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[flagged] Unvaccinated Covid patients cost the U.S. health system billions of dollars (kff.org)
23 points by toomuchtodo 7 days ago | hide | past | favorite | 65 comments





What are we going to do now, ban smokers from the health system because they take up more cancer beds? Ban obese people because they didn't stop eating? Ban people who don't exercise because it's easy to do, and provably lowers chance of disease? Don't respond to car accidents due to speeding since it was preventable?

As soon as you start excluding people from the health system because of lifestyle choices, you are deciding who should live and die.


Actually, smokers and obese actually save Governments money on healthcare and pension costs, because they die earlier:

https://taxfoundation.org/new-study-shows-smokers-and-obese-...

"According to the research, a person of normal weight costs on average £210,000 over their lifetime, a smoker just £165,000 and an obese person £187,000."


"Because they tend to live longer" so ok let's not vaccinate because the unvaccinated will die off faster and cost the healthcare way less

If there was a safe and effective vaccine against lung cancer and obesity do you think your argument would be as strong?

There is a safe and effective vaccine against cervical cancer. Hospitals still care for unvaccinated cervical cancer patients.

https://www.cancer.gov/news-events/cancer-currents-blog/2020...


The HPV vaccine is given to boys and girls for free in Australia, and they’re on their way to eradicating cervical and other cancers associated with HPV. Vaccines are compulsory to receive child care and family tax benefits.

https://www.thelancet.com/journals/lanpub/article/PIIS2468-2...


you mean the vaccine that isn't universally available for free to all americans?

why would you bother making such a silly comparison?


The HPV vaccine is available for free to all Americans with medical insurance regulated under the Affordable Care Act (Obamacare). That's the vast majority.

https://www.healthcare.gov/preventive-care-adults/

We do still unfortunately have about 8% uninsured but local health departments occasionally offer free vaccination clinics for them.


Y'know, Obamacare mandated coverage of alcoholism and drug addiction in all plans: That is, no one can opt out of paying for other people's problems even when they are caused by a completely optional activity.

I am all for a reforming health care markets and getting third party payers out of the system. Until then ...


That is quite wise and a necessary and basic consideration for a society to get to public healthcare. It will always cost you if you introduce it, but you eliminate severe financial risks in case it hits you. If that is your own doing or not is of secondary importance.

> "you" is doing a lot of work in that sentence.

The vaccine against obesity is a healthy diet. It's cheap, it's easy, it's all about choice.

Ahh yes…truly spoken like someone who has never dealt with obesity and weight issues.

For what it’s worth folks, it’s not cheap, it’s not easy, but it is about choice and it will be a battle of will every day of someone’s life. Pretty sure I can speak from experience here— I have spent the last four years taking off 170lbs through diet and exercise.


You don't know what I am. Any fat person who has lost weight will tell you it was simple once they overcome putting the fork down and got used to hunger pains until their stomach gets small enough.

But sure, let's just inject ourselves with experimental drugs instead of working out because it's easier. (it's not, you will die anyway)

Food is cheap, that's the problem, even healthy food is cheap, not the whole food shit, but the boring stuff.

Cook your own food, eat only once or twice until your stomach is small, you get used to it.

Getting a shot is not going to help any fat fuck fight covid.


I am a fat person who has lost weight. Lots and lots of weight—170lbs over 4 years. 460+ to currently 290. So let’s just say I know for a fact that the phrase: “any fat person will tell you it was simple” is complete BS. This fat person would never ever say that. So your comment is false just by my example. I know quite a few people with similar stories to my own. I know for a fact they wouldn’t make that comment either, simply because when folks who have lost large amounts talk about their weight loss journey, we talk specifically about how difficult it is.

But you are right, I don’t know what you are, but I can deduce a few things from your comments with enough certainty that given the opportunity to bet on it, I would. I am certain that you were never obese and never lost a significant amount of weight because you have zero perspective on how easy or hard it is just from the statement you made. Also, the term “fat fuck” you used also gives you away. You see, every fat person I know who has lost significant weight doesn’t make comments like that, because it’s pretty damned offensive. Like nearly n-word offensive to overweight people. See, we tend to be hyper sympathetic to people struggling to lose weight…because we know how truly hard it is—-both being obese and losing weight too.

Additionally, I suspect that you are probably pretty young (also because of the “fat fuck” comment). I suspect likely a teenager and certainly young enough that someone else buys and prepares the food you eat, probably a parent. No one who buys food 2021 would characterize healthy food as “cheap”. It ain’t.

Thank you for your opinion and advice, and I hope should you ever gain weight and need to lose it, I hope it works for you as easily as you claim it to me.


It’s much easier to spend an hour getting a vaccine than it is to live a healthy life.

if you want to live to 30, sure.

I assume insurers could choose to not cover the treatment costs for a condition if you decided not to get vaccinated. Exposing someone to the full cost of an avoidable expense is a solid method of disincentivizing reckless behavior during a pandemic (smoking and obesity are not comparable).

If you can prove vaccination status, of course, costs should still be covered for hospitalization, as you made the very little effort to derisk.


Your assumption is wrong. Any medical insurance plan regulated under the Affordable Care Act (Obamacare) is not legally allowed to deny coverage or raise premiums based on vaccination status.

According to the CDC, obesity is a significant risk factor for COVID-19.

https://www.healthcare.gov/how-plans-set-your-premiums/

https://www.cdc.gov/mmwr/volumes/70/wr/mm7010e4.htm


It does, however, apparently allow for employers to charge employees more for insurance under a “wellness” scheme. This is how Delta is charging unvaccinated employees $200/month.

Edit- I am also familiar with wellness incentives/charges around smoking, obesity, and exercise.


Following up, it appears that insurers can use vaccination status in pricing healthcare costs shouldered by the insured. Several insurers have already begun to do this (Aetna and UnitedHealthcare). Coverage isn’t denied, nor are premiums raised, but it’s done through no longer waiving copayments from COVID treatment costs.

https://khn.org/news/article/analysis-dont-want-a-vaccine-be...

https://khn.org/news/article/time-to-say-goodbye-to-some-ins...


Wow, that’s disappointing, but not surprising for American healthcare (don’t cover everyone, but no personal responsibility expectations from those who are covered). We’ll just have to let the fire burn through the forest I suppose and eat the costs from these people until travel and employment vaccination mandates kick in.

Obesity costs the US healthcare system 147 billion per year. We need Health Passports right now if cost is an issue. 5.7 over 3 months is nothing compared to the cost of obesity.

If smoking were contagious with an R-factor of 3-6, overflowing hospitals and ICUs, and could be cured by two shots a year, it might not be a bad idea.

A better example, actually, is someone refusing free treatment for lung cancer at stage 1, because they believe that cancer isn't real and Big Onco is trying to kill them, and then barging into the hospital, and demanding treatment when they hit stage 3. I'd have very little sympathy for that person.


Very few unhealthy people will ever cost as much as a Methusalem getting pensions and health care. So should we introduce forced euthanasia?

Who says we won’t care for these people? This says their choice not to get vaccinated is costing billions.

Re: Cigarettes and seatbelts are bad analogies. Society (via the government) has made moves to reduce smoking and encourage seat belt wearing. Looks like the same is now happening for vaccinations with Biden’s new mandates.

Finally, the US healthcare system already decides who should live or die… either intentionally or structurally.


We tax cigarettes. My understanding is the tax is restricted in the budget to only go towards paying for healthcare for smokers. So the smokers can stay, at least.

So that's a job best left to private insurance companies excluding coverage?

Triage exists for a reason, and it seems reasonable to apply that here. If you want to accept the risks of your “lifestyle choice”, you should be the one who faces the consequences by being lower in priority for healthcare. If I exercise and eat right, when I need an ICU bed I should be given priority over someone who accepted the risk of eating fast food three times a day, surely?

Regardless of the moral issue, due to EMTALA hospitals are legally required to care for unstable patients regardless of whether they made unhealthy choices. Changing that would require an Act of Congress.

You can dump covid patients with low odds of a positive outcome off support equipment (vents and ECMOs) when healthier patients come in for treatment and equipment supply is constrained. This is already occurring (crisis standard of care).

Get vaccinated.


This could be a way that systemic pro-vax bias reinforces the statistical outcomes.

Especially in Israel, where their coronavirus spread reaches new heights [1], despite 78% of their population being innoculated! [2]

1. https://www.timesofisrael.com/health-ministry-chief-says-cor...

2. https://www.haaretz.com/israel-news/israel-vaccine-data-how-...

They have to do something because the vaccine just isn't stemming the tide!


They are also giving boosters out. Someone please explain why Israel is struggling with COVID-19?

Because the vaccine helps a lot; but doesn’t solve Covid.

Even at 100% vaccination rate there would still be issues, less issues, but far from Zero.


I'm guessing that's eligible population as the numbers mentioned in the article line up more with around 66% of the total population, which isn't enough to stem the tide.

Triage isn't about making a moral decision. It's a decision of balancing patient medical needs vs resource availability.

Just what the world (and especially, I hesitate to say as an outsider, the USA?) needs - more divisiveness!

While we're at it: obesity, lung cancer, liver issues, diabetes, skin issues, addiction issues, some mental health issues, broken bones! - all to varying extents often/can be caused by certain choices.

Ban them all, only what, acts of God and (resp. including) genetics treated here?

(Just to perhaps head off some of the hate: I've nothing to do with the US health system, and am 'fully' vaccinated.)


the world doesn't get less divisive because you ignore the burden that people have on resource limited public health systems. Hear no evil, see no evil, speak no evil?

You're exactly right that not being vaccinated is not unique in this regard. Which is an argument for more intervention. People should obviously be treated even if their illness is a consequence of choice, but this also implies we can have a say in what people do. Population health is always a collective matter, as this pandemic shows. We all share the same ecosystem.

Singapore spends 6% of its GDP on healthcare compared to 20% in the US. In Singapore the live expectancy is 83 years, the highest in the world. Some American states rank below mainland China, the nation ranks below Cuba.


Well I think it does, because saying 'people making decision X costs us Y' creates a division.

Not to say that education, rehabilitation, etc. as appropriate doesn't have its place alongside treatment. And I'm by no means holding up US healthcare (or expenditure on it) as a model system.

(I'm commenting from the UK - in broadest possible terms, our political left thinks our NHS is great and the model system - just needs more spent on it; the right thinks the NHS is great and Singapore has the model system.)


“Nothing kills more Americans than heart disease and stroke. More than 868,000 Americans die of heart disease or stroke every year—that’s one-third of all deaths. These diseases take an economic toll, as well, costing our health care system $214 billion per year and causing $138 billion in lost productivity on the job”

If we legislated based on cost to healthcare we would have already gone after heart disease. Heart disease is mostly avoidable and it’s caused by choices we make over our lives.

https://www.cdc.gov/chronicdisease/about/costs/index.htm


It is a choice made by our environment first. That is, it's practically impossible to walk to your grocery store in most circumstances. Ditto for food environment and possible chemical factors that influences our weight.

Remember that the obesity epidemic started in the 80s. Before then, it's not like we don't lack access to all the food that we ever want to eat.

And then finally our choices. We could exercise choices to fix our problem, individually or collectively, but it's a difficult uphill struggle.

However, vaccination is different. It is not a struggle to walk into your pharamacy and get a flu or covid-19 vaccine. The only problem was the information environment that people are immersed in that dissuade people to take an otherwise very easy action to do.


https://www.theatlantic.com/health/archive/2021/09/covid-hos...

> ... roughly half of all the hospitalized patients showing up on COVID-data dashboards in 2021 may have been admitted for another reason entirely, or had only a mild presentation of disease ... this study suggests that COVID hospitalization tallies can’t be taken as a simple measure of the prevalence of severe or even moderate disease, because they might inflate the true numbers by a factor of two ... referring to decisions about school closures, business restrictions, mask requirements, and so on, “we should refine the definition of hospitalization. Those patients who are there with rather than from COVID don’t belong in the metric.”


Obesity costs $147 billion per year according to the CDC.

People should need health passports to eat fast food or buy unhealthy foods. /s


If there was a safe, low cost shot to prevent obesity I’d get it in a second.

There is actually a very safe and free method to prevent obesity. It's called eating a healthy diet. Count calories and watch the pounds fall off. If you really want to speed up the process you can throw in some exercise.

Hunter and gatherer tribes don't count calories, yet they're not fat. Obesity took off in the 80s, yet availability of fast food wasn't suddenly forced upon us. Exercise is healthy, but your metabolism adapt to the amount of exercise you do by adjusting its basal metabolism. It's not that great of a tool for weight loss, but you should do it for health.

Anyway, I am speaking of this as a person who lost 32 lbs over the past four months without having to count a calories and who attempted to overcome basal metabolism adaptation by sheer high level of physical activities.


They asked for a shot, something that takes minutes, maybe an hour or two total of minimal effort. You’re prescribing something that takes a fair bit of effort over years. Just go get the vaccine.

How is something you need to actively do every day and has a significant impact on your QoL even comparable to a two time shot. Honestly it's very hard to take post like this seriously.

Yes eating a healthy diet and getting to a normal weight can have a huge positive impact on your QoL. We can do that along with vaccination; they aren't exclusive. And both will significantly reduce your COVID-19 risk.

https://www.cdc.gov/mmwr/volumes/70/wr/mm7010e4.htm


What is hard for me to take seriously is that everyone just wants a pill or a shot to solve their problems. If you are obese, COVID is one of many things that could/will kill you. Every human has to eat but they have a choice to eat healthy or unhealthy foods. Just eat healthy and your obesity will go away.

It's not nearly that simple. See the Nova episode "The Truth About Fat" for a good summary of the current science. It may be available for free online here [1], although Nova episodes go in and out of free availability (unless you are a donor to a PBS station then I believe you can get them all).

[1] https://www.wgbh.org/program/nova/the-truth-about-fat


There are whole societies that remains relatively lean. Pretty sure it's not a choice. It may be their food diet, or their chemical environment, or something else.

Note that the Hadza people, one of the most active people in the world, burn about the same amount of calories as sedentary population in Europe and the US.


So many false equivalencies being made in the comments here.

Unvaccinated people are simultaneously people with a right to care despite their bad choices, and people whose bad choices are harming them and those around them. No dissonance or hypocrisy required to believe both are true.

The hard part, acknowledging that, is reducing that harm.

And yes - I believe choosing not to be vaccinated against COVID is a bad or even immoral choice, depending on the reasons. I understand why someone would, but I don't support it, and I don't have to in order to think people who make that choice are still worth something as people.


The hard part is agreeing on who presents the greatest risk to the vulnerable, and whether that risk warrants unprecedented coercion.

The coercion is not unprecedented, and the greatest risk is fairly obvious. I don't agree.

Wasn't the cost of the vaccines even more billions?

This is what baffled me about the article. The amount of money spent on vaccine development and production likely dwarves the cost of the unvaccinated. They have accidentally argued against vaccines if all we care about is cost.

Is that reported-to-insurance billions of dollars or actual billions of dollars?

“The analysis estimates that the preventable costs of treating unvaccinated patients in the hospitals total $3.7 billion in August, almost twice the estimates for June and July combined. The total preventable costs for those three months now stand at an estimated $5.7 billion.”

https://www.healthsystemtracker.org/brief/unvaccinated-covid...


> $5.7 billion

Or, 0.0007 Afghanistan Wars.*

* For those who do the math, I'm including the interest.


That is laughably cheap in the grand scheme of things

cool now do obesity

just stop being fat

The sad part of this narrative, including cursory information both from this article and what mainstream outlets report, is the notion that only a certain racial subset of the country is "unvaccinated". I'm vaccinated and I find it troubling that so many, especially those in my minority demographic, still cite invalid information as a reason to not become vaccinated.

Even as a member of a minority group, the notion that we'd deny healthcare to any group of people especially when there's a connotation of race (yes, even if the narrative is meant to be against uneducated poor white people) is fundamentally wrong.

The feigned empathy for the unvaccinated is down right appalling in this country. One day, we're cheering that white trump supporters are dying en-masse from covid. And now, the calls to continue draconian measures until an overwhelming percentage of people are vaccinated is basically criminal.

This is obviously going to be downvoted, but it's time to really think about what choices we make now could lead to in a not so distant future. If Australia is what 5 years into the future holds, I'm not too interested in remaining in this country.




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