It’s a sad fact, but in the near future most governments will be struggling to cover the medical costs of their ageing populations. As a result, many countries are exploring ways to save money to case the financial burden. One way of cutting costs would be to ‘punish’ people with unhealthy lifestyles by making them pay for their own medical care: people who smoke, drink excessively, use sunbeds, overeat, don’t wear seatbelts, … in short, people who knowingly put their health at risk.

So, is it correct that public money is used the same way for people who follow a correct lifestyle and run into inevitable problems and for those who instead harm themselves with their lifestyle?

The debate is today, more than ever, legitimate: now that public health must also provide for the sickness caused by the Covid pandemic, the costs weighing on it are increasingly huge.

If before the health costs caused by Covid were justified for everyone in the same way, since we still did not have a solution, that is the vaccine, to date the money that the government spends on medical costs caused by Covid is devoted almost entirely to those who get sick because they refuse to get vaccinated.

For this reason, governments are asking themselves whether it is right to continue to pay for those who oppose the solution that is offered to them, risking not having resources for those who get ill, unfortunately, despite the vaccine.

Let’s analyze the situation in Italy: the following data show the incidence that Italian citizens, distinguished between vaccinated and unvaccinated, are having on the various aspects of the pandemic:

The problem we are talking about immediately skips over: the burden on the health system is almost entirely those who are opposing this system. Why keep paying for them?

According to article 32 of the Italian Constitution, “the Republic protects health as a fundamental right of the individual and in the interest of the community, and guarantees free medical care to the indigent. Nobody can be obliged to a specific health treatment except by law. The law cannot, in any case, violate the limits imposed by respect for the human person.

“It would not be lawful for Italy to deny health care costs to a citizen, whatever the motivation.


On the other hand, if one dwells on the passage that declares “… protects health as … … in the interest of the community, …”, it could be said that making those who oppose the solution offered by the state pay out of their own pockets for the good of the citizens wellbeing.

But such a sanction, unprecedented and almost revolutionary for our legal system, can only derive from a generalized vaccination obligation, which in turn should be provided for by a state law. This hypothesis, in Italy, will therefore probably never materialize.

If in Italy we should fall back on less aggressive measures to try to revive the fate of the pandemic, other countries in the world are already thinking of implementing drastic measures:

Singapore is an example, which stated that, starting December 8, it will stop paying the medical bills of coronavirus patients who have refused to be vaccinated. The city is in fact facing its worst wave of infections since the beginning of the pandemic with around 2,000-3,000 new cases per day and some deaths and the substantial majority of those in need of intensive care contributing disproportionately to the pressure on health infrastructure is represented precisely by those who refuse the vaccine.

A similar proposal, but so far only intimidating, has also been made in the German Land of Thuringia which, struggling with a boom in infections, threatens to no longer accept unvaccinated Covid patients in hospitals.

Obviously, establishing whether the health care costs borne by the state should be a right or not for every citizen becomes a problem of particular importance today that these costs have become particularly large due to the pandemic … especially because it is clear that most public money is to date intended for the care of people who have fallen ill because they refused the solution that could have saved them the disease and saved the state from further expenses for their care.

If a person chooses to make a choice that exposes him to a risk and in spite of himself pays the consequences, it is right that he takes responsibility for the harm that has happened to him and that he pays for the treatment it entails.

Despite this, in accordance with the right of choice and the right to health, establishing that you can impose or deny something to someone is not a hypothesis currently available in our country.

Could it be that in the near future it will become essential to arrive at such measures? I think that if the state should ever find itself in a condition so drastic as to risk collapse, the way to make those who do not deserve the services they receive pay from the public purse will be found and will be concretized.

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