State versus Federal Responsibility

Who’s responsible for the public’s safety?

Who should shoulder the burden of COVID-19?

It’s not as clear cut as some politicians or the media would have the public believe.

There are multiple elements associated with the Coronavirus response—there’s planning and execution, resource inventory and procurement as well as coordination—on top of all this, there are regulatory issues.

When we take an unemotional look at the issue, there’s a little bit for everyone.

From the State’s perspective—they are the ones who know their healthcare capacity. The Federal government doesn’t have that information. (Read: What is Our Healthcare System’s Capacity)

More important, every State has its own unique set of variables—population densities, demographics, health resources…etc., therefore the State is best suited to develop the right plan for their community.

If planning were pushed up to the Federal government, States would get a cookie cutter plan; a general plan that wouldn’t be optimized for any particular State.

Given this alone, planning must reside with the State.

Seasonal Flu

We should look to the seasonal flu to gain clarity as to responsibilities of state and federal governments regarding the Coronavirus.

In 2017-18, 79,400 American deaths were attributed to the seasonal flu, in 2018-19 that number was 61,200.

In 2017-18 there were approximately 959,000 hospitalizations—nearly 1 million hospitalizations.

Was our nation’s healthcare capacity overwhelmed?

Who devised the various plans to prevent each State’s healthcare system from being overwhelmed?

The question: Exactly, how did the country handle the seasonal flu outbreaks in each of those years?

Is the seasonal flu largely a state’s affair or is the federal government the driver?

Does the federal government establish an overall plan of action every state must then follow?

We should relate the Coronavirus to a known epidemic—the seasonal flu.

When we do this, we gain a level of clarity into the responsibilities of the state versus the federal government.

We should apply that knowledge to the current Covid-19 outbreak.

Furthermore, it is the medical professionals within the State that will eventually carryout whatever plan has been developed.

Resource inventory and procurement represents a mixed bag.

If the State has done its due diligence, then inventory as well as procurement will be addressed by the State.

After all, it’s the State’s plan, they should know what inventory is necessary to execute their plan—not the Federal government.

They may call upon the Federal government for certain aid—but to rely on the Federal government for equipment such as ventilators or beds, puts the State at risk, as they would be one of many seeking access to limited resources.

So where does the Federal government fit in—if planning, execution, and inventory reside with the State?

The Federal government’s responsibility: provide the resources required if either the situation becomes more dire than expected; or in the case of the current Coronavirus outbreak, States failed to plan at all.

This is where we find ourselves today.

There was plenty of forewarning for States to create a game plan to address the Coronavirus—few if any did. (Read: Nursing Homes—The Failure of State Leaders)

Add to this the panic induced by the media—it’s little wonder the Federal government has had to take a much larger role in the Coronavirus outbreak.

Are there areas where the Federal government should be solely responsible?

Absolutely.

In the area of coordination the Federal government has a place, however, no State should put itself at the mercy of the Federal government for critical needs—especially when there are other States vying for the same scarce resources.

The Federal government also has the ability to marshal the manufacturing resources of the country either through approaching nationwide manufacturers directly or through the use of the Defense Production Act.

Perhaps, the greatest role for the Federal government during the Coronavirus outbreak is in the area of regulation.

The Federal government can step in and remove regulations permitting alternative use of products, such as N95 respirator masks sold to the construction industry being allowed to be used by healthcare providers, or to allow manufacturers to bypass regulatory requirements, as in the case of auto manufacturers producing ventilators.

The Federal government also carries the burden of providing testing, anti-viral medication and vaccine production.

The dilemma with the current situation—States were woefully unprepared.

In turn, the Federal government could not make up for the States’ deficiencies.

This is the rub—each party has a burden to shoulder—if one doesn’t do its part the whole system fails.

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