Ira Lacher returns to the topic of what is owed to Americans who have chosen to remain unvaccinated for COVID-19.

Wow, unvaccinated America: Are you in luck!

Nah, not from any new discovery that prevents you from getting COVID-19, or that if you get it you won’t die (actually, you’re 15 times more likely to than if you’re vaccinated, and 29 times more likely to land in an ICU). But hey — if an emergency room is in your unvaccinated future, you’ve got unlimited dice rolls because you’re guaranteed to get medical attention. Which puts you ahead of someone who might have brain cancer. Wow! Can you buy me a Powerball ticket?

This great good fortune favoring you, unvaccinated America, results from what is known as the “duty of care” doctrine: A doctor has a moral, ethical, and legal obligation to treat a patient to the best of the physician’s ability; failure to do so can invite a malpractice suit. Further, hospitals that participate in Medicare must, under federal law, stabilize an ER patient’s condition, regardless of the person’s ability to pay, or at least transfer that patient to a suitable institution.

But not everyone loves someone on a winning streak. Health care providers may have to treat you — but they may not want to.

One doctor in Alabama says that starting October 1, he won’t treat you if you’re not vaccinated. In a letter to his patients, Mobile physician Dr. Jason Valentine said he can’t force patients to be vaccinated but added: “I also cannot continue to watch my patients suffer and die from an eminently preventable disease.” He concluded, “If you wish to keep me as your physician, documentation of your vaccination will suffice. If you wish to choose another physician, we will be happy to transfer your records.”

Patients of South Florida physician Dr. Linda Marraccini got the same message, effective September 15. “It’s not fair for people who are unvaccinated to harm other people,” she told Newsweek, adding that societal responsibility trumps personal freedom. “Responsibility has to do with each individual. This is a global health issue, and everyone owns part of that responsibility.”

So be aware, you plungers: House rules — the ethics and legality of refusing to treat unvaxxed COVID patients — are changing. “Patients who don’t vaccinate but rely on the protection that comes from being in communities of vaccinated people are free riding, and risking harm to others,” says Patricia Illingworth, an ethics expert at Northeastern University in Boston.

That breeze you feel may not be someone blowing on your dice but blowback. Mark Morocco, a physician in Los Angeles, writing in The Los Angeles Times, called the unvaccinated “patients we love to hate.” He continued: “Anger among front-line healthcare workers remains professionally hidden behind our masks and the oaths we swear to our patients and profession. We will continue to do our best for everyone who comes to the hospital. But that doesn’t stop the whispered grumbling outside exam rooms and in hallways as we gear up to care for our neighbors.”

Other medical professionals aren’t mincing words. “Unvaccinated people have clearly expressed the opinion they don’t want anything to do with conventional health care. Then they show up for some of that conventional health care in the ER. That’s like the idea you’re married at home and single at work,” Dr. Tom Benzoni, a Des Moines-area ER physician, told Andie Dominick of The Des Moines Register. “If you’ve rejected the vaccine, you should reject the treatments. That has to be discussed. If I’m not good enough for you, then I’m not good enough for you.”

This notion is even creeping into triage: treating first those more likely to survive. In one area of north Texas, if you’re unvaccinated and need to be treated, take a number: A task force of critical-care doctors has considered whether it’s OK to treat a vaccinated COVID patient before you because they’re more likely to live. “Our situation is bad, and if numbers continue in the direction they’re going there is a realistic potential that triage guidelines will need to be utilized,” Dr. Mark Casanova, the task force’s spokesman, told Forbes. The same warning was given by a group of hospitals in Memphis, Tennessee, a state where nearly 1,100 inhabit ICUs.

So, maybe what I said at the outset about you being lucky was not so spot-on?

Nah — go ahead and keep those bets coming, and let ’em ride.

But about you buying me a Powerball ticket? Let’s just forget that.