One detects a pattern in American politics: Every challenge is a crisis, every crisis is the Moral Equivalent of War, and winning that war, we are told, means giving the Left everything it demands, without opposition and generally with no regard for the Constitution, process, or democratic norms. “Never let a good crisis to go waste,” as Rahm Emanuel famously put it.
And so it is with COVID-19.
The novel coronavirus outbreak — a genuine crisis and a real emergency — already is being exploited by Democrats with an eye on the upcoming presidential campaign and political contests beyond that. The emergency demonstrates, they say, the necessity of everything progressives have been demanding for the past 20 years.
That begins with a “universal” health-care system along lines generally described as “European.” The most obvious problems with that are there is no such thing as a “European”-style health-care system; Europe has many different kinds of health-care systems, and very few of them are, in fact, the British-Canadian national-monopoly model that ensorcells our Democrats. The system in Switzerland is different from the one in Sweden which is different from the one in the United Kingdom.
Another shortcoming of that line of argument is that Europe’s health-care systems are not performing especially well. Italy, once ranked the second-best health-care system in the world by the World Health Organization, is overwhelmed by the epidemic. The New York Times reports: “The mayor of one town complained that doctors were forced to decide not to treat the very old, leaving them to die. In another town, patients with coronavirus-caused pneumonia were being sent home. Elsewhere, a nurse collapsed with her mask on, her photograph becoming a symbol of overwhelmed medical staff.”
One country over, the Swiss canton of Ticino has closed its border with Italy, and the rest of the country is preparing emergency quarantine measures. Switzerland is a reminder that it matters how programs are designed and also matters — perhaps more — how they are implemented. The so-called Affordable Care Act was based in part on the Swiss health-care system, which has a rigorously enforced individual mandate — compliance is practically 100 percent. The U.S. attempt to enforce an individual mandated failed but was never seriously attempted to begin with. Similarly, Switzerland is preparing to hand out CHF5,000-per-violation fines (about $5,300) to enforce its quarantine. In France, the mayor of Landerneau is still defending his town’s decision to host 3,500 revelers, painted blue and frolicking, as part of the world’s largest Smurf celebration.
If you think the United States in a public-health emergency is going to be more like Switzerland than Italy — have you met Americans?
Governments are built on top of cultures and societies. Point to the deficiencies of Italy’s universal health-care program and American progressives will say, essentially, “Well, that’s a bad one, and we want a good one, instead.” Well. Presumably, we’d also like to have better police departments, a better Department of Agriculture, better drivers’-license bureaus, etc. — but the fact that we have the ones we have ought to be of some interest to policymakers on guard against utopian delusions.
Government is not a theater for moral performance — it is a convenience, something we use to solve problems that are difficult to solve in other ways. If we wish to be effective in doing that, then we must begin by understanding and identifying the problems, one at a time.
It is entirely possible to maintain a system that has the capacity to respond to discrete emergencies without building a program of universal permanent benefits. Not only is it possible to do so, it is necessary to treat these as separate projects: Even if you believe that programs of universal permanent benefits are desirable (not only in health care but in paid leave, child-care subsidies, etc.) you should understand that building emergency-response systems and building quotidian social programs are fundamentally different enterprises. A bigger welfare state is not insurance against unpredictable events.
(None of the above need be taken as a defense of current U.S. health-care practices.)
It is the nature of epidemics to be unpredictable in the specifics. What is needed, then, are agencies that are liberally empowered to act within well-defined parameters, with sufficient capacity and expertise to respond adequately to a wide range of related threats.
How to achieve that?
Begin with two cheers for the so-called deep state: Communities of expertise of the kind we rely on to respond to crises will necessarily be autonomous (to a degree not expected of, say, the FDIC), which will make them resistant to some policy changes demanded by democratically elected officials, who have a predictable habit of raiding the budgets and staffs of emergency-preparedness organizations when they themselves see no emergency on the horizon. (Which they never do.) Donald Trump’s 2021 budget proposal would cut the CDC budget by 15 percent, including a $35 million cut to the Infectious Diseases Rapid Response Reserve Fund’s annual contribution. Trump’s budget chief was in Congress defending those cuts on Tuesday. Meeting short-term budget goals by reducing annual contributions intended to fund future requirements is familiar enough: Democrats have been doing that with government-employee pension funds for decades — another financial crisis in the making. There is nothing new under the Washington sun.
An epidemic is a specific problem in a specific class of problems. If your response to that problem is “Do exactly what I wanted you to do before there was a problem,” then you have not thought about the problem carefully enough.