Even though we are entering the third year of the COVID-19 pandemic, we are still in the midst of it. Perhaps not many predicted this at the end of 2019?
Although we don’t really know when this will be over, we should perhaps still look ahead to the time after the acute crisis. In one way or another, the world will “normalize” the pandemic.
Normalization means that we will likely change our perceptions of what is normal, i.e., various norms. We can already see that the perception of what is “normal” with remote work has changed.
This, in turn, will probably affect more binding norms, such as legislation regarding taxation, population registration, and more.
One can make the questions as complicated as possible.
Will the view of individual responsibility in relation to the common good change due to this pandemic? Specifically: how will we view the issue of freedom of choice when it comes to taking or not taking vaccines?
How far does individual choice extend, and what are the consequences of the choices we make?
Vaccines concern health and are therefore a highly personal and sensitive issue. At the same time, the pandemic shows that an individual’s decision concretely affects others. In matters of health, not only individual freedom of choice is often emphasized, but also the societal structures that either restrict or facilitate the individual in making healthy decisions.
Beyond the structures, many questions about health are further complicated by several other issues.
These include how clear an understanding the individual and the expert have of what is “healthier” in choosing between alternatives in a given specific case – and what it means for the “common good.” How far should one take into account, for example, heredity and the limitations or possibilities that an individual’s genotype may entail?
One can make the questions as complicated as possible.
Is compulsion the most effective way to go?
One way to seek answers to these questions is to calculate the risks, as is done with insurance. In fact, much of health care concerns insurance. We have both statutory insurance, “social insurance,” which includes, for example, health insurance, and various voluntary products on the market for extended protection, such as “medical expense insurance.”
In matters of both vaccinations and insurance, we see that other countries have systems different from ours. Austria looks set to become the first EU country to make vaccinations mandatory. Will others follow? How should those who do not want to take the vaccine be handled? Is compulsion the most effective way to go, and how does it align with other values in liberal democracies?
How do subjective rights and public services relate to different behaviors and choices?
Here, individual choice has not been given much room to maneuver.
In the insurance sector, we already see that the norm is that different groups pay different premiums, and some may not even be granted insurance. There are various bonus systems, for example, for car insurance, which are tied to the policyholder’s history. For accidents, different sports are classified according to risk.
Then, with travel or home insurance, one can choose the level of deductible they are willing to take. Furthermore, the benefits provided by the insurance vary.
For pensions, a reform has been made where the retirement age gradually increases and for those born in 1965 or later is not predetermined but linked to life expectancy. Here, individual choice has not been given much room to maneuver.
Sick pay, on the other hand, is calculated based on one’s annual income. When looking at different insurance policies, there are many different logics for how to manage risk both for individuals and on an aggregate level, for example, entire age groups.
Is this pandemic a unique exception, or will it affect issues on a more general level?
In the focus of the COVID-19 pandemic are the measures and restrictions decided upon, considering the burden on public healthcare.
Can healthcare be kept functional, and can it manage all patients? It is self-evident that everyone should receive care, regardless of whether they are vaccinated or not. However, it seems clear that those who are not vaccinated are at higher risk of both becoming ill and having a worse course of illness.
If one is not in favor of compulsion, as in Austria, is it then unreasonable to view the choice not to vaccinate as a choice comparable to practicing a sport perceived as having a higher risk of injury?
Should one’s own free choice be given importance? Are there structural factors that influence it, and to what extent? What do we know about “risk groups” and how homogeneous are these groups? Is it reasonable that the risk premium, i.e., a higher price for health insurance, can be imposed because one happens to belong to a certain age group or to a group where there is generally evidence of higher accident proneness? Should they be combined? It seems acceptable that, for example, age and smoking affect what kind of private health insurance one can get and what it costs.
If in the future vaccinations are seen as an issue affecting, for example, health insurance premiums for employees, will it lead to other questions also being considered?
Is this pandemic a unique exception, or will it affect issues on a more general level?
This article by Georg Henrik Wrede was previously published in Swedish on Kommuntorget.
Georg Henrik Wrede 