Ebola, Ferguson and political narratives

By Lorenzo

The Ebola virus reaching the US and the ongoing troubles and controversy over a police shooting in Ferguson, Missouri display the power and the dangers of political narratives from all sides, both of US politics and more broadly.

Thus, one of the more tired and embarrassing responses to Ebola mis-steps in the US has to been to decry “budget cuts” at the National Institutes of Health (NIH) and related agencies, thereby fulfilling two perennial progressivist tropes–there is never enough money and more money makes it better.

Evading responsibility
Embarrassing because:

  • dealing with viral outbreaks is rather their core business [particularly the CDC, but the US Health and Human Services Department generally], and having an appropriate action plan ready to go should not be very expensive [even if implementing it may be]; and
  • (2) the NIH spends a considerable amount of money, an amount which has gone up dramatically over the last decade and a half.

In 2000, the NIH had a total budget of $17.8bn, which rose rapidly to $28.6bn in 2005 and has hovered around $29-$30bn ever since. Quite a lot of money and not subject to any serious cuts. (It is a bigger budget than the Australian Defence Force.) This did not stop the current head of the NIH blaming the failure to come up with an Ebola vaccine on “a decade of stagnant spending“. Yes, that is a bureaucrat evading responsibility, but the Huffington Post headline blames “budget cuts”; and the “budget cuts!” and “more money!” memes are very useful for evading responsibility.

The Centres for Disease Control and Prevention (CDC) has a budget of around $6.5bn in recent years, also after considerable increases under the Bush II Administration.

Then there is the US Department of Health and Human Services (HHS), which the NIH and CDC are part of. It, and its subordinate agencies, has a total budget of, in 2013, $886bn; in 2014, $958bn; and, in 2015, $1trn. That is a significantly bigger budget than the US Defence Department and more than twice the expenditure of the entire Federal Government of the Commonwealth of Australia.

Again, effective plans for dealing with a possible viral outbreak which has been raging in West Africa for months, how much does that cost, really? [Including health guidelines one might adopt from people with experience.] The HHS has, for example, enormously more resources than, say Nigeria or Senegal, who have both successfully dealt with much worse outbreaks and provide learning experiences that a competent bureaucracy might notice. (Though Peter Turchin raises a rather nastier possible explanation for the somewhat lacklustre response.)

If a trillion dollar budget does not generate satisfactory competence in a basic area of responsibility, no amount of money is going to. Indeed, at that sort of scale, more money, and the extra responsibility that does with it, is almost certainly going to generate less basic competence, not more. It does rather look like something of a failure of the administrative state (though the degree of “failure” is being rather overdone).

Apart from being easy tropes, fulfilling a preferred political narrative, “budget cuts!”, “more money!” also do something such narratives are often about–they divert attention from awkward facts likely to cause cognitive dissonance. The cognitive dissonance here being a (very well-funded) government bureaucracy does absolutely nothing to provide any guarantee of effectiveness, or even basic competence. The omni-competent state that progressivist politics implicitly or explicitly postulates will solve problems–if just given the correct goals and the funding-which-is-never-enough–does not really exist.

Worse, as we have seen with the head of the NIH, the memes in question actively work to evade responsibility–and that is precisely the point. Holding government agencies and spending programs genuinely accountable for their competence and effectiveness not only makes “the government will fix it” much more complicated, it can actively and seriously undermine that central presumption.

This is not merely an “political narratives” issue. It goes right to the heart of holding governments and their agencies accountable. Political narratives matter, and in a very direct sense.

President Obama’s response to the agencies on the ground letting him down–in the “embarrassing the President in the news cycle” sense–was to appoint an Ebola “czar”. Both he and his predecessor have been very inclined to such appointments, far more so than previous postwar presidents. That is partly because both President Obama and President Bush II are mediocre administrators, by US Presidential standards. It is also likely to be partly a response to the 24-hour news cycle–President Clinton was much more inclined than his postwar predecessors to appoint such folk, though not nearly as inclined as his two successors. It may also be partly a response to the growth of the US Federal Government–the more it does, the harder it is to coordinate.  But I would rate administrative competence as the main driver: Bush II and Obama are simply not very good at such (witness Obama’s appalling failure to appoint people to vacancies on the US Federal Reserve Board), and political officers are what you turn to when you can’t make the ordinary bureaucracy do what you want.

[This piece on problems in the administration of National Security by the Administration is less than re-assuring, further indicating a lack administrative competence. Jeb Bush–who, as a former Governor 0f Florida, has a lot of experience in crisis-management–has criticised the Administration’s simple message management, contrasting it with his own efforts in somewhat similar circumstances: also not an expensive matter.]

Three languages of politics
Which brings us to Ferguson, Missouri and the police-and-blacks issue that the killing of Michael Brown by police offer Darren Wilson and subsequent riots brought (yet again) to the fore. The controversy over what did and did not happen (the killing itself remains distinctly murky) provides an excellent example of Arnold Kling‘s The Three Languages of Politics (which he discusses here, I recommend listening): the progressive oppression/oppressor axis, the conservative civilisation/barbarism axis and the libertarian freedom/coercion axis.

Reading progressivist and conservative online commentary on matters Ferguson is to enter two different world views that barely interact. Among conservatives, it was about “race baiting”, appropriate behaviour when stopped by a police offer and (lack of) civic engagement–in other words, how progressivists make things worse and the civilisation v. barbarism axis. Among progressivists, it was yet another unarmed black men being killed in police-initiated or massively over-reacting incidents, police incitement and abuse of authority, narrow and unbalanced reporting of a mainly black community–in other words, a civil rights matter, one of oppression and oppressed.

Then there was the libertarian commentary, which particularly focused on the militarisation of US police forces–notably in Republican Sen. Rand Paul’s opinion piece in Time. Libertarians have been warming about the militarisation of US police for some time, as in this 2006 article by Glenn Reynolds in Popular Mechanics. A concern that has spread to conservatives, as in this 2013 Heritage Foundation analysis. Sen. Paul managed nods to both the civilisation/barbarism narrative:

The outrage in Ferguson is understandable—though there is never an excuse for rioting or looting. There is a legitimate role for the police to keep the peace, but there should be a difference between a police response and a military response.

And to the oppressor/oppression narrative:

Given the racial disparities in our criminal justice system, it is impossible for African-Americans not to feel like their government is particularly targeting them. …

Anyone who thinks that race does not still, even if inadvertently, skew the application of criminal justice in this country is just not paying close enough attention. Our prisons are full of black and brown men and women who are serving inappropriately long and harsh sentences for non-violent mistakes in their youth.

While focusing on critiquing the militarisation of US police forces (freedom/coercion):

When you couple this militarization of law enforcement with an erosion of civil liberties and due process that allows the police to become judge and jury—national security letters, no-knock searches, broad general warrants, pre-conviction forfeiture—we begin to have a very serious problem on our hands.

Militarisation combines power and separation: it separates the police from the local citizenry while elevating their sense of power over them, not a happy combination. At which point, (conservative and libertarian) opposition to gun control is surely a factor. A recurring claim in favour of widespread gun ownership is that “an armed society is a polite society”. Historically, that is not true; it more often breeds a violent, honour-obsessed society. What an armed society does apparently breed is not polite police folk, but paranoid ones. And, with the militarisation of US police forces, courtesy of the US Federal Government, ludicrously over-armed paranoid ones; also not a happy combination.

But not randomly paranoid ones. Young men are the most likely corpses from fatal police-initiated/disproportionate reaction shootings, particularly young black men.

To the extent that these shootings become matters of public debate, they tend to disappear in the talking-past-each other self-supporting political narratives seen regarding events in Ferguson, Missouri. But freedom is, ultimately, indivisible. A long history of US police forces being able to evade responsibility for how they treat black folk (and other low-status groups, but particularly black folk) turns out to be not something that can be quarantined away from, well, everyone else. As a man whose son was shot by a police officer 10 years ago wrote recently:

Our country is simply not paying enough attention to the terrible lack of accountability of police departments and the way it affects all of us—regardless of race or ethnicity. Because if a blond-haired, blue-eyed boy — that was my son, Michael — can be shot in the head under a street light with his hands cuffed behind his back, in front of five eyewitnesses (including his mother and sister), and his father was a retired Air Force lieutenant colonel who flew in three wars for his country — that’s me — and I still couldn’t get anything done about it, then Joe the plumber and Javier the roofer aren’t going to be able to do anything about it either.

Michael Z. Williamson (website here) is a military SF writer of libertarian views with a strong interest in military history. (His novel Freehold, for example, is basically the Winter War in space.) His recent collections of short stories and other writings, Tour of Duty, contains two pieces which detail his experiences with the IPD (Indianapolis Police Department). His view of the police:

Lesson here: they’re hired goons, not at all concerned with law and order (p.446).

They are mercenary thugs, hired by my tax dollars to oppress me in the name of corporate America. Not even whores, as whores are paid for their work (p.447).

His view of correction officers after being arrested and held overnight:

I have learned that you are petty, gutless Fascists who are so pitiful as to find solace in your own wretched lives in bullying people with problems, helpless to resist you, until they turn into caged animals for your amusement (p.462).

Remember, he is a white US military veteran. (If a conservative is a liberal who has been mugged by reality, perhaps a libertarian is a conservative who has had one too many dealings with government officials.)

[Frank Serpico–yes, from the movie–discusses writes about the continuing problems of (lack of) police accountability in the US.]

Techniques of evasion of accountability can spread–both from bureaucracy to bureaucracy and from low-status group to well, anyone and everyone. Which, as this article in conservative journal National Review sets out, leads to a pattern of inadequately accountable government agencies:

It’s perverse: If an ordinary citizen makes a typo on his 1040EZ, he could be on the hook for untold sums of money, fines, even jail time. When the IRS abuses its power to harass political enemies, nothing happens. A few years ago, an employer of mine entered the wrong Social Security number on my paperwork — I have barbaric handwriting — and the error took months of telephone calls and mail to fix, a period of time over which I was threatened with all sorts of nasty consequences by the Social Security Administration and the IRS. But when the Social Security Administration oversees the payment of millions of dollars in benefits to Nazi war criminals summering on Croatian beaches, nothing happens. If you’re an ordinary schmo, a typo can land you in jail. If you work for the government, you can burn the face off a baby and walk.

The clear and present danger
Discussions of the uncivil tribalism of contemporary US politics and the power of political narratives tend to talk about it as unfortunate, regrettable, be nice if we could do better. But the problem is much deeper than that. The way the tribal narratives are actually operating is to frustrate political accountability and breed dangerously unaccountable government agencies.

If one is trying to deal with the world as it is, rather than as you would like to think of it, then the question becomes; is that an appropriate axis to view this problem? Or merely one you find congenial? For example, phenomena such as the Islamic State and al-Qaeda are really not usefully viewed through the oppressor/oppressed axis (unless, perhaps, you realise that their aim is to be oppressors). The civilisation-v-barbarism and even liberty/coercion axes are much more appropriate. (Which is why progressivists tend to end up saying such inane, or worse, things on the issue.) Though, that is a relative, rather than absolute judgement, since blanket condemnations of Islam are not useful either. Conversely, equal rights for queer folk really is not raging barbarism, not a threat to civilised order.

But the virulent political tribalism and war-of-the-narratives of contemporary US politics are having much more invidious effects in fostering a whole lots of distracting delusions about issues that seriously matter:

  • Government agencies are not automatically reliable toys which can be waved to generate social justice.
  • If you are going to be so keen on an armed society, you better think a lot more seriously about the position that puts police officers in.
  • Yes, there is a problem with police treatment of specific groups (particularly young black men) and no that is not about keeping you safe; obsessing with not conceding an inch to the concerns of those other folk is just creating homicidally unaccountable police departments and, by copying and contagion, undermining accountability in government agencies generally.
  • No, abusing due process to target those “evil others” really is a big deal.
  • Yes, there does come a point when privileging public sector unions undermines basic effectiveness and accountability.

And so on.

Creating cultures and processes of accountability in government agencies is hard, grinding work. Not least because it means giving up so congenial notions on the way through. But if the shouting political tribes of the US do not look up from their status games and start noticing what their cognitive civil war is doing in corrupting basic processes of government and government administration, then the culture of inadequate accountability among US government agencies is just going to get worse and worse. Which can lead to places I doubt few, if any, of the shouting political tribalists want to go.

ADDENDA After I posted this, I came across this comment by SF writer John Scalzi:

Broadly speaking, the Republicans are frothing ideologues, the Democrats are incompetent …

Sounds about right.

A political scientist notes the lack of interest in cooperation embodied in the competing narratives.

Public sector pensions are driving US city and state governments towards bankruptcy.

[Cross-posted from Thinking Out Aloud.]

13 Comments

  1. conrad
    Posted October 26, 2014 at 10:58 am | Permalink

    ” (1) dealing with viral outbreaks is rather their core business, and having an appropriate action plan ready to go should not be very expensive; and
    (2) the NIH spends a considerable amount of money, an amount which has gone up dramatically over the last decade and a half. ”

    Is it really their core business and are plans not very expensive? On the first of these, I would in fact think it isn’t — the NIH is a big body funding large amounts of research, and I would have thought it is actually the CDC that is responsible (perhaps someone more familiar with the US system can chip in here). This doesn’t mean the NIH shouldn’t be funding stuff to do with ebola (they probably do) but they are generally one step away from the action, unlike the CDC. In addition, lots of the increase in their budget would have gone to other areas also considered essential (or least low-hanging fruit), like mental health, which creates problems vastly worse than ebola will in the US, and will still be here when ebola is gone. I also checked the CDC’s budget and it is $6.9 billion, which doesn’t sound a lot considering their scope. I imagine both those organizations are also under the thumb politically too, so a lot of the growth is probably in areas that they are more or less obliged to look at it. Obviously, ebola wasn’t one of them.

    The second question you raise is how much a plan costs — I think the answer is vastly more than you think it does. This is because you first need work out what to do, then you need to implement often quite costly things that require infrastructure (e.g., containment facilities, drug stock piles that need to be refreshed every few years), and then you need to do the hardest thing in very privatized systems, which is to get some sort of apriori co-operation going. I.e., you need someone to negotiate with any number of partners, you then need to train them and so on. This is one of the things people don’t understand about privatized health care (and other stuff. e.g., quarantine, airports..). It isn’t just helping you get better, it’s keeping other people away from you.

    On this note, I had the joy of living HK when SARs was on, and you could really see the problems and why it was so hard to deal with. In HK, curiously everything worked well, hospitals did what they were supposed and so on. But that wasn’t the case everywhere else. For example, in mainland China, hospitals would simply refuse to take these people (it hurts business after all, and some of these people couldn’t afford to pay anyway) until the government threatened them with jail if they didn’t. At least in Beijing, they also commandeered a few hospitals just for SARs (including one my colleagues and I worked at doing MRI sometimes — Make sure you read the note on the door before you touch anything or try to go inside a hospital LOL!). In other places that are far more civil than mainland China (e.g.,. Taiwan), staff simply didn’t turn up due to the risk and so on. So getting plans for this sort of thing that actually work, and keeping people trained as the years clock through is actually quite hard and expensive.

  2. conrad
    Posted October 26, 2014 at 11:04 am | Permalink

    Here’s another reasons it’s probably the CDC.

    They are responsible for monitoring influenza and stockpiles of anti-influenza drugs. http://www.cdc.gov/flu/about/qa/antiviralresistance.htm

  3. Posted October 26, 2014 at 1:31 pm | Permalink

    [email protected]+2 I wrote “and related agencies” because there are the issues about “why don’t you have a vaccine?” (presumably, because it is hard) which is an NIH matter and having an action plan, which is a CDC matter.

    But even with the CDC, we are talking an organisation with a budget of several US$bn. What struck me is that they do not even seem to have a thought-through “if it gets here, then we …”. That bit is surely not expensive: implementing it may be, but then you ask for supplementary funding.

  4. kvd
    Posted October 27, 2014 at 2:33 am | Permalink

    Lorenzo, interesting post as always. I see in your comments on the US handling of Ebola you have a reference to The Federalist (you link under “failure of the administrative state”) but I’d like to point to an earlier Federalist article regarding planning and preparedness, and “who’s in charge”.

    I guess my point is, this planning and response capability is not a new issue, but both you, and Conrad above, talk as if it is? Or perhaps I’m misreading you both.

  5. conrad
    Posted October 27, 2014 at 4:05 am | Permalink

    NIH funds projects and ideas — it doesn’t generally create them. This is why things like the anti-influenza drugs were not done by them despite being utterly obvious things you would want (they have been in part funded by them after the initial creation). The other reason is because the type of drugs you are talking about cost hundreds of millions of dollars to get into production. You might ask what about the other 100 diseases there are. Why not a SARs vaccine (I think finally developed by the Chinese government)? Why not a Ross River Vaccine? and so on. This is a problem (or a feature) of their mandate, but this a political problem. If people want them developing stuff on their own, their mandate would have to change. So unless somewhat wanted to develop an ebola vaccine (a disease which has historically always burnt itself out), which no-one did, nothing is going to get done until the last minute.

    Also even the CDC certainly has plans. This is why they have the monitoring system and infectious disease hospitals. But the reality is the only way you will stop ebola getting into the country is to ban people from certain countries coming. You could try and cooperate with international and privately run airports (most, for example, have temperature screening), but this is hopeless in these massively corrupt places.

  6. Posted October 30, 2014 at 3:15 pm | Permalink

    [email protected] Actually, my point is that it really shouldn’t be. You have these hugely expensive structures, intelligent planning for contingencies should be part of the deal.

    [email protected] The lack of a vaccine is not the issue, my issue is the pathetic excuse. As for response, there is both entry and response after entry. The Administration has been very unimpressive on both.

  7. John H.
    Posted November 1, 2014 at 5:05 pm | Permalink

    You have these hugely expensive structures, intelligent planning for contingencies should be part of the deal.

    Not a hope. There are so many potential pathogens out there and it takes so long to prepare therapies and vaccines that no amount of planning can address every possible contingency. Costs are prohibitive. Ebola is one of a set of hemorrhagic viruses. In the past the outbreak of Ebola has been easily contained. From a priority point of view the CDC has too many potential threats to address.

  8. Posted November 2, 2014 at 6:46 am | Permalink

    [email protected] But it is not every contingency, is it? This was a large, multi-country outbreak in West Africa, it’s likelihood of reaching the US had moved beyond being mere contingency.

    Moreover, how hard is it to base recommended protocols on, for example, those of Doctors Without Borders? Rather than scrambling after the fact to move in that direction.

  9. conrad
    Posted November 4, 2014 at 4:22 am | Permalink

    I think you’ll find it’s very hard to get people to follow recommended protocols. In big public organisations (like hospitals), all have any number of rules people are supposed to abide by but don’t (for example, at my university, I think I have at least 9 different sets of rules and regulations like OHS, discrimination, copyright, whistle blowing, …. I am supposed to be aware of and every 3 years I fill in some forms showing I know them). Even things like hand-washing and getting people to take a yearly influenza vaccination are hard . Ebola should be easy in this respect because it has a self-preservation component, but when you see things like “clipboard man” you realize you can never stop people’s stupidity. You should ask anyone you know that works in a big public hospital and see what they say.

  10. Posted November 19, 2014 at 10:30 am | Permalink

    [email protected] Which is a bit scary, when you think about it. But my point was more about not seeming to know what tell folk to do in the first place.

  11. John H.
    Posted November 28, 2014 at 12:15 pm | Permalink

    But it is not every contingency, is it?

    The problem in the USA was about the behavior at hospitals Lorenzo. The CDC cannot be held to account for the failure at the hospital level.

    Studies show that protocols are too often breached. For eg, last I read we should wash our hands for at least 30 secs with full lather. Studies in hospitals show that even that most basic of protocols is often breached.

  12. Posted November 29, 2014 at 5:43 am | Permalink

    [email protected] Not entirely. I go back to the CDC etc not seeming to have a proper grip on what to tell people. Which is not a money problem.

  13. John H.
    Posted December 20, 2014 at 3:58 pm | Permalink

    Yes entirely Lorenzo. To blame the CDC for personal behaviors outside of their control is ridiculous. In these days we don’t even need the CDC to inform, ever since the famous Baltimore investigation of Biolab infection control facilities it has long been known that there are protocols to follow and if the CDC didn’t tell them those protocols that is no excuse.

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