Lessons learned? Review of a great review.

After great events, will the US government and political system learn from mistakes? Or will we raise the bridges and enshrine whatever was done last time as holy writ, to be repeated again? Reputations of people in power push for the latter. But learning from mistakes is the only way to get ahead. 

Bailouts and stimulus from 2008 seem to have followed the latter possibility. Will the lesson from covid look skeptically on the disastrous performance of CDC and FDA, evaluate whether lockdowns did good commensurate with cost, question the need to spread trillions of newly printed money around, measure the  effectiveness of masks that have now become political symbols? Or will this simply be enshrined as the playbook? Do we twist every event to push our partisan narratives, facts be damned? A blame-Trump-for-everything camp offers some hope, but they're not clear what they would do differently as most of the world's response was the same or less effective than our own. 

This big question frames a must-read Alex Tabarrok Marginal Revolution review of Andy Slavitt’s Preventable. The review doesn't just destroy an otherwise forgettable book, but it really raises these larger questions whether we are so politically polarized that we can no longer learn from mistakes. 

In contemporary discussion, people can just say things that are blatantly untrue, and it all washes over us. 

The standard narrative ... leads Slavitt to make blanket assertions—the kind that everyone of a certain type knows to be true–but in fact are false. He writes, for example:

In comparison to most of these other countries, the American public was impatient, untrusting, and unaccustomed to sacrificing individual rights for the public good. (p. 65)

Data from the Oxford Coronavirus Government Response Tracker (OxCGRT) show that the US “sacrifice” as measured by the stringency of the COVID policy response–school closures; workplace closures; restrictions on public gatherings; restrictions on internal movements; mask requirements; testing requirements and so forth–was well within the European and Canadian average.

The pandemic and the lockdowns split Americans from their friends and families. Birthdays, anniversaries, even funerals were relegated to Zoom. Jobs and businesses were lost in the millions. Children couldn’t see their friends or even play in the park. Churches and bars were shuttered. Music was silenced. Americans sacrificed plenty.

... Some of Slavitt’s assertions are absurd.

The U.S. response to the pandemic differed from the response in other parts of the world largely in the degree to which the government was reluctant to interfere with our system of laissez-faire capitalism…

Laissez-faire capitalism??! Political hyperbole paired with lazy writing. It would be laughable except for the fact that such hyperbole biases our thinking. 

I think the problem is deeper. It's not that this is "hyperbole." It's that this is the sort of mushy sentiment that one can pass around at Washington cocktail parties as easily as write on the front pages of all major media these days, and everyone says yes, sure, without batting an eyelash. It's not hyperbole, it is the unquestioned narrative, it's an inshallah people can add to any statement without question. That's the true danger. 

Laissez-faire capitalism??! The US hasn't had laissez-faire capitalism since, well Wickard v. Filburn 1942 (you can’t grow wheat on your own land to make your own bread if the federal government does t like it.) 

If you read Slavitt uncritically you’d assume–as Slavitt does–that when the pandemic hit, US workers were cast aside to fend for themselves. In fact, the US fiscal response to the pandemic was among the largest and most generous in the world. An unemployed minimum wage worker in the United States, for example, was paid a much larger share of their income during the pandemic than a similar worker in Canada, France, or Germany

To say nothing of a year and counting of eviction moratoriums and more. 

Perhaps because Slavitt believes his own hyperbole about a laissez-faire economy he can’t quite bring himself to say that Operation Warp Speed, a big government program of early investment to accelerate vaccines, was a tremendous success. Instead he winds up complaining that “even with $1 billion worth of funding for research and development, Moderna ended up selling its vaccine at about twice the cost of an influenza vaccine.” (p. 190). Can you believe it? A life-saving, economy-boosting, pandemic ending, incredibly-cheap vaccine, cost twice as much as the flu vaccine! The horror. 

As Alex has said previously, all you need to know about cost-benefit analysis is that Trillions > Billions. I remember the scandal. Pharmaceutical companies are making billions! Yes. And given that the budgetary cost has been $5 trillion in one year, in the US alone, plus the GDP cost, the human suffering and death, we should send the vaccine companies a nice $100 billion check along with flowers, chocolates, a thank you card, and a "I hope you'll be there next time" note. But that would not fit the narrative. 

Slavitt’s simple narrative–Trump bad, Biden good, Follow the Science, Be Kind–can’t help us as we try to improve future policy. Slavitt ignores most of the big questions. Why did the CDC fail in its primary mission? Indeed, why did the CDC often slow our response? Why did the NIH not quickly fund COVID research giving us better insight on the virus and its spread? Why were the states so moribund and listless? Why did the United States fail to adopt first doses first, even though that policy successfully saved lives by speeding up vaccinations in Great Britain and Canada?

To the extent that Slavitt does offer policy recommendations they aren’t about reforming the CDC, FDA or NIH. Instead he offers us a tired laundry list; a living wage, affordable housing, voting reform, lobbying reform, national broadband, and reduction of income inequality.

I'm surprised that tackle climate isn't in there too. After all you can make some connection between climate and spread of bugs.. 

Surprise! The pandemic justified everything you believed all along! But many countries with these reforms performed poorly during the pandemic and many without, such as authoritarian China, performed relatively well. All good things do not correlate.

Trump’s mishandling of the pandemic make it easy to blame him and call it a day. But the rot is deep. If we do not get to the core of our problems we will not be ready for the next emergency. If we are lucky, we might face the next emergency with better leadership but a great country does not rely on luck. 

Even here Alex pulls a punch. There are a lot of countries not headed by Donald J. Trump that did the same or a lot worse than the US -- most of Europe.  

A great country relies on an honest discussion, not censored by tech companies or guided by narrative-preserving partisan media, on what worked and what did not, to assemble actual knowledge, embodied in the procedures of a ready bureaucracy, not on the wisdom of whomever happens to be in the Oval Office to dream up on the spot. 


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