Opinion | When you drown the government in the bathtub, people die

I had been expecting this for 21 years.

“It’s not a matter of ‘if,’ but ‘when,’” the legendary epidemiologist D.A. Henderson told me in 1999 when we discussed the likelihood of a biological event causing mass destruction.

In 2001, I wrote about experts urging a “medical Manhattan Project” for new vaccines, antibiotics and antivirals.

Reporting on a congressional briefing in 2005, I quoted public health experts predicting a pandemic that would overwhelm hospitals and exhaust respirator supplies. “I want to emphasize the certainty that a pandemic will occur,” the Mayo Clinic’s Gregory Poland said.

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In 2009, during the swine flu scare, I relayed warnings about “the nation’s patchwork of a public health system” and the need for better “vaccine and public-health infrastructure before a more severe pandemic comes along.”

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I repeat these things not to pretend I was prescient but to show that the nation’s top scientists and public health experts were shouting these warnings from the rooftops — deafeningly, unanimously and consistently. In the years after the 2001 terrorist attacks, the Bush and Obama administrations seemed to be listening.

But then came the tea party, the anti-government conservatism that infected the Republican Party in 2010 and triumphed with President Trump’s election. Perhaps the best articulation of its ideology came from the anti-tax activist Grover Norquist, who once said: “I don’t want to abolish government. I simply want to reduce it to the size where I can drag it into the bathroom and drown it in the bathtub.”

They got their wish. What you see today is your government, drowning — a government that couldn’t produce a rudimentary test for coronavirus, that couldn’t contain the pandemic as other countries have done, that couldn’t produce enough ventilators for the sick or even enough face masks and gowns for health-care workers.

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Now it is time to drown this disastrous philosophy in the bathtub — and with it the poisonous attitude that the government is a harmful “beast” that must be “starved.” It is not an exaggeration to say that this ideology caused the current debacle with a deliberate strategy to sabotage government.

Overall, entitlement programs continued to grow, and the Pentagon’s many friends protected its budget. And Trump has abandoned responsible budgeting. But in one area, the tea party types, with their sequesters, debt-limit standoffs and other austerity schemes, did all too well. Between 2011 and 2018, nondefense discretionary spending fell by 12 percent — and, with it, the government’s already iffy ability to prevent and ameliorate public health emergencies unraveled.

John Auerbach, president of Trust for America’s Health, described for me the fallout: Over a dozen years, the Public Health Emergency Preparedness grants to state and local public health departments were cut by a third and the Hospital Preparedness Program cut in half, 60,000 jobs were lost at state and local public health departments, and similarly severe cuts were made to laboratories. A $15 billion grant program under the 2010 Affordable Care Act, the Prevention and Public Health Fund, was plundered for other purposes.

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Now Americans are paying for this with their lives — and their livelihoods.

If the United States had more public health capacity, it “absolutely” would have been on par with Singapore, South Korea and Taiwan, which have far fewer cases, Auerbach said. South Korea has had 4 deaths per 1 million people, Singapore 1 death per million, and Taiwan 0.2 deaths per million. The United States: 39 per million — and rising fast.

To have mitigated the virus the way Singapore, South Korea and Taiwan did would have required spending about $4.5 billion a year on public health, Auerbach estimates. Instead, we’re spending trillions to rescue the economy.

Democrats aren’t blameless in pandemic preparedness. And some Republicans tried to be responsible — but the starve-the-beast crowd wouldn’t hear of it.

After Sen. Arlen Specter (R-Pa.) voted for the 2009 stimulus bill because he secured $10 billion for the National Institutes of Health, he was essentially forced out of the GOP. Rising in the party were people such as Rep. Jim Jordan (Ohio), whose far-right Republican Study Committee in 2011 proposed a plan, applauded by GOP leadership, to cut NIH funding by 40 percent.

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In 2014, NIH chief Francis Collins said there likely would have been a vaccine for the Ebola outbreak if not for a 10 percent cut in NIH funding between 2010 and 2014 that included halving Ebola vaccine research. Republicans jeered.

In 2016, when President Barack Obama requested $1.9 billion to fight the Zika virus, Republicans in Congress sat on the request for seven months and then cut it nearly in half.

Since then, Trump has proposed cuts to the NIH and the Centers for Disease Control and Prevention so severe even congressional Republicans rejected them. And last month they fed the “beast” a $2.2 trillion feast to fight the pandemic.

The Opinions section is looking for stories of how the coronavirus has affected people of all walks of life. Write to us.

Now they know: When you drown the government in the bathtub, people die.

Read more:

Read a letter in response to this piece

Michael S. Saag: What an infectious disease specialist learned about the virus — from getting it

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Jennifer Rubin: What if facts matter?

Dana Milbank: This pandemic is Trump’s Vietnam. He has earned his bone spurs.

Marc A. Thiessen: China should be legally liable for the pandemic damage it has done

Letter to the Editor: Security or bigotry at the NIH?

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