Health Care

Big Government Has Hurt Our Ability to Deal with This Crisis

A doctor walks near an ambulance at the Life Care Center of Kirkland, a long-term care facility linked to several confirmed coronavirus cases, in Kirkland, Wash., March 5, 2020. (Lindsey Wasson/Reuters)
But now it’s time for the government to get involved.

The middle of a pandemic is not the easiest time to argue for limited government. As The Atlantic put it a few days ago, “There are no libertarians in a pandemic.” Indeed, this is precisely the time when we want government to do certain things, and many of those things involve a vigorous and active government (not to mention a competent one). I’m quite comfortable with the government providing testing and requiring or at least facilitating social distancing, to cite just a couple of examples.

Yet before we swing too far from “government shouldn’t do anything” to “government should do everything,” it is worth taking stock of all the ways in which big government has contributed to making this outbreak worse.

The government’s most obvious failure so far has been the slowness of testing. The Trump administration’s failure to recognize the urgency of the situation was undoubtedly a contributing factor. But a bigger issue was red tape, bureaucracy, and over-caution on the part of regulatory agencies. Notably, the Centers for Disease Control and Prevention insisted on creating its own diagnostic kit, rather than adopt those already available from other sources, such as the World Health Organization, which had made kits available to more than 60 countries.

Making matters worse, the CDC botched its first attempt at a test kit. In response, some laboratories tried to take matters into their own hands and create their own kits, only to be blocked by the FDA, which insisted that laboratories first obtain an Emergency Use Authorization, which added more delays. Those delays allowed the virus to circulate undetected for weeks and certainly contributed to its spread.

Now that testing is finally coming online, the biggest concern is a lack of hospital beds and other equipment such as ventilators. Here again, big government has been part of the problem. For example, 35 states have restrictive certificate-of-need laws that allow existing hospitals and other health providers to block new construction or the purchase of equipment by new and competing providers. Designed to deliberately reduce capacity and reduce competition, these laws have helped lead to a shortage of capacity to handle the expected surge in coronavirus cases.

It is not just beds and equipment that are in short supply; it’s doctors, too. Yet restrictive “scope of practice” laws make it harder for non-physician professionals such as nurses, nurse practitioners, physician assistants, and others to step in and pick up the slack. At the same time, immigration restrictions have limited the supply of foreign doctors. And restrictions on telemedicine make it harder for physicians to see patients over distances, exacerbating shortages in rural areas and forcing physicians to expose themselves to the virus unnecessarily. The Trump administration has wisely lifted some telemedicine restrictions, but those rules had already inhibited the growth of telemedicine infrastructure and reduced options. Moreover, state regulations remain a barrier.

Big government continues to cause problems on fronts beyond health care itself. For example, price controls, in the guise of anti-price-gouging regulations, have led to hoarding and panic buying. At times of shortage (say, for hand sanitizer or toilet paper), we should want prices to rise in order to discourage overconsumption and to encourage increased production. For example, if the price of toilet paper rose, those who really needed it would still buy it, but others would be discouraged from “stocking up, just in case.” The empty shelves we are seeing are, in part, due to well-intentioned but economically deficient regulations.

It is also worth remembering that a government that gets too big and tries to do too much often ends up losing focus and failing to do those things it really should. For example, the Centers for Disease Control might have been better prepared for, say, controlling this disease, if it had spent less effort on studying child car seats, vaping, and guns.

Finally, our lack of fiscal discipline during good times has limited our ability to respond to the economic fallout from this crisis. Even before the economy started to tank, the Trump administration had run up trillion-dollar deficits for the first time in seven years. Now, when additional government spending may be needed in the short term, the long-term consequences could be severe.

Similarly, when this is all over, we are going to need to rebuild our economy. More debt, more mandates on business, and more regulations will only make the recovery longer, slower, and harder.

In short, big government has left us less prepared and less able to deal with the crisis we now face.

That is not a call for government inaction. Limited government does not mean no government. The coronavirus is real, it is dangerous, and it is not under control. But maybe, just maybe, if we had heeded advocates of limited government more, we might be better positioned when we do want the government to act.

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