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- The Pandemic vs. the Shutdown: What’s the Worst That Could Happen? - May 20, 2020
Check out the New York Times report on the Federal government’s more than a decade-long attempt to procure ventilators for a national emergency stockpile. The effort began in 2007 and involved a complete false start after awarding a contract to a small California company. Good progress was being made and a prototype was sent to Washington in 2011. The small company got bought out by a much bigger medical equipment supply company, which was eventually bought by another company. The initial contract was canceled in 2014 and the Federal government eventually selected Philips as the supplier. The ventilator was no approved by the FDA until July 2019 and 10,000 units are to be delivered in mid-2020. Thirteen years after recognizing the problem, the Federal government still does not have the ventilators.
The reporting is excellent, although the interpretation is faulty: “The stalled efforts to create a new class of cheap, easy-to-use ventilators highlights the perils of outsourcing projects with critical public health implications to private companies; their focus on maximizing profits is not always consistent with the government’s goal of preparing for a future crisis.” Instead this strikes me as another example of government failure related to this crisis. Federal procurement is notoriously bureaucratic and slow, and beneath the surface of the story lies the FDA’s burdensome requirements to prove effectiveness. The prototypes impressed the head of the CDC, Dr. Thomas Frieden. The “purchaser” within the Federal government was satisfied with the ventilators yet they had to receive FDA approval. The first ventilator design was never approved. When rules and processes drag out any entrepreneurial effort for five years or more, things can happen, like the persons within the Federal government who saw the need moving on to new jobs or getting busy with other duties. And I doubt anyone in the Federal government will lose their job or pension for taking more than 12 years to procure the ventilators.
We have yet another government failure. Managing the response to contagious diseases and viruses, or public health, is one of the core functions of government. Limited government does not mean ineffective government; we assign vitally important core functions to government because they are so important and we the people cannot readily accomplish them ourselves. We should want a limited government to be highly effective. And perhaps it would be if Washington did not undertake so many less important or unnecessary tasks. For example, while the Federal government failed to procure ventilators, the Obama administration was trying to transform the nation’s healthcare system. If Congress was not so busy passing and trying to repeal the Affordable Care Act, perhaps some members could have noticed that the ventilators they had appropriated money for had never been purchased.