Commentators criticizing authoritarian health policies from the mainstream left could turn more radical. I hope they do.
Leftist critics of heavy-handed political responses to the Covid-19 pandemic have rightly noted multiple concerns. School closures risk decades-long damage to the most vulnerable students. Business closures harmed workers and employers even as they enjoyed substantial support from members of the laptop class, on whom they imposed minimal costs. Vaccine mandates have funneled billions into the pockets of well-connected corporations: Pfizer’s annual income, for instance, has jumped from $40 to $100 billion. Decisions about vaccine rollouts and emergency use authorizations for vaccines have been subjected to troubling political pressure. And many restrictive policies have not been supported by randomized trials of interventions and therapies.
Unsurprisingly, state action has ensured that the vulnerable have lost out while the well-connected have thrived. And centralizing decision-making has rendered it easy both for politics to take the place of science and for mistakes to be dramatically amplified. Such difficulties lie behind many of the problems the critics identify. But even people who recognize those problems can find top-down solutions attractive.
The California Academy of Sciences, a San Francisco science museum, announced a policy requiring that guests aged five through eleven demonstrate that they’d received Covid-19 boosters. In a recent conversation, UC San Francisco medical school professor Vinay Prasad and fellow physician Zubin Damania noted the absence of scientific grounding for the policy. But they also expressed concern that a museum was using its “coercive” power to make a health-policy decision on its own. They seem, along with fellow leftist and Rutgers law professor Jacob Hale Russell, to favor a top-down, uniform, governmental decision about boosters.
But the museum’s policy doesn’t qualify as coercive: Cal Academy has simply opted not to associate with particular patrons. Someone can criticize the policy as wrongheaded, even deeply objectionable, without treating a private actor’s decision not to associate as coercive, as involving the unjust use of force.
In addition, there’s something odd about the idea—embraced by Prasad, Damania, and Russell—that what’s needed is a uniform, top-down decision, that there’s something wrong with CalAcademy’s willingness to draw on available scientific information to determine on its own with whom it will associate.
After all, it’s been uniform, top-down decision-making that’s created the problems that understandably worry some health-policy analysts on the mainstream left. This kind of decision-making has channeled resources to favored corporations. It has been predictably distorted by politicians’ fears that they will be blamed for disasters that occur while they hold office (“Not on my watch!”) and by their desires that constituents see them doing something, anything, in response to crises. And it has highlighted the difficulties associated with the reliance on experts that has characterized much of the left since early in the twentieth century.
There are multiple problems with this kind of reliance. The formation of expert opinion is a social practice, unavoidably affected not only by the quest for truth but also by everything from the availability of funding to the desire for approval from one’s professional and social peers. It can be especially appealing for experts who’ve been invited to serve as pundits or decision-makers to speak with more confidence than data and analysis warrant in order to justify the trust that’s been placed in them. That doesn’t mean that we don’t have a great deal to learn from people who’ve studied particular topics in depth. But it does mean that there are reasons not to move directly from whatever they say to the forcible imposition of rules on others.
Even when scientific conclusions can be embraced with real confidence, they rarely if ever require particular policy choices. That’s because there are multiple goods involved in almost any choice. These goods are qualitatively different, and it will normally be perfectly reasonable to rank them in different ways.
Decentralized experimentation allows different people to assess the recommendations of experts in different ways and to embrace and encourage different personal and institutional paths in light of those recommendations. Some of those paths, like CalAcademy’s, may be mistaken. But we all learn more when people are free to try out alternatives, experiencing the results themselves and showing others what those results look like so those others can decide whether to emulate them or not, than when whole cities, whole regions, even whole countries are subjected to uniform rules. Of course, experiments can go awry. Of course people can make mistakes; but those mistakes are likely to be much less dangerous than when made for everyone at once.
Good institutions make good decisions more likely. Flexibility at the grassroots level allows people to test and winnow social practices and to act on their varying priorities. This kind of flexibility can equip us to avoid harming the vulnerable, funneling resources to elite cartels, and ignoring the social and political pressures on experts. Taking leftist concerns about health policy seriously means making room for social experimentation.