The Journal Gazette
Friday, February 19, 2021 1:00 am

Winners - and losers - with real-life outcomes

Abe Schwab

All public policies are bad. For somebody.

All public policies have winners and losers, whether we like it or not. When the decision is made about how to distribute a resource, or to organize an activity, or to prioritize the use of a public space, some people will come out better than they were, and others will lose out or, at the very least, not get as much.

This uneven distribution is not always intentional, but can be the result of the strategic goals and decisions made about how to achieve those goals.

This is nowhere more evident than the varied decisions made by states in the distribution of COVID-19 vaccines.

After, along with the other states, vaccinating first responders and health care workers, Indiana has taken a simplistic approach: distribution by age. And there are real virtues to this approach.

Determining eligibility is simple; however, Indiana's policy compromises protecting younger vulnerable populations by prioritizing simplicity and efficiency.

This might be the right call for Indiana. Making the determinations of eligibility more complex might overload the capabilities of the Hoosier state.

Other states have chosen more complicated methods that include determining who counts as a member of a more vulnerable population or who counts as part of a population more likely to be exposed. In such states, teachers and other essential workers will be more likely to “win,” but this will come at the cost of efficiency and simplicity.

In Indiana, you only need an ID that shows age to determine eligibility. For more complicated methods you might need to use pay stubs, medically verified diagnoses, etc.

So which approach is the right one? Depends on what you think is most important.

By making the criteria for determining who gets a vaccine as simple as possible, the vaccine distribution in Indiana will be more efficient. And this will likely save some lives.

It also means that some individuals who are more likely to be harmed or killed by COVID-19 will not be able to get the vaccine yet. And this will likely cost some lives.

I can appreciate the value of keeping the process a simple one for Hoosiers to follow. But I can also appreciate how younger individuals who are vulnerable to serious harms or death would find the focus on efficiency to be cold and inhuman.

There is no perfect system that we've identified. No state that has distributed vaccines flawlessly. Since we don't know how to do it perfectly, we have to decide what we value most in the decisions we make.

In many ways, the Indiana policy reflects our market economic system.

It will be able to get the job done efficiently, and maybe that will be best overall. But as a result of this policy, some people, most likely those at the margins and who are more vulnerable to severe disease and death, will die. And they wouldn't have if we had done things differently.

Abe Schwab is a professor of philosophy and director of Ethics Across the Curriculum at Purdue Fort Wayne who specializes in applied ethics.

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