We Need Big Government to Save Us From the Pandemic

As coronavirus crisscrossed the globe in March, The Economist ran an editorial acknowledging the urgent need for a “big government” response but insisting that government must shrink back as soon as the crisis has passed. Their argument reflected the traditional conservative commitment to limited government. Conservatives going back to the 18th century have viewed government as a threat to liberty, and conservative economists in the 20th century linked the small government ideal to free-market capitalism. But the Covid-19 crisis makes utterly clear why some problems demand big government solutions, and why they can’t just be temporary.

For decades, scientists have been warning that an emerging virus could cause a pandemic and that America was woefully underprepared. As long ago as 1988, the Institute of Medicine—an arm of the National Academies of Science—suggested that the risk of a new epidemic justified an expanded federal government role in public health. The states could and should do most of the day-to day work of public health, but epidemics were different. “Only the federal government can focus attention and resources that such a health problem demands,” they concluded, because the federal government Is “structured in a way that allows [for a] clearly defined national focus point.”

In 2019, in a meeting that now seems clairvoyant, experts at the Center for Health Security at the Johns Hopkins University addressed “preparedness for a high-impact respiratory pathogen pandemic.” Spoiler alert: they concluded that we were not prepared. Among their recommendations: that countries should improve their core public health capacities and develop national action plans, improve their capacities for real-time decision-making, prepare for interruptions in the availability of essential supplies and equipment, and develop the capacity for “surge manufacturing in crisis.” Second spoiler alert: their advice was largely ignored.

Over the past 30 years, the advice of leading scientists on a wide range of issues—from pandemic preparedness to climate change—has been widely discounted and sometimes rejected outright. In part that’s because we humans aren’t always great at planning ahead, but a major reason is the influence of conservative thinking that insists on limiting the size of the federal government and disputes the underlying science. The covid-19 crisis has now exposed the limits of this sort of thinking in a particularly acute way.

The interventions necessary to avoid the worst effects of an emergent disease—stockpiling supplies, educating people about hand-washing and social distancing, developing accurate tests and implementing them equitably, and sustaining the research infrastructure that can kick in to develop a vaccine—are not readily undertaken by the private sector. There’s little or no business case for stockpiling a billion face masks. Nor can we rely on the private sector to step up to the plate when a new virus emerges, because by then it is too late. The “just in time” supply model that dominates in the private sector is efficient for many purposes, but it does not work in the face of a pandemic.

Among the many things that were ignored was advice offered more than a decade ago that the national government should stockpile ventilators. Following conventional wisdom that the private sector was more efficient than the public sector, in one instance the decision was made to contract with a private vendor. But then the vendor was bought, the new owner reneged, the ventilators were never manufactured and now thousands of lives are at risk for their lack.

For any problem that has a scientific, medical, or technological component, the challenge is not simply to mobilize resources when they are needed, but to have them ready in advance. It takes a year or more to build a laboratory; it takes a decade to train a cadre of scientists and engineers. We can no more muster on demand the needed expertise and infrastructure to fight a pandemic than we could suddenly raise a professional military, replete with battleships and aircraft carriers, within weeks of an attack. Nearly all conservatives acknowledge the need for national defense, yet they have been loath to acknowledge that government is needed to address a wide range of problems that markets can’t or won’t solve on their own.

The comparative Covid-19 experience of South Korea and the United States proves that when a well-organized national government acts efficiently on good technical advice, even big problems can be tackled and outcomes substantially improved. Government is not necessarily inefficient, but it will be inefficient if it lacks the will and wherewithal to address a crisis. And this is what we have seen in the U.S. in the past few months. A federal government—hostile to governance itself—at first denied the crisis and then, ignoring expert advice, grossly mismanaged it. And continues to do so even as the full scope of the crisis is brutally clear.

Countries that have mounted a strong, centralized response—South Korea, Germany, China—are doing a better job containing the virus, and therefore saving lines, than those that have not. This comes as no surprise to most epidemiologists. Few local/state governments have the capacity to mobilize the necessary resources, and—since viruses don’t respect political boundaries—the broader the response, the more likely it is to work.

To be sure, governments can be oppressive and autocrats will exploit a crisis to grab power. (Already in the U.S. three states have passed laws to criminalize political protests against fossil fuels.) And it stands to reason that the larger the government the more oppressive it can become. But history reveals no necessary correlation between the scale of a national government and the coercion of its citizens. Most western European governments are by many measures “bigger” than the American government (for example, in levels of taxation and provision of social services) but they are at least as democratic. Nor is there a necessary correlation between economic and political freedom. Since the death of Mao Zedong, China has radically liberalized its markets, but political liberalization has not followed.

There’s an obvious lesson here for the impending climate crisis. For three decades, conservatives have downplayed or denied its reality, in large part for fear of “big government” solutions. It’s too late for early action on climate change, but it is not too late to be organized and take action. It will require government, and some of that government will necessarily be big. In the U.S., we may have missed the boat on the pandemic, but there’s still time to get on board on climate change. Government is not the solution to all our problems, but it is the solution to many of our biggest ones.