Let the ultra-rich and influential skip the line for Covid-19 vaccines? Hear me out – STAT

Its one thing to talk about vaccinating the majority of people living in the United States to stop the Covid-19 pandemic. Its another thing to do it and pay for it.

Epidemiologists tell us we need 75% or more of Americans to be immune to Covid-19 to create herd immunity. Much of that immunity will come from vaccinations. Recent polls show only about 60% of Americans are willing to take the vaccine. Visualize a line of people willing to take the shots: As of now, its much too short.

A vaccine program will also be expensive, even though recipients are told they will get vaccinated for free. One thing Ive learned in life is that free is rarely a good price for anything. Especially something of great value, like protection from a deadly disease.

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Leveraging the difference between price and value with creative approaches can nudge more Americans to get vaccinated and simultaneously fund the vaccination program. I propose a citizen-led program with three basic objectives:

The first two parts of the proposal are linked: Have the wealthiest and most influential Americans donate large sums of money to get to the front of the vaccine line, and use that money to fund the broader effort to vaccinate people against Covid-19. While some may donate because it is the right thing to do, Id expect a substantial portion of the money raised to come from businesses that want greater certainty for themselves in a very uncertain world.

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Donations would come from five tiers. For each tier, the mechanism is the same. People (or businesses on behalf of their people), donate money to get to the front of the Covid-19 vaccine line. There are limited available slots and getting the vaccine must be publicly documented so others can be motivated by these influential figures.

In the first tier, 100 of the wealthiest Americans each donate $100 million to be first in line for a vaccine, getting it within the first weeks of availability. This raises $10 billion.

In the second tier, 1,000 people each donate $10 million to get vaccinated within the first month. This raises another $10 billion.

You can see where this is going: The third tier requires a $1 million contribution for up to 10,000 people. The fourth, $100,000 for up to 100,000 people. The fifth and final tier requires a $25,000 donation from up to 400,000 people. Everyone participating in the program is vaccinated within the first two months of vaccine availability. The bigger the donation, the further toward the front one goes.

All told, this raises $50 billion for the cause by vaccinating just 511,000 people.

What would this $50 billion be used for, since the federal government has said it (thanks, taxpayers) is paying for the vaccines? A lot. I dont pretend to know the optimal ways to spend this money, but I do know there are plenty of places it can help.

At the highest level, it can cover some of the governments vaccination costs and save taxpayers some debt. But I think it will be more useful if it aids states and localities in filling voids in their vaccine distribution processes, essentially creating flexibility where it is needed. That can mean everything from better serving those in remote locations to providing information in languages other than English. It can mean funding for vaccine programs where standard channels struggle, such as for people who are homeless or undocumented. Perhaps it means paying for child care so health care workers can put in overtime, allowing people to get vaccinated more hours of the day. And for those wholl have a tough time going to a clinic, it can pay for programs to bring the vaccine to peoples homes.

In short, it can help get past the multitude of barriers to vaccine access, big and small, that exist in the U.S.

Paying to get to the front of the line might seem obscene. But with 331 million people in the United States, this donor group is just 0.17% of the population. If the program seems too aggressive, removing the lowest tier still raises $40 billion with 111,100 vaccinations, which I estimate is less than one hours worth of anticipated peak vaccine capacity.

This whole idea fails if it interferes with getting vaccines into the arms of the people who need it most. The program is designed to ensure a maximum delay of no more than 24 hours for anyone, anywhere, at any point. The maximum average delay is under eight hours. Having a comparatively small numbers of donors makes this work.

A lot of vaccinations can be funded with $50 billion. At about $150 per U.S. resident, the money raised from the 0.17% can cover the cost of most perhaps all vaccinations for Americans.

Involving influencers is an essential part of this program, much as the federal government tapped Elvis Presley to promote the stalled 1956 polio vaccination program. As these influencers share their vaccinations on traditional and social media, virtually everyone unsure about getting a Covid-19 vaccine will see someone they admire getting it. The line for people wanting a Covid-19 vaccine will grow.

Success depends on a good sales pitch. This isnt the logic-driven scholarly pitch that you can find on a daily basis. Instead, it is a pitch that reaches the reluctant and recalcitrant. In marketing parlance, influencers reach people where they are.

Nothing reinforces the idea that getting a vaccine is a good idea like someone paying big money to move up in line. Seeing people motivated to get to the front of the line creates a perception of value, which is always a useful part of a sales pitch a phenomenon weve seen ranging from Hamilton tickets to new PlayStations.

Few things offer more actual value than a vaccine against a rampaging deadly disease. But for too many people, the perception of value is missing here. Having influencers from most every segment of society get vaccinated alters this perception and changes the game for the U.S.

How might this work? Ill offer sports as an example.

U.S. professional sports leagues like the NFL, NBA, National Womens Soccer League, and MLB currently have little or no certainty around their business. The same is true for the 2020 Olympics, to be held in Tokyo in the summer of 2021. The availability of vaccines changes that.

Vaccines mean no canceled games and more time to practice. They mean the ability to travel without expensive and frustrating bubbles. A teams performance will no longer turn on Covid-19, as happened when the Denver Broncos football team was unable to field an experienced quarterback against the New Orleans Saints and lost 31 to 3.

There are about 5,000 athletes in these team sports, with another 5,000 first-line staff members. Teams could pay $100,000 per person for early access to vaccines, generating $1 billion for vaccination efforts. The Tokyo Olympics has no shortage of wealthy stakeholders: team sponsors, the media, and others have a vested interest in making the games work.

Some leagues might even decide its worthwhile to fund lower-level operations. For example, the NHL might choose to fund the American Hockey League in the lowest tier, or MLB might fund its farm teams.

Athletes are likely to be last on the official list of vaccine recipients as they constitute one of the lowest-profile risk groups: very healthy people under age 40. But in return for the sort of money that can vaccinate millions of people, these organizations get business certainty while their employees get paycheck certainty.

Equally important, athletes are influencers. Or put another way, 83% of Americans know who Tom Brady is.

My proposal is neither conservative or liberal or it can be portrayed as both.

For conservatives, it is a free-market solution: People and businesses are making a choice on how they use their money. Liberals can view it as a wealth tax: People who can afford it pay for early access to a vaccine and, in doing so, pay for others to get vaccinated.

I believe that the concept is inherently nonpolitical. Instead it is a solutions-oriented approach to concerns that have been raised about U.S. vaccination programs. Are wealthy individuals finding ways to move forward in the vaccine line without offering up anything for the rest of society? Princeton sociology professor Shamus Khan says it is happening now and he is concerned this will grow dramatically.

We need solutions.

By establishing one price for the vaccine free we artificially constrain ourselves to that price and exclude other pricing models able to deliver better results for society.

One other program idea Im aware of assigns a cost to the vaccine. Former Congressman John Delaney offered this solution: pay each American $1,500 to get a Covid-19 vaccine.

His intriguing idea has two notable deficiencies compared to my plan. One is that it costs an enormous amount of money nearly $400 billion to vaccinate enough people for herd immunity compared to collecting money for vaccination programs. The second is that it does nothing to bring influencers into the equation, but assumes that money is a sufficient influencer on its own. Delaney offers what some will see as a bribe, bound to increase skepticism in the quarters where there is already a lot of skepticism.

When I have a new idea and want to test it, Ill often call a specific family member and run it by him. Paraphrasing John F. Kennedy from a very different context, I do this not because it is easy, but because it is hard. In many respects, especially politically, this family member and I couldnt be more different. Im well to the left, he self-describes as to the right of Genghis Kahn. For me, he is the very definition of a hard sell.

So I asked him if hed be willing to pay $10,000 to move up in line for a Covid-19 vaccination. He responded that hed pay $100,000. His reasoning? Hed done well in the stock market this year and would be happy to both move up and help. Hed spent a career in uniform defending America against military threats. Defending Americans against a deadly disease didnt seem much different. He could afford it and hed do it.

To be sure, one persons opinion isnt proof a program like this would work, but it did clear a high hurdle for me.

As happens with my family and me, when enough elements come together we find agreement. With the pandemic, by understanding goals correctly and ditching artificial constraints, we build a vaccination program that better serves the nation.

Alan Levine is a technology executive for Wright Williams and Kelly, which specializes in optimizing complex manufacturing environments for products such as integrated circuits and solar cells.

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Let the ultra-rich and influential skip the line for Covid-19 vaccines? Hear me out - STAT