that child by public health authorities." I applaud the idea, but the link shown by a public health authority by either the 'beyond a shadow of a doubt' or 'preponderance of evidence' standard would be far from "easy" to prove.

Henry P. Kaplan said...

As the sociologist David Reisman observed, more than 50 years ago, the act of making public policy clear by putting it into law, changes behavior. The standard of proof is less important than the act of society in defining acceptable and non-acceptable conduct.