Act has a policy that is not nearly so radical as it appears: $250 to everyone who gets double vaccinated. Duncan Greive argues that to get to 90%, it’s worth a shot.
It’s a truly jaw-dropping goal, as audacious as it is admirable: 90% vaccination rates across 20 DHBs. Audacious because were we to achieve it we would have vaulted from among the least-vaccinated developed countries to being among the most vaccinated populations in the world in a few short months. Admirable because in doing so we would protect precisely the kind of marginalised communities and vulnerable populations that have been most severely impacted by the virus on both economic and health terms in other countries.
To do this the government has pulled a vast array of levers, more each week, mirroring the spread of delta in Auckland, and the unfolding crisis in small-medium businesses. This includes mandating vaccines for large events; mandating vaccines for staff and customers of hospitality businesses; mandating vaccines for hairdressers and mandating vaccines for gyms. This is only the mandates, and only those issued in the last week.
There have been multiple ad campaigns, an expertly staged announcement and very stern words issued from lecterns and monitors. What has been the net result?
Sadly, our vaccination numbers have barely budged in the five days since the traffic light system was announced. In fact, they’ve trended down – likely because of the long weekend, but even Tuesday’s numbers, which should have shown evidence of pent-up demand, were right in lockstep with the week prior to the announcements, and down on the week leading up to Super Saturday. Any honest reading of the charts suggests that the announcements, despite being widely applauded and having a clear logic to them, are not impacting the communities we need them to.
This might be in part because, outside of Auckland and parts of the Waikato, this is all abstracted: these regions are already living in the equivalent of amber, and thus have nowhere near the same day-to-day incentive to get vaccinated. This mirrors the Australian experience, where only in the states that have had major delta outbreaks and associated lockdowns – NSW and Victoria – have 90% of the eligible populations had a first dose, with most of the rest stubbornly in the 70s. Chillingly, a delta outbreak remains the vaccine’s best marketing.
Be very afraid
This will be terrifying for the government, because it shows that our path to vaccinating 90% nationwide will be far more difficult than we had anticipated. And every day that we wait, we live with the accelerating consequences.
Auckland remains fenced off from the rest of the country, with no plausible path to its internal borders opening. The city’s population is locked down and suffering all of the social isolation and mental health impacts that go along with that. Its students are mostly at home, sliding backwards compared to their peers outside the city. Much of our population outside Auckland remains very exposed to a virus that is highly adept at working around boundaries, with a pair of cases in Christchurch this morning the latest troubling proof. Businesses inside Auckland are unable to trade normally, and many tourism businesses outside the city are slowly starving without its people travelling.
To address this, the government has committed to doubling its resurgence payment to small and medium-sized businesses, to the point when it will soon be spending close to $1 billion a fortnight propping up business in and out of the city. While grateful, what they really want to be doing is trading, not held in suspended animation until a target that currently seems a long way off is met. And all the while the risks of social cohesion fraying continue to grow, with the vaccinated ever more resentful of those they perceive as holding back their freedom, and Aucklanders of areas outside its bounds that condemn it to being a city state for the foreseeable future.
With this as the backdrop, it’s understandable that the government is pulling every lever it can to get vaccination rates up. It’s also quite concerning that those rates do not rise. So it’s surely worth considering whether there is any lever, anywhere, which has yet to be pulled.
The last lever
There is one: cash. It’s the most powerful motivator we know, the same one we use to get us up in the morning and to show up to work, and exchange for anything we want. It’s also something the government is currently fire-hosing out to businesses every week to keep them on life support until that distant day when they can reopen.
That number: $940 million. Every two weeks, for who knows how long. It’s a huge number, the kind we used to see in the media only when there was a new waterfront stadium or harbour bridge or railway link. A dizzying figure the likes of which only a tiny handful of people can truly contemplate.
It’s almost $250 for everyone aged 12 or over in New Zealand. This is precisely the amount Act has proposed be paid to everyone in New Zealand on receiving the second dose of the vaccine. It might seem distasteful, but it’s not a radical or inherently right-wing idea, and has been endorsed by Democrat luminaries like president Biden and recently rolled out by New York mayor Bill de Blasio. In fact, it is already in use here informally and on an ad-hoc basis, with some employers paying staff and community providers using everything from pizza to Pak n’ Save vouchers to get people vaccinated.
It would help separate the vaccine hesitant from the truly anti-vax, and help fund the petrol costs and other financial barriers where those factors still stand in their way. It’s very simple, and could be administered by the likes of the IRD or MSD with cooperation from the Ministry of Health. It would also help reveal those populations that are likely to need even more targeted assistance to be vaccinated, by removing the bulk of those facing hidden financial barriers.
Beyond that is an excellent bonus impact: it would function as a giant economic stimulus, just as we head into a period when finances are traditionally strained. Larger households could expect to get $1,500 or more, a meaningful amount of money for those struggling to make ends meet. A mass one-off payment could be expected to flow quickly out into neighbouring retail and hospitality businesses, just as they attempt to recover from a long period of lockdown or reduced activity.
Will it work?
How impactful will it be? Results vary wildly according to factors like the political dysfunction of the country involved, which is why payments don’t seem to work on Republican Trump supporters. One German study suggested that a €50 (NZ$80) payment could increase vaccination rates by 2% or more. That number alone would be enough to move some DHBs past 90%, potentially more given that New Zealand is a far poorer country than Germany, and $250 being a significantly larger amount. A Swedish study showed a very small incentive of around $40 increased vaccination rates by 4.2%.
A Californian study was even more promising, suggesting up to a third of the unvaccinated could be persuaded for a $100 payment (some said it would decrease their inclination, but again, vaccination is politicised in the US in a way that it is mercifully much less so here). It’s also worth remembering that not everyone who gets a first dose returns for their second, with around one in 10 failing to show up in the US. A similar experience here would indicate that we need well over 90% to get a first dose – or a powerful financial incentive to return for a second.
The fact that it’s an Act Party idea will inherently make it a hard political sell for some. But this government has proven admirably adept at taking good ideas from other parties and recasting them as its own. And we live in an era of uncommon bipartisanship on certain issues, as last week’s housing accord with National showed.
More to the point, an idea’s provenance should be of no consequence given the scale and stakes of delta’s challenge. Given that we have now tried persuasion, and compulsion, it’s worth trying the incentive we use to make people do literally everything else.