What a Free-Market in Vaccination Preferences Would Look Like

I’ve been asked if it’s possible to “let the market sort it out” on vaccines. I generally dislike that phrase because of it implies that markets are instigating agents, when in fact, markets respond to human desires and goals. Additionally, the phrase is also often followed by an irritating lack of detail as to how markets would actually “sort it out.” So let’s try to provide some detail.

Presumably, many human beings like to live and do business in places where people feel they are relatively free of the risk of infection of various disease, but at the same time, different people evaluate risks differently, and act accordingly.

So for just a quick look at some of the characteristics of a truly free market in regards to vaccine preferences, let’s examine some likely free-market scenarios:

  • Physicians can choose their patients – this should never be more than an internal ethical matter for physicians. In a free market, physicians, attorneys, accountants, and janitors are free to be as selective with their clients as they wish, basing their decisions to do business with clients on whatever criteria they choose.
  • Physicians can practice without government-sanctioned licenses. Governments cannot artificially restrict the supply of physicians by deciding who is and who is not fit to practice medicine, or which higher ed. institutions are allowed to teach medicine.
  • Physicians who dissent from their professional associations/licensing boards can not be prosecuted by the state or forced out of practicing medicine. They can be kicked out of private professional associations, of course, but it is also legal for doctors to found competing professional associations with different values.
  • Private establishments are free to require vaccination. This includes mandates imposed by landlords on residents,  private schools on their pupils, pool clubs on members, and employers on employees. This could also be extended to condo associations, covenant-controlled communities, malls, supermarkets and any other institution that could be privately owned and operated (which is to say, everything).  Note that this only applies to private institutions. Public institutions that are mandatory, allow no competition, or are funded by tax dollars cannot legitimately require vaccination since they have already coerced participation from many who may not desire vaccination. Similar public institutions that cannot legitimately mandate vaccines include government-owned airports (pretty much every major metro airport), public streets, taxpayer funded sports facilities, etc.
  • In practice of course, just as many institutions elect to be “mandatory vaccinated” establishments, other will be “voluntarily vaccinated (or not)” establishments. Some doctors really push vaccines and some do not. Some employers really push vaccines and others do not. some schools push it and some do not.
  • Those who want a flexible doctor can choose one, and those who want a flexible employer can choose one.
  • The role of government in all of this, of course, is to maximize competition by completely removing itself from the relationship between private institutions and customers.
  • The name of the game is decentralization, variety, and choice.
  • Those who are concerned about infection need not live in communities, shop at stores, use schools, or be employed at workplaces that do not mandate vaccination.

As a final note, we might ask ourselves: “well, why don’t more private establishments require vaccination now?” For example, the small outbreak of measles at Disneyland prompts us to ask “why doesn’t Disneyland require vaccination from its customers?” The answer, as if often the case, comes down to private owners trying to externalize costs by having the taxpayers pay for vaccination mandates and enforcement. For example, if Disneyland were to require vaccination, it would need to verify vaccination and refuse entry to those who could not offer proof.

This isn’t actually as far fetched as it sounds. In a world where vaccination verification were something valued by the market, it is not difficult at all to imagine a third-party organization that would provide reliable streamlined verification services, just as private organizations today offer streamlined security checks on financial transactions for private firms. But Disneyland (in our example) wants no such thing, partly because the cost of such a policy is not zero, and partly because it would alienate some potential customers. It is far better for Disney corporation in t his case to support a government mandate on vaccination. In this way, the public that is concerned about measles will not fear any measles outbreak at a Disney Park, but Disney didn’t have to actually do anything to attain this situation. The full cost of solving Disney’s disease-outbreak problem is instead being borne by taxpayers to pay for enforcement and by those who had wished to employ vaccines in a manner different from that outlined in the government mandate. They no longer have the choice.

Little Jimmy Taxpayer is forced to undergo medical procedures against his will, and meanwhile, Disney’s stock price goes up 5 percent.




11:00 pm on February 9, 2015