America’s broken healthcare system and the COVID vaccine
By 
Sarah Kliff reports that some people are refusing to take the vaccine because they don’t believe it will really be free:
When Paul Moser considers getting a coronavirus vaccine, he also thinks about his outstanding medical debt: $1,200 from a few urology visits that he has been unable to pay off.
Mr. Moser, a 52-year-old gas station cashier in New YorkState, has friends who were surprised by bills for coronavirus tests, and worries the same could happen with the vaccine. For now, he’s holding off on getting his shot.
“We were told by the legislators that all the testing was supposed to be free, and then surprise, it’s $150,” he said. “I agree it’s important to get vaccinated, but I don’t have a sense of urgency around it.”
Congress passed laws barring pharmacies and hospitals from billing patients for coronavirus vaccines. Signs at vaccination sites advertise that the shot is free. From the beginning, health officials and government leaders have told the public it won’t cost anything. And there have been few reports of people experiencing charges.
Even so, some unvaccinated adults cite concerns about a surprise bill as a reason for not getting the shot. Many of them are accustomed to a health system in which the bills are frequent, large and often unexpected.
A recent Kaiser Family Foundation poll found that about a third of unvaccinated adults were unsure whether insurance covered the new vaccine and were concerned they might need to pay for the shot. The concern was especially pronounced among Hispanic and Black survey respondents.
Apologists for the worst healthcare system among major liberal democracies like to say that patients having “skin in game” [i.e. being left on the hook for major expenses] will discourage people from seeking healthcare. They’re not wrong about that. Where they’re obviously wrong is in thinking that this is a good thing. There are much better ways of controlling costs (which the American system is also notoriously bad at!) without producing all kinds of onerous and often unexpected charges that cause people not to seek treatments they need.