The Weekly Sift

Disease should make us think like a species, not like rugged individualists.

One perverse aspect of the public reaction to Ebola is the way it seems to be playing politically, at least in the short run. Ebola is making people afraid, and pushing them towards the party whose central narrative is about fear and anger: the Republicans.

Republican politicians are certainly playing up this angle: exaggerating the threat, and calling for xenophobic actions to combat it — cut off contact with Africa, seal the border against … well it’s not clear against who. Candidates have been amalgamating all the current fear-objects into one nightmare narrative: ISIS terrorists are going to infect themselves with Ebola, then sneak across our southern border to spread it here.

Senator Ron Johnson and Rep. Joe Wilson have put it most bluntly, but Republican Senate candidates around the country — Scott Brown, Thom Tillis, Cory Gardner — have been highlighting the pieces of this dark fantasy and hoping voters will assemble it for themselves: Ebola, ISIS, southern border.

Like most nightmares, this one evaporates as soon as you look at it by daylight: Ebola sucks as a bio-weapon, because it’s so hard to spread, and by the time the carriers were contagious they’d mostly just want to sleep; they certainly wouldn’t be able to swim the Rio Grande or hike the Arizona desert. Except in fantasy, no one has found any links between ISIS and Mexico. And unlike Texas, Mexico has no Ebola cases so far; if anybody should want to seal the border, it should be them, not us.

But nightmares — even very, very unlikely ones — raise fear, and fear makes people vote Republican. Or at least that’s what Republicans believe.

A rational person, though, ought to become more liberal when they think about Ebola, not more conservative. Here’s why.

1. Ebola points out why we need government. Libertarian rhetoric about sovereign individuals has a lot of superficial charm. But biology knows nothing about that; humanity is a species, and sometimes we have to act as a species. We do this through government.

If you want to get some distance on these issues, I recommend reading John Barry’s The Great Influenza, about the 1918-19 epidemic that killed as many as 100 million people around the world. The cities that did well with that plague were the ones whose governments were most draconian about it. As you read, try to imagine a plague hitting Galt’s Gulch, where each sovereign ubermensch would do his own research and make up his own mind about the disease and how to handle it. I don’t think they’d do very well.

There’s a lot of thankless, profitless work involved in controlling Ebola. For example, tracking down all the people who have been in contact with an infected person, and testing or quarantining them. It’s hard to imagine a free-market system that would do this well. The most obvious libertarian system would make individuals responsible for tracking their own exposure, and if some more complicated system created a profit motive for controlling a small outbreak, waiting until it’s a larger outbreak would be even more profitable.

2. Ebola points out why we need a fully funded government. When there’s no immediate threat of disease, government agencies like the CDC look like bureaucratic waste. When Rand Paul put out a “Tea Party budget” in 2011, it included a big cut in the CDC, and virtually no explanation as to how this would affect its mission. As I explained at the time:

sometimes you don’t get even that much justification, and the cut seems to be based on little more than an ideological assumption that waste must be in there somewhere. Take the CDC again. It’s our front line against plagues and epidemics, the folks we depend on to helicopter down in astronaut suits if SARS or ebola breaks out or drug-resistant tuberculosis gets out of hand. It has a total budget of $6.342 billion in 2011, so $1.165 billion represents a 28% cut for the final 2/3 of the year (assuming Paul’s bill could be passed immediately).

How should the CDC fulfill its mission with 28% less money? Given how disastrous a mistake could be, you might hope for some kind of expert justification, maybe a new strategy based on a medical study or two. Nope. The overview just suggests “focusing on domestic priorities rather than spending billions on overseas initiatives.” So basically, the CDC should stop worrying about plagues in other countries, and wait until they show up here. In Rand Paul’s world, that kind of thinking saves money.

I quote from my 2011 article to make this point: Hindsight wasn’t necessary to grasp how misguided this was.

NIH Director Francis Collins has speculated that we’d have an Ebola vaccine by now if not for the budget cuts that did get made: The $37 million we spent on Ebola vaccine research in 2010 was down to $18 million by 2014. Various other people have pushed back against that speculation. (And then Mike the Mad Biologist pushed forward again.) But the bottom line is simple: If you could reach back in time and reverse those cuts, wouldn’t you?

Now ask yourself: How many other cuts are like that? How many other agencies not currently in the headlines are we looking at as “wasteful spending” when it’s just that we don’t personally need them right now? And is it possible that events might make us wish we’d spent more before the emergency hit?

3. Ebola points out why we need a fully staffed government. Wouldn’t it be nice to have a surgeon general about now? (Just as it would have been nice to have had an ambassador to Russia when the Ukraine thing broke out or a Turkish ambassador as we were trying to get Turkey’s cooperation in opposing ISIS.) As former Surgeon General Regina Benjamin put it:

The surgeon general is America’s doctor. Delivering information to the American people in a language they can understand. Not having one right now, you don’t have that face and that person that the American people can identify with as their doctor who’s looking out for them on a large scale.

But we don’t have one because of the NRA. President Obama nominated Dr. Vivek Murthy back in March. But it turned out that Murthy views gun violence as a public health problem. (So does the AMA.) That makes him unacceptable to the NRA, so the Senate has been unable to confirm him (and a recent Supreme Court ruling prevents Obama from installing him as a recess appointment).

It wasn’t so long ago that the Senate believed in staffing the government, without making every appointment into a political football. But today’s Republicans have blocked Obama’s appointments on principle, even when they have no issue with the nominee. If they get control of the Senate in the upcoming election, expect the government to remain understaffed at least until the next administration.

If you’ve ever worked in an understaffed department, you know what that means: Stuff falls through the cracks. When that inevitably happens, Republicans will blame “government” rather than the true culprit: understaffed government.

4. Ebola demonstrates why we need to fund foreign aid. Foreign aid is one of the most unpopular parts of the federal budget (possibly because Americans grossly overestimate how much we spend on it). But viruses point out that the world is more interconnected than our political systems account for.

Bush administration officials used to tell us that we had to fight terrorism “over there” or else we’d eventually have to fight it over here. That’s debatable when it comes to terrorism, but it’s absolutely the fact when you talk about contagious diseases.

Ebola is controllable — previous outbreaks have been controlled, and the world has gone entire years without new cases. But ultimately it has to be controlled at the source, in west Africa.

Now widen your view a little: Anyplace in the world where people are living in unhealthy and unhygienic conditions, the next super-bug might be evolving. Any population that is “off the grid” of the global medical establishment might where a pandemic gets rolling before anyone notices.

5. The specter of a deadly infection demonstrates why we need universal health care. Conservative rhetoric revolves around individuals, and in particular how wrong it is to “give” individuals benefits — like health care — that they haven’t “earned”. Such individuals become “dependent on government” and take money away from “job creators”. It’s even worse if some of those benefits reach people who entered the country illegally or stayed past the expiration of their visas.

But when an infection gets loose, you want everybody who might be sick to seek treatment. You don’t want them to stay away from doctors because they can’t pay, or avoid the emergency room for fear of being deported, or not tell anybody about that undocumented cousin they might have infected.

I’m still not terribly worried about the spread of Ebola in the United States. (The number of cases and the likelihood of spreading the infection are both low.) But we might not be so lucky with the next disease. That’s why we should all be tremendously grateful that (so far) ObamaCare has gotten health insurance to ten million more people, and we should be working to plug the holes in that system rather than tear it down.

If a real epidemic got rolling, where would you rather be? In Massachusetts, where the model for ObamaCare, RomneyCare, became law in 2006, and only 1.2% of the population lacks health insurance? Or in a conservative wonderland like Texas, where 24.8% — probably including the Hispanics who clean your office or work in the kitchen at your favorite restaurant — are uninsured?

6. The Ebola panic demonstrates the danger of legitimizing conspiracy theories. During a plague, you need affected people to cooperate with the containment plan — seek treatment, accept quarantine, and report all their contacts truthfully — while unaffected people stay calm rather than doing panicky, stupid things. That’s when it’s important that the country trust its scientific establishment and its government.

Now of course it is important that the media and the political process police the trustworthiness of both those institutions. On those rare occasions when scientists fake data, they should be exposed. When the government lies, the media should investigate and seek the truth.

But what we’ve been seeing inside the conservative news bubble during these last six years goes way beyond that. Political opportunism has been seeking every opportunity to tear down public trust, even when — maybe especially when — the accusations are baseless.

And so, much of the public believes that the scientific community is involved in an elaborate conspiracy to promote a climate change “hoax”, or to destroy the Christian religion via the theory of evolution. So how can we believe what the doctors are telling us about Ebola?

And the Obama administration? If President Obama faked his birth certificate to hide the fact that he’s not really eligible to be president, if he’s been plotting to destroy the U.S. since he was a student, if he has a gun-confiscation plan that’s always just a month or two from implementation, if he is funding “death panels” that will decide whether your life is worth saving, if he has a “Kenyan, anti-colonial” worldview, if he “hates white people” or “has a deep-seated hatred of white people or the white culture” … why would his administration tell us the truth about Ebola? Fox News’ resident psychologist Keith Ablow lays it out:

[Obama’s] affinities, his affiliations are with [Africans]. Not us. That’s what people seem unwilling to accept. He’s their leader … we don’t have a president. We don’t have a president who has the American people as his primary interest.

This is irresponsibility on a grand scale. Every era has a lunatic fringe with paranoid notions. But this kind of stuff comes from governors, members of Congress, a news network, and lots of other folks who seem to be part of a trustworthy establishment. And major national leaders — I’m looking at you, John Boehner and Mitch McConnell — sit at the same table and humor the purveyors of this destructive nonsense.

So it’s no wonder we’re seeing all kinds of weird behavior out there: Like the school in Maine that suspended a teacher for 21 days (the incubation period of Ebola) because she’s been to Dallas. Her hotel was less than ten miles from the hospital where two nurses got infected, so how can we have her in the same room with our children? (The local news report on this mentions a local parent who believes the government has “downplayed risk factors”. I wonder where he gets his news.) Thursday, several entire schools closed in Texas and Ohio because of Ebola contagion fears.

What would happen if we were having a real epidemic? I think mobs would be roaming the streets, burning down the houses of suspected carriers — all because the conservative movement and the Republican Party have prioritized destroying Obama over maintaining public trust in trustworthy institutions.

Pandering to people’s worst instincts may seem like a political freebie. But it isn’t. There’s a big social cost to this kind of stuff. But “social cost” is one of those things that conservatives are trained not to see. And that’s a 7th reason why you should be a liberal.