The article poses four questions to understand the costs of "medical freedom," particularly in the context of changes in vaccination requirements. The first question is whether the new policy will lead to a decline in vaccination rates and an increase in vaccine-preventable diseases. The third issue is the burden on taxpayers of higher costs for health departments and Medicaid programs. According to a review of studies from Johns Hopkins, each case of measles costs an average of $58,951, including direct medical costs, treatment, quarantine and outbreak response. A dose of the MMR vaccine costs the government approximately $26. A fourth issue is the economic impact on communities and businesses where epidemics cause lost productivity. One study from Washington reports a productivity loss of $18,065 per case of measles. One person's decision not to vaccinate has real costs to the neighborhood, including vulnerable children, taxpayers, and communities forced to bear the health and financial burden.