Some argue that the government should require young women to be vaccinated against Human Papillomavirus (HPV), a disease that can lead to cervical cancer and genital warts. Although this policy is well-intentioned, mandating the HPV vaccine would grow the level of government involvement and lead to more harm than good.
Cervical cancer is certainly a problem, and it is easy to empathize with women who are afflicted by the disease. However, there exist many disorders and diseases that afflict people, and imposing mandates of coverage of these problems would lead to a myriad of problems, including higher costs, invasion of privacy, and wasteful spending.
In particular, mandates cause the cost of health care to rise overall. When the government forces insurers to cover certain illnesses, then insurers pass this cost onto everybody, not just for the affected populations. Autism mandates are a prime example of this. All insurance policies are forced to carry mandates against insurance, even if the policyholder is not at risk of developing autism, which means that people end up paying more for health insurance. Rising health care costs are likely to hurt low-income people the most, since this population spends a greater percentage of their income on health care.
There is a public choice argument too. Medical decisions, such as the decision to get a vaccine, are private decisions that are better when made individually, not collectively. These are conversations that best occur between the patient and her physician, not her elected representatives. Policymakers face a different set of incentives than physicians and patients, and they don’t necessarily have improved health outcomes in mind. Individuals need to weigh the costs and the benefits of getting vaccinated by themselves. Imposing a one-size-fits-all health policy on everyone is dangerous, since certain side effects may arise in an individual after administering the vaccine, as Michele Bachmann recently discussed.
A problem with mandates and nudges is that they rely on the assumption that the government knows better than individuals do. They assume that people are stupid or uninformed and can’t make the right decision on their own. In addition, they assume that people have the same decision processes in their public life and private life. They assume that decision makers will assess costs and benefits the same way regardless.
Policymakers should consider the opportunity cost of the vaccination program. What other things could the federal government do with that money? If policymakers pass this mandate during the time that they are making cuts to education, is this an admission that vaccinating children against sexually-transmitted diseases is more important than educating them?
Before policymakers decide to mandate vaccinations, they should think first whether it is already being provided in the market. Is lack of vaccines a material failure of private market to achieve the goal of providing vaccines? This is very unlikely – the infrastructure for supplying vaccinations is alive and well in the United States. Additionally, many forms of health insurance aid exist in the status quo. There are public insurance programs that cater to poor populations and children, including Medicaid and SCHIP.
Supporters of mandated HPV arguments tend use the externality argument. They say that the benefits of having a highly vaccinated study far exceed the costs of the program, but this may not be rooted in reality. How many people would get vaccinated anyway using their private funds, after a consultation with their physician?
Although the ostensible reason for HPV vaccinations may be public health, the real motivation behind this policy may be political profit. Merck is the biggest manufacturer for HPV, and the company has lobbied hard for the vaccine mandates. It is just like a big supporter for the full-body scanners at airline security stations was the company that manufactures the machines.
We’d be better off if the government didn’t mandate the HPV vaccine for girls and young women. The market is already providing the service of vaccinating, and individuals would be free to make private healthcare decisions on their own.
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