Two things, however, are abundantly clear. First, the virus is potentially serious enough that you should wash your hands. A lot. Grab a handrail as you went down the stairs? Wash your hands. Returning home from the grocery store? Wash your hands. About to pull a chip from the chip bowl? Wash your hands first. Happen to be strolling past a bathroom but don’t need to go? Make a quick pit stop anyway to wash your hands.
It’s also obvious, however, that the federal government will have to do more than tell everyone to wash their hands, or even get out of its own way and let hospitals test for coronavirus. For example, Congress and President Trump should jointly announce that the federal government will pick up 100 percent of the costs of testing and treatment.
Conservatives and libertarians should enthusiastically support them.
Libertarians? Support a government-run health-care program? Why yes, because controlling infectious disease is a genuine public good. By which I don’t mean “something I think the public should pay for.”
A true public good, as economists define it, is something like a lighthouse or national defense: It benefits almost everyone, and it’s hard to exclude anyone from those benefits. If the fine people of Maine establish a militia to fight off invading Canadians, everyone benefits, but states farther south might be sorely tempted to let Mainers foot the bill. Those sorts of goods justify taxation to even the most stringent libertarians.
Much of what goes under the rubric of “public health” these days isn’t a public good in that sense — at least not unless the definition is broadened to assert that people “catch” obesity or smoking or alcoholism in the same way people used to catch cholera.
But trying to keep someone from harming themselves through their own dangerous choices is quite different from trying to stop people from catching a potentially fatal disease when they engage in some unavoidable activity, such as leaving their house or drinking water. Most notably, measures to curb voluntary self-harm tend to be considerably more coercive than, say, measures to ensure a safe, reliable supply of drinking water. Unless forcibly stopped, many people will keep smoking, even knowing the dangers. By contrast, most people would have to be forced to knowingly drink a glass full of cholera-laden fluid.
This goalpost moving has given libertarians and many conservatives an understandable allergy to programs sold under the rubric of public health. But although many of the things called “public health” aren’t all that public, stopping a respiratory disease with a potentially high fatality rate indisputably is. And to do so, screening and treating the sick need to be made as easy as possible.
If hospitals slap sick people who come in to get tested with bills for thousands of dollars, then fewer people are likely to willingly seek to get tested. Instead, they’ll tell themselves their cough is just a cold and perhaps try to go about their daily lives, unwittingly spreading the virus.
Which is why it is imperative that, in addition to boosting funding for research and state-level public health efforts, the government must reassure the public that people won’t suffer a financial penalty for doing the right thing. It might even turn out that the virus isn’t as bad as many fear and that this funding will not have been necessary — in which case, it also won’t have cost the government very much.
Undoubtedly some readers are thinking, “What a great argument for single payer!” That’s a fair point, though one to be addressed another day. For now, I’d urge those folks not to attach coronavirus to their larger ideological project for the same reason I’m asking conservatives and libertarians not to let their aversion to government health-care programs overcome their common sense.
However serious coronavirus turns out to be, we won’t fix this situation by debating a single-payer system that might get passed several years hence. But nor can we address it by simply washing our hands.