Why I don't support making anti-vaxxers pay for COVID healthcare

Years ago, I used to smoke.  Holiday 20s, in fact.  I guess they seemed like the perfect accompaniment to a Greggs instant coffee.

You could say I am blessed with better lungs than judgement.  I'd never had a respiratory problem before then, and I haven't had one since.  But on that day, in my early (non-holiday) 20s, I wasn't so lucky.  I ended up in Dunedin hospital, and some kind of bronchial infection was detected.

Looking back, I think the culprit was more likely the mould in my awful student flat.  But I still got 'the talk' from a hospital staffer - and the talk was harsh.  She dressed me down, told me I had the lungs of an old person, left me in no doubt that my foolishness was to blame.  Later, I remember leaving the hospital, sniffing back tears. 

I chucked half a pack of cigarettes, symbolically, into the bin in the carpark.  

I kind of wish I could go back in time and fish that half a pack out of the bin.  Smokes are so expensive now, it would be about equivalent in value to my retirement savings.  

And I wish I could tell you that I learned my lesson.  I did eventually - but only weeks after the hospital incident, I was back on the Holiday 20s.  Shame is intense in the moment, but it does little to create constructive long-term change.

Singapore has introduced a policy to make the unvaccinated pay for their healthcare if they get COVID.  Policy nerds - the bad habit I adopted after being a smoker - love to bat this stuff around.  So does everyone: these are important issues. 

If our ICUs are overwhelmed with the unvaccinated, there won’t be enough room for everyone else.  For your kid injured in a car crash, your immuno-compromised grandad who gets the flu, or your mum whose brain tumour surgery must be delayed for the lack of a recovery bed.  

Everything about this situation is counterintuitive; grates on our sense of what is right and fair.  We have the right to be angry.      

Here's where I've got to.  

• Making unvaccinated people with COVID pay for their healthcare could cause them financial hardship.
• Or it could deter them from healthcare - which is bad for them, and increases the chance they'll infect others.
• Our public health system is universal.  Universal is, in some ways, simple to run - you don't need to work out who to charge for what.
• If we start charging some people for some healthcare needs, who's to say where it would logically end?

So that's what my policy brain is telling me.  Here's what's coming from my heart. 

When I chucked my smokes in the bin that time, I remember how I felt.  Disgraced, mostly.  And if I'm honest, a kind of parasite.  This was the 90s, and user pays was all the rage.  But there was an element of blame to it.  If you made bad life choices, you shouldn't expect to charge your folly back to the New Zealand public.

User pays was loser pays - and don't you worry, us losers knew it.  

Maybe my analogy doesn't hold.  You could argue that 90s smoker me had more self-awareness, less crass disregard for others, than the average anti-vaxxer.  Maybe that's fair.  But it wasn't enough to stop me.  It was a time and a place I felt a little lost.  My life didn't feel entirely within my control, and I wasn't the person I wanted to be.  So I did something that hurt me.

Even if I didn't know it, I needed compassion.

We are all fools from time to time.  It's just that some fools self-correct sooner, do less damage along the way.  

Compassion, too, must be a universal service.  We are all vulnerable, in our reasoning, in a hospital bed, on a ventilator, at the end.