Don’t Reform The CDC. Shut It Down

Fight disease with free markets, not central planning

Note to readers: The audiobook of “Think Right or Wrong, Not Left or Right: A 21st Century Citizen Guide (2nd Expanded Edition)” is now available. Get it via Amazon (U.S., U.K., France or Germany) or directly on Audible (and it should be available on iTunes any day). In addition to the rich content, you get the added bonus of my carefully curated Swedish accent. And now on to this weeks topic, the to be or not to be of the Center for Disease Control (CDC).

Some weeks ago, the CDC belatedly admitted what everybody already knew: that it botched its handling of the Covid-19 pandemic. The agency is nebulously promising improvements focused on communication, timeliness and accountability. Experts differ on whether the CDC’s proposed actions are sufficient or if more substantial reforms are needed. However, reading the commentaries on both the political right and left, nobody seems to be questioning the agency’s raison d'être: Whether combatting disease in general, and pandemics in particular, should be part of the role of government?

Now, I’m sure the CDC is full of dedicated employees who are as disappointed in the failures of the agency over the past few years as the rest of us. I’m not necessarily critical of their efforts, as they’re trapped in a system that I would argue cannot be consistently successful in practice. Because of its status as a government monopoly, the CDC has “cornered the market” for coordinating the fight against pandemics. All government monopolies are protected by legislation and regulations, which serve as barriers to entry for the competing ideas that make the free marketplace supremely dynamic in other areas with less or no government involvement. This legislative regulatory “bubble” irrevocably fosters a central planning, “one size fits all,” mentality that is very hard to change from within the organization. Absent competition, the bubble is really difficult to pop.

What would the U.S. (and the world) look like without the CDC? Would new pandemics rage out of control? Would the population be decimated as back in the Black Death days? Or would perhaps individuals, corporations, and NGOs create a thriving marketplace that meets the demands for both fighting current and preparing for future pandemic threats? I’d bet on the latter, but let’s look a little closer. Some of this I’ve adapted from the book, but I think it bears repeating as much of it has yet to go mainstream (I’ll primarily offer my thoughts on the practical advantages of replacing the CDC with free market solutions in this post. I’ll discuss the moral, individual rights violating, dimension of the CDC—and most other government agencies—in a future article).

Without the CDC and other government health agencies, we—individuals, corporations and NGOs—would not be falsely lulled into thinking that there will be a major government disaster response, or any kind of bailout. Corporations in all industries would prepare for pandemics just as they plan for natural disasters of all kinds, be they earthquakes, volcanic eruptions, tsunamis, floods, droughts, etc. Mitigating and, over time, avoiding catastrophic events is essential for the bottom line.

For example, pandemics are real threats to health-insurance companies and hospital organizations. They would face huge losses or bankruptcy, and irreparable damage to their reputation, if they were not adequately serving their customers—the policy holders and patients—in the event of a pandemic. Consequently, they would invest in pandemic preparedness. They would have plans in place to quickly increase hospital capacity and staffing in an emergency and, if need be, to temporarily delay elective procedures. They would stock excess critical medical supplies and devices and make sure their suppliers have plans in place to quickly ramp up production should the need arise. And as part of providing health insurance, they would ask you up front to agree to terms related to managing a pandemic, such as wearing masks, socially distancing, and getting vaccinated (and if you don’t like the terms, you look for health insurance elsewhere).

Even more importantly, investing in pandemic prevention would become the norm. Absent the CDC and government regulation, health-insurance and healthcare companies would work closely with the biotech, diagnostic, pharmaceutical, and medical device industries, and with NGOs (think Gates foundation, universities, other research institutions, and the like) on long-range strategies. They would constantly scan the globe for new infectious disease threats to not be caught off guard. They would work with local communities on modifying cultural habits: “How can we help remove bat and pangolin from your diet?” They would invest in both faster vaccine development, manufacturing and distribution, and in more efficient vaccines. And along the way, they would develop rational safety standards without government involvement, because lack thereof is another threat to their reputation and survival.

It is not unthinkable that in a not-too-distant future a new virus with pandemic potential would be detected and gene-sequenced, and a vaccine developed, tested, mass-produced and mass-distributed in a matter of weeks, not months or years. This may sound like science fiction, but it is just another example of the free market unleashing the unimagined in this area. Just as many of the technologies we enjoy today were the stuff of science fiction only decades ago, there is good reason to think this would apply to pandemic preparation and avoidance as well. We saw glimpses during the recent pandemic of what progress is possible in areas where markets are allowed to function in relative freedom: biotech companies identifying the genome of COVID-19, diagnostic companies ramping up the production of tests, and pharmaceutical companies creating early batches of synthetic vaccine in record time and subsequently ramping up production and distribution so that all who wanted could get vaccinated. The problems we saw with delays were either directly related to federal (CDC, NIH, FDA, etc.), state and local government interference, or a result of lack of preparedness on behalf of the industries in question due to the expectation that the government would shoulder those responsibilities.

So, wouldn’t the government have any role to play? Yes, it would enforce quarantine of verified infectious individuals, as allowing them to move around freely would pose a threat to the individual rights of others, and it would prosecute and punish offenders (the level of enforcement and punishment would depend on the severity of the disease, for which standards would evolve over time). But this would be part of law enforcement and the judiciary, not a government health bureaucracy. In addition, as part of its role in maintaining a foreign policy, our government would help negotiate or demand access for U.S. companies and NGOs to areas where pandemics may break out in the future. But with the continuous progress made towards stopping pandemics in their tracks, the government’s role would get smaller and smaller over time.

If the health insurance, healthcare, biotechnology, diagnostic, pharmaceutical, and medical device industries had shouldered the responsibilities for pandemic preparedness and prevention without the CDC and other government involvement, pandemics would have received a lot more attention over the past 50 years. Yet-to-be-experienced advances would already be a reality, and it is not out of the question that the COVID-19 pandemic would have been largely avoided. The fact that it wasn’t is but one price we pay for living in a society where the government has a monopoly on much of the response to pandemics.

So, what would happen to the good folks at the CDC? Not to worry, if we announced tomorrow that the CDC is no more, I suspect they would be snapped up in a heartbeat by health insurance, healthcare and other companies, and by existing and new NGOs, as their expertise would be critical in building up the knowledge required to face future pandemic threats. Obviously, we need a more organized transition, but you get the idea.

What do you think? Feel free to use the comments to poke holes in my reasoning.