One narrative currently being circulated in support of vaccine mandates is that unvaccinated people will cause an undue strain on the healthcare system because they are more likely to contract covid-19 and take up hospital beds that could be used for other people. Presumably, by “other people” they mean those who took the vaccine like they were told to do.
This sentiment seems to be behind statements like the one in a recent Washington Post opinion article that “[t]he unvaccinated are killing people in ways they probably never imagined.” It also seems to be behind the decision of about seventy-five doctors in Florida to stage a “symbolic walkout” to “protest a surge in unvaccinated COVID-19 patients.” A glance through any social media platform will likely turn up more of this narrative that unvaccinated people will cripple the US healthcare system.
This narrative is ultimately being used by supporters of vaccine mandates to paint anyone who declines to fall in line with their wishes regarding vaccination as not only dangerous, but immoral.
The Implied Assumption That Healthcare Is a Communal Resource
Those who oppose mandates appear to have a strong argument that, if the vaccines work, the vaccinated should have no need to force others to be vaccinated as well. The burdens of being unvaccinated will fall on the shoulders of the unvaccinated, so no justification exists to require them to do differently.
In response, many of those seeking to impose vaccine mandates have taken up the argument that the unvaccinated will still harm society simply by putting undue strain on the healthcare system when they inevitably fall ill in droves. This group claims that failure to be vaccinated represents a needless exhaustion of scarce healthcare resources and is therefore an unethical choice.
Even if true, and there are reasons to be skeptical of it, this is merely a utilitarian argument, but somehow it has managed to transform into a moral one in many people’s eyes. How has this happened?
We typically do not view someone purchasing a service as injuring others just because he leaves a little less of it behind for everyone else, as all human activity would be unethical by that standard. Most people would only view this as unethical if it involved consuming resources belonging to someone else. For this reason, in order to cast the act of being unvaccinated as unethical, healthcare resources must be viewed as a communal good, i.e., as resources that belong to society collectively rather than to the individuals who produce or buy them. Individuals who get sick do not merely purchase medicine, they use up medicine that belongs to everyone else.
That our political elites already hold something like this collective attitude toward healthcare is no secret, the US president recently scolding that “our patience is wearing thin” with the unvaccinated and their personal medical choices.
Communal Attitudes to Healthcare Foster False Moral Claims about Its Use
If the average person can be habituated to adopt this communal attitude toward healthcare resources, it can then be wielded as a moral bludgeon against anyone dissenting from the mandates of the community’s leaders. This supposed collective ownership of healthcare resources implies the right of society to control how individuals use those resources. Those found wasting the community’s resources are to be disdained as its enemies.
The intensity of emotion around the subject of healthcare during a pandemic can only push this tendency further. Panicked members of society can be more easily convinced that others are morally obligated to preserve those communal healthcare resources at the expense of all other considerations.
Thus members of society come to vilify an individual’s simple act of considering alternatives and weighing the costs and benefits to himself. It is not acceptable that a person use his own judgment to determine what course of action will be in his own interest; he is required to concede to the collective judgment and adopt whatever medical interventions society deems best—not what society deems best for his personal health, but what it deems best for society as a collective whole.
The primary problem with this characterization is that it just isn’t true that healthcare is a “communal resource” in this sense. Healthcare resources are simply those medical materials and services individuals are willing to provide to purchasers who are willing to pay for them (artificial state programs like Medicare notwithstanding).
Thousands of individuals make healthcare decisions and purchase medical services for themselves like this every day. But the average person does not see each individual doing these things for himself. He sees only the net effect of those thousands of actions going on day after day, resulting in the “healthcare system” as we know it. It is something akin to a mass delusion that this collection of interconnected individual actions is conflated in the minds of many as a collective entity.
Ludwig von Mises dealt with the idea of collective social systems adroitly in Socialism: An Economic and Sociological Analysis. Mises addressed the long history of intellectual thought in which it was assumed some external purpose imbued society with something like a personhood of its own. But early thinkers were naïve to the fact that the existence of interconnected societies is only made possible once individuals begin to engage in a division of labor. It is this action by individuals, explainable entirely by their desires to serve their own individual ends, that is responsible for the advancement of societies. Mises says that “the primitive thinker always sees things as having been organized from outside, never as having grown themselves, organically” (p. 296).
Instead, Mises teaches that society is the result of many individuals acting independently and voluntarily for their own interests. Cooperation is therefore required, not by force, but because this cooperation is the means by which one man may cause another to do something voluntarily that benefits him. “Society exists only where willing becomes a co-willing and action co-action. To strive jointly towards aims which alone individuals could not reach at all, or not with equal effectiveness—that is society.” (p. 297)
The collective view stands opposed to this understanding of society:
The collectivist movement of the present day derives its strength not from an inner want on the part of modern scientific thought but from the political will of an epoch which yearns after Romanticism and Mysticism. Spiritual movements are revolts of thought against inertia, of the few against the many; of those who because they are strong in spirit are strongest alone against those who can express themselves only in the mass and the mob, and who are significant only because they are numerous. Collectivism is the opposite of all this, the weapon of those who wish to kill mind and thought. (p. 64)
Almost one hundred years after this writing, the collectivist elements in our societies seem even more eager to crush mind and thought than before. Today, the threat of moral condemnation for anyone daring to question their directives on vaccination is just one more instrument they have adapted for this purpose.
