When the history of the pandemic is written, “get your own ventilators” will be our version of “let them eat cake.”
As the coronavirus bore down on a fragile and ill-prepared public health system, President Donald Trump told the nation’s governors that they were essentially on their own in dealing with the country’s most severe crisis since World War II. “Governors are supposed to be doing a lot of this work, and they are doing a lot of this work,” Trump informed the press after his now-infamous conference call. “The federal government is not supposed to be out there buying vast amounts of items and then shipping. You know, we’re not a shipping clerk.”
While Trump delivered the message in his singularly callous way, his disavowal of national responsibility in the midst of crisis is unfortunately nothing new in US history. From the Civil War to the Great Depression to today, the need for rapid and nationally coordinated action in the face of grave circumstances has been thwarted by one of the basic institutional features of our political system: federalism.
The extensive fragmentation of political authority in the US is a barrier to effective government action at the national level even in the best of times. But amid a crisis like this one it has been downright deadly.
Confusion, Chaos, and Competition
The Trump administration’s “do-it-yourself” approach to crisis management has generated an enormous amount of confusion, chaos, and competition at the state and local levels. Instead of issuing clear guidance on what should be done to effectively suppress the spread of the virus, the federal government has let a hundred weeds bloom.
Jostling between states for precious supplies like ventilators, N95 respirators, and protective gowns is driving prices through the roof and delaying shipment to where they’re needed most. The situation has gotten so dire that hospitals have begun bartering with each other to overcome barriers to effective supply and distribution.
Because Washington has refused to effectively commandeer medical supply chains, states have been forced into bidding wars with each other on the open market. As New York governor Andrew Cuomo recently complained to the press, “You now literally will have a company call you up and say, ‘Well, California just outbid you.’ … It’s like being on eBay with fifty other states.”
In Illinois, Governor JB Pritzker is tapping airline CEOs to organize an airlift of medical supplies from China to his state. The state’s inability to secure an adequate supply of personal protective equipment (PPE) for frontline care providers has been exacerbated by blatant profiteering on the part of private businesses. According to Senator Dick Durbin, an Illinois company is holding back a major sale of COVID–19 supplies to the state government by “‘playing hard to get’ while seeking a better price from another state.”
This week governors in Florida, Georgia, and Mississippi finally issued stay-at-home orders, far later than their counterparts in other parts of the country. Indeed, the issuance and observance of stay-at-home orders and social distancing guidelines has varied widely by region.
According to a recent New York Times analysis, residents of the Northeast, Midwest, and West Coast have largely complied with these measures, even where they came too late (i.e. New York). By contrast, a number of state governments in the former Confederacy and the interior West have allowed for a patchwork of state, county, and municipal level responses to the crisis. Their residents continue to travel widely and spread the virus further.
This situation would be concerning anywhere in the US. But it portends especially bad times for the southern states, which are poorer and sicker than the rest of the country, and which tend to have even more fragile public-health systems. The severe outbreak in Louisiana, which has already registered nearly ten thousand infections and hundreds of deaths, offers the rest of the region a grim image of its near future.
The New York metropolitan area is currently the epicenter of the pandemic. While it has the advantage of vast wealth and world-class medical institutions, its response has been severely hamstrung by the fragmentation of political authority.
Open conflict between Governor Cuomo and New York City mayor Bill de Blasio has generated weeks of mixed signals, a lack of coordination that has resulted in unnecessary delays, and a distressingly relaxed approach to the crisis among many New Yorkers. Cuomo’s stay-at-home order is not being meaningfully enforced in wide swathes of the city, and it has been effective only to the extent that the public has voluntarily cooperated with it. For too many New Yorkers — certainly for me — a walk to and from the grocery store feels like a game of Russian roulette.
When a CNN journalist recently asked Vice President Mike Pence why the federal government has not issued a national stay-at-home order, he offered a non-answer about being “very inspired” by the voluntary cooperation with the social distancing guidelines his administration has repeatedly sent mixed signals about.
Celebration of the DIY spirit in the face of grave national crisis runs deep in the American grain. When the Civil War broke out in 1861, popular enthusiasm for the Union’s cause led thousands of volunteers to flood into the ranks of state and local regiments. This surge, however, quickly overran the federal bureaucracy’s capacity to equip its forces, and the wide variation in state and local-level recruitment processes added up to chaos and confusion on the national level.
The ensuing delays in organizing the army prevented the Union from fully capitalizing on its manpower advantage over the Confederacy, helping bring it perilously close to defeat in the early days of the war. By the summer of 1862, President Abraham Lincoln had no choice but to push through a militia bill that, among other things, empowered him to call state militias up to federal service. According to James McPherson, this act was “of dubious legality and confusing arithmetic,” but it achieved its purpose of building up the army and creating a greater degree of uniformity out of a patchwork of state and local recruitment processes.
Enforcing the act required a vast expansion of national power at the expense of the states, including the deployment of Union troops to suppress local resistance and carry out the president’s quasi-draft. But this circumvention of the limits on national power had to be carried out in order to meet the crisis and take the fight to the Confederates.
A similar dynamic played out in the early days of the Great Depression. Herbert Hoover entered the White House in 1929 with a reputation as an apostle of rational planning. That reputation was well deserved, but he nonetheless insisted that relief of destitute Americans amid the Great Depression was the responsibility of local and private actors — not the national government.
Hoover advocated “collective self-help” and “cooperation in the community” over “the use of political agencies” and “governmental restraints.” He would have been inspired, not appalled, by the fact that New York’s Mount Sinai Hospital had to fly in hundreds of thousands of masks from overseas with the help of Warren Buffett and Goldman Sachs.
As the historian Irving Bernstein observed, Hoover argued that “the primary obligation” for crisis relief
rested upon the family, the neighbor, the landlord, and the employer. … The second line was the local community — the established private relief organizations affiliated in most cities with the Community Chest or the new public agencies financed out of tax revenues in some municipalities. In a grave emergency the state might offer its assistance. Federal intervention, however, was to be avoided at virtually any cost.
Such intervention supposedly posed a threat to moral character, personal independence, and private initiative.
Of course, local and private resources proved no match for the scale of the Great Depression. Effective action required a vast restructuring of the nation’s political economy and a national policy on public relief and social security.
Both Lincoln and Roosevelt had no choice but to centralize power in the federal government to marshal the resources and coordination needed to deal with the challenges before them. They eventually did so, but the American fragmentation of political authority, coupled with the bias toward localism and voluntarism it generates, resulted in wasted time and wasted lives.
In both cases, the necessary assertion of national-level power was incomplete and temporary. Both Reconstruction and whatever potential existed for radicalizing the New Deal order were thwarted by a reassertion of local control, states’ rights, and private initiative after the period of crisis mobilization passed.
An appropriate response to the current crisis and its aftermath will demand a reconfiguration of political authority resembling those of the 1860s and the 1930s. Like the great crises of the past, it has laid bare the fundamental failures of our archaic and dysfunctional institutions.
The unceasing wail of ambulance sirens in our cities is a grim reminder of the virus’s horrifying toll. Unless we want the sacrifices on the front lines to be made in vain, those sirens must also be a call to fundamental national reconstruction.