n the real world and in most studies, incentives tend to work just fine. They have been used to help drug users get and stay clean and to encourage people with HIV to take their medications. When the UCLA COVID-19 Health and Politics Project surveyed unvaccinated Americans, it found that roughly a third said they would be more likely to get the shot if they received $100. Incentives are so widely deployed and validated that citing specific research defending them feels almost silly—it’s like having to offer proof that the internal combustion engine makes cars go.
Despite all the evidence in favor of public-health incentives, America has been slow to adopt them, at least until now. (San Francisco and the Department of Veterans Affairs are two notable exceptions.) What’s held us back? Maybe it’s our lack of a strong public-health system, or the sense that the government shouldn’t interfere too much with people’s choices. Or maybe it’s our Puritan ethic that favors morality over transaction.
But these explanations tend to align with conservative values, and much of the griping about vaccine incentives seems to be coming from the left. Some scolds have expressed concerns that bribing people with such tools of the devil as donuts, lottery tickets, beer, and hot dogs will make people like these unhealthy indulgences. But that’s confused thinking. Things serve as rewards only for people who already like them. If your boss rewarded you for your good work by dumping her trash can on your desk, would you suddenly be thrilled by trash heaps?
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