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Pandemics Are the Health of the State

Whatever we might think of the concept of historical inevitability, one thing seems predictable: that when the present epidemic of the new coronavirus is over, there will be much debate over the lessons to be drawn from it. These lessons will depend on assessment of the effects, both positive and negative, of what was done during it. It is unlikely that any debate will be conclusive, in the sense that no rational man could disagree with any particular conclusion; the ideological noise will be loud, even deafening.

In fact, the debate is already beginning, though the end of the epidemic is not yet in sight and vital questions, for example as to the true fatality rate of infection, are still to be answered. Even this question, which seems purely factual, will give rise to multiple revisions. And what is the proper measure of severity in any case, number of deaths occasioned, or number of years of human life lost? The two measures may give very different notions of how serious the epidemic was, at least by comparison with other epidemics.

The more variables, the more scope for reasonable disagreement, and no doubt for unreasonable and acrimonious controversy also. How far were the measures taken effective and therefore necessary? Could and should they have been taken sooner, or could and should they have been more targeted at the especially vulnerable? Did anyone properly take into account the negative effects of what was proposed? There will be histories and revisionist histories for a century to come.

In France, much of the commentary so far examines the proper role of the state in ameliorating both the epidemic itself and its economic after-effects. The predominant message is that state action is the only means by which this can be done; and I think few would dispute that, whatever the role of the state ought to have been, or ought to be in the future, the state, relative to the rest of society, has in fact been considerably strengthened by the epidemic. Furthermore, there are many who want it to be strengthened yet further, and who welcome the quasi-totalitarian control of people’s lives that the epidemic provoked. Jean-François Revel wrote a book titled The Totalitarian Temptation more than forty years ago, and totalitarianism is still tempting, at least to some; I still hear eulogies to the war years, when the population was said to have eaten more healthily than ever before thanks to government allocation to all of a carefully- and scientifically-calculated nutritious and balanced diet. We did it then, why can’t we do it now, especially as overeating of the wrong foods has led to an epidemic of diseases such as Type II Diabetes? The cost of this is often borne by the public purse; why, therefore, have the keepers of the public purse not the locus standi to dictate the population’s diet?

Consistency, at least in matters of public policy, is no doubt the hobgoblin of little minds, and not every argument has to be followed to its logical conclusion. Philosophical abstractions cannot be the sole guide to our political actions, though neither can they be entirely disregarded. The man with no principles is a scoundrel; the man with only principles is a fanatic.

A foretaste of the discussions and no doubt political disputes to come was published in the French left-wing newspaper, Libération, on the 27 March. The newspaper has come a long way in the direction of reason and moderation since its foundation by Sartre in his most Maoist days and is now a journal of the domesticated left. The article that caught my eye bore the headline “Covid-19: the return of the Welfare State?” It is by a Jesuit professor, Gaël Giraud, at one of France’s elite colleges.

The following words are printed in red: “If there are French dying of coronavirus, it is because three decades of budgetary austerity have reduced the capacity of our public hospital service.” Most of the article is an attack on the bête noire of practically all French intellectuals, the so-called neoliberalism, that is to say the economic policies that have been followed (with variations) by all western countries in the last few decades.

No doubt there are many things to be said against those policies: for example, their propensity to produce bubbles with seemingly accelerating frequency. These are the result of the desire to reconcile spending more than we earn with keeping visible inflation down, which results in the issuing of money and debt on the one hand and the outsourcing of production on the other, ordinary goods remaining cheap while asset values increase out of all proportion to their returns. Moreover, one of the greatest spenders of more than it earns is the state for—among other things—the maintenance of the welfare state. There is a liberal aspect of this policy, it is true, namely the free movement of capital; but in its aspect of the public provision of services such as healthcare, pensions, education, etc., it would be as accurate to call it neo-socialist as to call it neo-liberal. Perhaps the best term would be neo-corporatist, in so far as it is large corporations and government bureaucracies that most benefit from the policy, a tendency that the shut-down of small businesses during the epidemic can only reinforce.

It seems to me curious that an intelligent, highly-educated and almost certainly very decent man could write such an article as the above without reference to the fact that public expenditure in France already represents 55 per cent or more of GDP, and that France has some of the most generous welfare provisions (generous, that is to their recipients) in the world, as well as some of the most rigid employment protections. None of this is liberal, at least in the economic meaning of the word liberal.

The author draws attention to the difference between France and Germany in the matter of provision of intensive care beds, so necessary during this epidemic (though probably affecting the overall death-rate less than often supposed). Germany has many more such beds than France, but the author fails to notice that the proportion of  GDP of the public sector in Germany is 13 per cent lower than that of France, and indeed in South Korea, where everyone is agreed—at least for the moment—that the epidemic was best-handled (revisionist interpretations are likely), the share of public expenditure of the GDP is less than a third of France’s.

This would suggest, at the very least, that the question is one of the efficiency of, or choices made by, the public sector, rather than of the “austerity” imposed upon it: and this in turn assumes that the determining factor of a country’s death rate from the virus is its hospital treatment of it, which may or not be the case. I do not say it of this author as an individual: but I have little doubt that there are many who will want to use the epidemic as a pretext for exerting more power and control over the population.

Reader Discussion

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on April 06, 2020 at 07:41:06 am

I fail to grasp the meaning of this essay's oddly-worded title. How, in fact, are ''pandemics the health of the state?"
Yet the essay trails off productively from the dead-end of its initial path, that of the currently unanswerable questions as to causation, spread, morbidity, mortality, and the comparative efficacy of different control measures and diverges down a much more instructive path, how the efficacy of the French welfare state's approach to Corona compares (using only the parameter of hospital beds) to that of Germany' welfare state, given that Germany spends a lower % of GDP on public welfare. Value is to be had in comparing two statist approaches to epidemic control, especially given, as Dalrymple says, that the "likely outcome of the comparison" "...would suggest, at the very least, that the question is one of the efficiency of, or choices made by, the public sector, rather than of the (financial) “austerity” imposed upon it..." New York City take note!
Yet, rather that comparing seemingly two statist approaches of modest success (using, at that, only one lesser parameter, hospital beds,) a far more useful comparison of Corona control economic efficiency and effectiveness in achieving control of spread, morbidity and mortality, would be a comparison of effective statist approaches, that of South Korea Taiwan (we should all insist on using the proper appellation "Nationalist China") and Singapore, with the failed satism of, say, Italy, the relatively hands-off, largely laissez faire approach of the socialist Swedes (epidemic irony!) and the outcomes (yet-to-be-determined) of the US's public-private venture, our unique statist-corporate venture in which private industry is deeply engaged and has made enormous contributions but has, by and large, been the slave of public masters.

Finally, comparative political systems and economics aside, I think it highly important for the US to consider the precedent it is setting in the path President Trump has thus far chosen. As Dalrymple notes, the crisis has opened the gateways in the US to an enormous expansion of centralized government control. I would go so far as to say that the US response to the Corona Crisis may lead to more rapid progress toward dirigisme than did the Great Depression.

And in that regard, it seems to me that America's response to the epidemic should weigh the following factors if we are not blindly to stay the current course:
1) Since early January 2020, when the US had its first clear Corona warnings, right up until now, decisions about what to do and what not to do about Corona have been made based solely on the authority of bureaucrats who profess that their expertise and knowledge are the only legitimate grounds for decision-making. The media and the Democrat Party for years and years (since about 1970) have promoted the false notion that decision-making in all matters that matter should be made by bureaucratic experts and based solely on the bureaucrats' so-called "scientific expertise." That expertise for decades has been especially hyped to the public based on the bureaucrats' use of often unverifiable, unreliable computer modelling. The entire climate=change alarmist hoax rests on bureaucrat-scientific hype and bureaucrats' reliance on unreliable computer modelling. In the Corona Crisis, decision-making by bureaucratic experts using deficient computer modelling has played a huge role. That deference in important decision-making to the bureaucrats, their over-hyped scientific expertise and their often unreliable computer models has been a big mistake in America for nearly 50 years. It was a huge mistake in the Corona Crisis. The bureaucrats have been wrong repeatedly in their judgments as to responding to public crises. Their assertions of undisputed scientific authority have been wrong repeatedly. Their computer models have been wrong repeatedly, especially on the big questions of projected health risk. The bureaucrats' expertise has been exaggerated and their decision-making skill has often been shown to be incompetent since 1970, most recently and most painfully on the Corona Crisis.
2) Under our constitution and pursuant to our best traditions, decisions in America about what to do on public matters that matter are, properly, to made by the people acting through their elected representatives: the President, Congress, governors and state legislatures. The people must not allow bureaucrats to make those decisions. Too much is at stake for the people to trust the bureaucrats and their over-hyped, underwhelming, too-often misguided scientific expertise.
3) From now on on Corona matters we the people must decide, on the one hand, whether to continue and even to expand the national economic shutdown (I will call that the "Bureaucrats' Option") or, on the other hand, to cautiously and incrementally reopen the economy according to a cost/benefit risk assessment strategy. ( I call that the republican option, small "r".)
4) Neither choice should be based on computer modelling UNTIL SUCH TIME as we have adequate data to justify the use of computer models to evaluate that choice.
5) Right now the data is NOT ADEQUATE to use computer modelling to assess the HEALTH costs of cautiously re-opening the economy (the "republican option'' and the current Swedish approach.) Prudence, reason and common sense in choosing the "republican option" must be our only guide.
6) However, the data is far more than adequate for computer models to predict the economic and health costs to the nation of a continued or expanded shut-down of the economy (the "Bureaucrats' Option.") There, too, prudence, reason and common sense must be our guide, but there we ALSO have the benefit of reliable computer modelling.
The economic and health costs of the "Bureaucrats' Option" are staggering, perhaps suicidal. Reason, prudence and common sense tell us that. AND the computer models shows us that.
7) The People, not the Bureaucrats, must make the decision if we are to avoid national calamity.

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Paladin
on April 06, 2020 at 12:56:19 pm

re: "modelling"
Comes news yesterday that the two primary modelling schools, The Imperial College and the Oxford College models have been themselves subjects of some controversy (usual academic tempest in teapot nonsense, of course) AND that their past records of predictive validity on a par with those of astologers, albeit it with the use of *seemingly* better empirical data. Their predictions on Swine flu and other potential pandemics during the past three decades have greatly exaggerated the (actual) impact of the outbreaks.
I suppose one can assert that (a hoped for, in the minds of some) "bad health" may also prove to be the "health of the state."

And a Postcript as this just came in:
It may also prove to be the "health" of the political partisan.
Local News station is reporting the comments of Washington State Attorney General Bob Ferguson that "Trump May Delay the Election"
And all this from a second rate lawyer formerly with a large Seattle Law firm with which I have some familiarity as with his intense partisanship.
So let us not overlook the never ending efforts on the part of "local" governments (States) to also enhance their own "health."
Scoundrels - one and all!

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gabe
on April 06, 2020 at 13:23:16 pm

https://mirrorofjustice.blogs.com/mirrorofjustice/2020/04/us-religious-freedom-ambassador-calls-for-release-of-prisoners-of-conscience.html

Some Good News in regards to Religious Liberty the protection of which will contribute to “the health of the State”, at home and abroad, including protection from those who desire to remove Divine Providence in the so called “Equality Act”, because they deny that our inherent unalienable Rights are Endowed to us from God.

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Nancy
on April 06, 2020 at 14:07:49 pm

“The man with no principles is a scoundrel; the man with only principles is a fanatic.”

This statement is erroneous in that it makes it appear as if a man who has principles, lies between two extremes.

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Nancy
on April 07, 2020 at 04:56:54 am

It is a bit early to draw all the lessons learned but mine so far are:
1. 'Wet food' markets are a bad thing for animal welfare and for global health
2. Good politicians are essential for correct response to pandemics but the one thing they do not need to do is motivate health workers. (I speak of the UK NHS) They are already motivated by their professionalism. Politicians are there to facilitate and I hope when all this is over politicians will stop micromanaging and just facilitate what clinicians know they have to do.

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Richard Spicer
Trackbacks
on April 06, 2020 at 15:13:28 pm

[…] neo-corporatist, in so far as it is large corporations and government bureaucracies that most benefit from the policy, a tendency that the shutdown of small businesses during the epidemic can only reinforce. […]

on April 10, 2020 at 10:32:55 am

[…] On our sister website, Law and Liberty, Theodore Dalrymple has a must-read article, “Pandemics is the Health of the State“. […]

on April 10, 2020 at 21:44:47 pm

[…] On our sister website, Law and Liberty, Theodore Dalrymple has a must-read article, “Pandemics is the Health of the State“. […]

on April 12, 2020 at 01:42:21 am

[…] On our sister website, Law and Liberty, Theodore Dalrymple has a must-read article, “Pandemics is the Health of the State“. […]

on April 30, 2020 at 18:00:52 pm

[…] Consistency, at least in matters of public policy, is no doubt the hobgoblin of little minds, and not every argument has to be followed to its logical conclusion. Philosophical abstractions cannot be the sole guide to our political actions, though neither can they be entirely disregarded. The man with no principles is a scoundrel; the man with only principles is a fanatic. – Theodore Dalrymple […]

on July 23, 2020 at 15:54:57 pm

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