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Here’s the cost of going unvaccinated

Delta Air Lines broke new ground recently by requiring unvaccinated employees to pay an extra $200 per month for company-provided health insurance. That may be a bargain for workers refusing to get vaccinated against Covid-19.

The average cost of hospitalization for Covid-19 is around $20,000, according to recently published data from the Kaiser Family Foundation. At $200 per month, it would take 100 months of added premiums, or more than 8 years’ worth, to cover the cost of a Covid hospital visit. That doesn’t cover lost worker productivity, testing and other disruptions, which is probably why Delta’s chief health officer said recently that the $200 monthly surcharge wouldn’t come close to fully covering the added costs related to unvaccinated workers.

[Read more: Vaccine mandates: Here are the companies requiring proof of inoculation from employees]

Delta (DAL) said the extra payments are meant to impose some accountability on unvaccinated workers who are raising costs and risks for everybody. Other companies could follow suit. The Food and Drug Administration’s full approval of the Pfizer Covid vaccine on Aug. 23 removes legal barriers some companies felt prevented them from requiring workers to get vaccinated, or treating unvaccinated workers differently from those who have gotten their shots. More companies are now requiring workers to get jabbed, and there’s some evidence more Americans will now be willing to get their shots.

But with about 26% of adult Americans still unvaccinated, companies are likely to be grappling with the ramifications of unprotected workers for months or years. Every unvaccinated person won’t get Covid, and every person who gets Covid won’t end up hospitalized. So every unvaccinated worker doesn’t represent a $20,000 risk. But unvaccinated workers clearly represent some higher cost of care. An obvious question for employers is whether that higher cost should be pooled among all workers, or borne directly by those choosing not to get vaccinated.

Mounting health and financial toll

Delta’s $200 per month insurance surcharge appears to be a compromise. Delta is choosing not to require current workers to get vaccinated as a condition of employment, as rival United (UAL) and many other companies are, for reasons the company hasn’t explained. It may have something to do with political opposition to vaccine mandates in Delta’s home state of Georgia. There are also questions as to whether charging some employees more for insurance complies with the Affordable Care Act, which prohibits higher insurance premiums for people with pre-existing conditions, except for narrow exceptions, such as smoking. So Delta could face a legal challenge.

What’s much more clear is the mounting health and financial toll associated with the unvaccinated. Kaiser estimates 113,000 unvaccinated Americans who were hospitalized with Covid-19 in June and July would have stayed out of the hospital had they gotten vaccinated. At an average cost of $20,000 per hospitalization, those unvaccinated Covid victims required about $2.3 billion in unnecessary health care spending, in just two months.

Most people don’t pay the full cost of a visit, since they have government or private-sector insurance. But the plans pay, and if higher costs for one type of illness raise overall costs, then the cost of insurance for everybody will go up. People without insurance do face the entire cost of a hospital visit, though sometimes hospitals negotiate the cost down or end up writing it off for people who can’t pay.

The cost of going unvaccinated is rising in a variety of ways. Some unvaxxed workers have lost their jobs because they refuse to abide by employer vaccine requirements, which courts have ruled legal. With full FDA approval of the Pfizer vaccine, many employers may decide they are legally obligated to require vaccines, to protect workers and customers. The unvaccinated also face a kind of outsider status as more states, cities and private organizations require proof of vaccination to eat at a restaurant or attend events like concerts and professional sports.

SOUTHFIELD, MI - AUGUST 24: A patient receives her booster dose of the Pfizer-BioNTech coronavirus (COVID-19) vaccine during an Oakland County Health Department vaccination clinic at the Southfield Pavilion on August 24, 2021 in Southfield, Michigan. Oakland County is the second county in Michigan to reach the state's goal of vaccinating 70% of its population. (Photo by Emily Elconin/Getty Images)

There’s also the obvious risk of dying. Health officials now say nearly every Covid death in the United States is preventable, since vaccines are widely available, for free, and they largely forestall death and serious illness. More than 31,000 Americans have died of Covid since the beginning of June, an astounding measure of needless loss. Many of those victims were workers lost to their companies forever and providers who no longer provide. The cost of dying is plainly higher than the cost of going unvaccinated, and at this point most Americans have the ability to avert both.

Rick Newman is the author of four books, including "Rebounders: How Winners Pivot from Setback to Success.” Follow him on Twitter: @rickjnewman. You can also send confidential tips, and click here to get Rick’s stories by email.

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