Much of the money dedicated to medical research and services comes from the federal government. These funds, and the priorities federal health agencies attach to it, trickle down to universities, research hospitals, and local health departments. While some may see this is a good way to coordinate efforts on important health goals, libertarians have criticized this top-down influence for corrupting the reliability of research.
More importantly in the current context, libertarians have long warned that undue influence shifted priorities, compelling researchers and institutions to divert resources away from critical issues, like infectious disease, to those that support government agencies’ goals, such as controlling people’s lifestyle choices. That shift, not a lack of resources or power, is the reason why U.S. health authorities were ill-prepared for COVID-19.
Never wanting to let a crisis go to waste, some within the government are already seeking to exploit the outbreak to lobby for more power and more funding. For example, at the Democratic presidential debate in South Carolina, candidates scorned the Trump administration’s cutting of the budget of the Centers for Disease Control and Prevention (CDC), essentially blaming those cuts for making the virus outbreak worse.
In part, the belief that funding for infectious diseases has been cut laid the groundwork for an emergency funding bill, giving the Department of Health and Human Services (under which the CDC operates) an additional $8.3 billion to address the novel coronavirus. This was similar to the argument made by the CDC during the 2014 outbreak of Ebola, for which various health agencies got an additional $6.2 billion in emergency funding.
Fact-checking, however, shows the claim that the CDC’s funding was cut is untrue. While Trump’s budget proposal did suggest cuts, these weren’t aimed at the CDC’s infectious disease projects and were ultimately rejected by Congress. In fact, not only has the CDC’s budget not been cut, it is bigger now than it ever was under the previous administration.
The problem isn’t that CDC’s budget is too small. The problem, as libertarians have and will continue to point out, is that budgets at federal health agencies like CDC are mismanaged.
At best, just 35 percent of appropriated funds in 2019 were marked for infectious diseases (or about $2.5 billion of its $7.3 billion budget). Much of that money is dedicated to existing infectious diseases, like the 45 percent for CDC programs on HIV/AIDS, viral hepatitis, sexually transmitted infections, and tuberculosis. $700 million was also marked for immunization and respiratory diseases, primarily funding the CDC’s efforts on the seasonal flu.
Of the remaining money in the CDC’s 2019 budget, just $510 million was set aside for emerging and zoonotic infectious diseases, a category that includes Lyme disease, chronic fatigue syndrome, and prion disease. Less than half, $185 million, went to emerging infectious diseases in the U.S., with an additional $131 million for global disease detection and the agency’s quarantine program.
Thus, of the CDC’s $7.3 billion budget, only about $300 million might have been set aside for programs and activities that could have helped the agency address an outbreak like COVID-19.
That’s not to say the other diseases and programs at CDC have no value, only that the agency has clearly grown more concerned with other things besides infectious disease. As a result, the CDC now spends a large portion of its budget on projects of questionable value.
A Google search will turn up no shortage of libertarian-leaning books, op-eds, studies, and think pieces questioning whether larger government is really better government in situations like this. Many of these have focused specifically on the CDC and its current capacity to carry out its core mission—controlling the spread of infectious disease—due to this “mission creep.”
Even with the recent Ebola scare, over the last 50 years or so, national and international health bodies have steadily refocused their interest away from infectious diseases and toward “lifestyle” issues. For example, for several years now, the CDC has dedicated upwards of a billion dollars of its budget to “chronic disease prevention.” This includes its efforts to prevent obesity, smoking, and other personal choices that, over the course of a lifetime, might have a detrimental impact on individual health. The agency also has funded projects of questionable value or which are already handled, and funded, by other federal agencies, covering such topics as environmental health, injury prevention and control, and occupational safety.
Prior to the outbreak of COVID-19, the CDC, the Food and Drug Administration, and even the World Health Organization have perplexing focused on the nonexistent “epidemic” of youth vaping. Collectively, they’ve spent billions on anti-vaping advertisements, biased research, and lobbying, wasted countless hours of congressional hearing time, and squandered public trust in their ability to target issues of critical importance. Had they remained focused on fighting communicable diseases instead of exhausting their funding and public goodwill on such lifestyle issues, perhaps they might have been better able to address real epidemics, like the COVID-19 outbreak.
Don’t expect many liberals or even conservatives to ask questions like that—not in the midst of a national emergency. Instead, expect them to focus on salvaging their public image, blaming someone else, and consolidating power.
People in power know there is no better time to expand that power than when fear is widespread. That fear can compel otherwise rational individuals to forfeit rights in exchange for a sense of security. In such moments, it’s libertarians—sometimes only libertarians—who warn that forfeiting rights and power to the government in emergencies is never temporary and rarely solves problems. One need only look back at the post-9/11 response to see how true that is. Even faced with other, tangible national crises, like government shutdowns, economic collapse, threats to national security, drug-use epidemics, health scares, and terrorism, libertarians have spoken consistently of the importance of maintaining individual liberty.
COVID-19 will be no different in that regard. Already, some are attempting to exploit COVID-19 panic to slip unwarranted power grabs under our collective nose. No doubt, in the coming weeks and months, both conservatives and liberals will use the outbreak in an effort to perpetuate xenophobic immigration rules, hinder international trade, expand rules on employment and health care, or even broaden government surveillance powers.
As J.D. Tuccille recently wrote in Reason:
[E]ven after the public panic retreats, the politicians’ calculations subside, and COVID-19 becomes more knowable and treatable, we’ll be left with the permanent swelling of government caused by the latest crisis.
As the libertarian economist Robert Higgs wrote in his seminal work, Crisis and Leviathan, quoting economist Calvin Hoover, “when critical extensions of government power are likely to occur … there is little opportunity for a meaningful vote on whether or not, as a matter of principle, the powers of the state should be extended. Instead, there is likely to be an insistent demand for emergency action of some sort and relatively little consideration of what the permanent effect will be.”
So, while the outbreak of COVID-19 is serious, the bigger threat to America might be further—and long-lasting—loss of civil liberties. For this reason, Americans better hope there really are libertarians in an epidemic, and perhaps listen to what they have to say.
This is the second of a two-part series. Part 1 is available here.