COLUMN: Freedom doesn’t need a crisis to save lives
Why must we wait until a crisis
before market-oriented solutions are tried? Why does it take a national
emergency before we loosen the noose of regulation just a little bit?
Why does it take a worldwide disaster before the powers that be will
grudgingly, achingly, permit a trickle of freedom to quench the parched
throats of the suffering?
In 2005, New Orleans public schools were failing. Facing high school graduation rates of 56%, FBI investigations showing financial malfeasance, and eight superintendents in 7 years, a statewide takeover was in the making.
Then Hurricane Katrina brought havoc and destruction to The Big Easy. Out of desperation, vouchers and school choice were put on the table. Parents would be allowed to pick schools anywhere they wanted. They would receive vouchers redeemable at any of them. All teachers were fired, to be rehired under a non-union contract. Newly formed charter schools would be responsible for personnel decisions and held to performance-based contracts by the state. If they didn’t meet them, they would close.
Today, virtually every public school in New Orleans is a charter school. Test scores and graduation rates are up dramatically, college entry rates are up, and the benefits appear to be positive across all income levels and ethnic groups. No system is perfect, but this one is working out darn well. So why did it take the worst natural disaster in American history to bring it into existence?
No one needs reminding we’re facing another crisis, this time on a global scale. We fell behind in testing because the Center for Disease Control insisted on banning all tests but its own, which turned out not to work. Public health workers in Seattle had to wait for days before receiving federal approval to use their tests, eventually doing the right thing by ignoring the requirement.
As a result, the FDA started giving “emergency” approval to biotech companies’ test kits, which as it so happened were faster, more reliable, and cheaper than the government version. Shocking, I know. In fact, just a few days ago the FDA eliminated the approval process.
So why did it take an emergency to get the FDA out of the way? Faster testing saves lives, slower testing kills them. Why for all this time has it been OK for people to die while tests and potentially lifesaving treatments waited for FDA approval?
Here’s another example. Recognizing that health care workers need to get to where they are needed, Colorado’s governor Jared Polis has relaxed the licensing requirements for out-of-state health workers. Any nurse or doctor licensed in one state can immediately get permission to practice in Colorado. Massachusetts has enacted similar “emergency” measures. Good on us. It’s absolutely the right thing to do.
But why is freedom of cross-state movement for medical professionals only permitted in an emergency? If the rules protected the public when we were healthy, do they somehow not protect the public when we are sick? By what possible rationalization will these rules be restored once the corona pandemic is over? When the virus disappears, would the social benefits of cross-state licensure disappear as well? I’d suggest the answer is a resounding and obvious “no.”
Might I suggest another target of opportunity? Most states in the U.S. have “Certificate of Need” laws for hospital construction. Surprise surprise, existing hospitals work very hard to stop such certificates being issued, assuring the public that more competition in health care is “not in the public interest”. That’s anti-capitalist, cronyism at its worst.
China, believe it or not, built a hospital near the center of the virus epidemic in less than two weeks. I defy any state with a CON law to do that. My prediction? If a state with a CON law needs a hospital built fast, there will be an “emergency” streamlined approval process. But again, why wait for the emergency? The fastest way to get a certificate of need is to not require one. That’s what 14 states, including Colorado, already do.
The next few weeks are going to be tough. But a lot of good will come out of what we’re going through. We’ll see how people can help each other in a crisis.
We’ll get even more testimony to the power of science. We’ll get a vaccine; the anti-vaxers will run away with their tails between their legs.
And hopefully, some of the streamlined, pro-freedom “emergency” measures we’ve adopted will stick around. They’ll save more lives that way.
Barry Fagin writes frequently about politics, technology, and public policy, and has won national awards for teaching and political activism. Readers can contact Fagin at barry@faginfamily.net.
In 2005, New Orleans public schools were failing. Facing high school graduation rates of 56%, FBI investigations showing financial malfeasance, and eight superintendents in 7 years, a statewide takeover was in the making.
Then Hurricane Katrina brought havoc and destruction to The Big Easy. Out of desperation, vouchers and school choice were put on the table. Parents would be allowed to pick schools anywhere they wanted. They would receive vouchers redeemable at any of them. All teachers were fired, to be rehired under a non-union contract. Newly formed charter schools would be responsible for personnel decisions and held to performance-based contracts by the state. If they didn’t meet them, they would close.
Today, virtually every public school in New Orleans is a charter school. Test scores and graduation rates are up dramatically, college entry rates are up, and the benefits appear to be positive across all income levels and ethnic groups. No system is perfect, but this one is working out darn well. So why did it take the worst natural disaster in American history to bring it into existence?
No one needs reminding we’re facing another crisis, this time on a global scale. We fell behind in testing because the Center for Disease Control insisted on banning all tests but its own, which turned out not to work. Public health workers in Seattle had to wait for days before receiving federal approval to use their tests, eventually doing the right thing by ignoring the requirement.
As a result, the FDA started giving “emergency” approval to biotech companies’ test kits, which as it so happened were faster, more reliable, and cheaper than the government version. Shocking, I know. In fact, just a few days ago the FDA eliminated the approval process.
So why did it take an emergency to get the FDA out of the way? Faster testing saves lives, slower testing kills them. Why for all this time has it been OK for people to die while tests and potentially lifesaving treatments waited for FDA approval?
Here’s another example. Recognizing that health care workers need to get to where they are needed, Colorado’s governor Jared Polis has relaxed the licensing requirements for out-of-state health workers. Any nurse or doctor licensed in one state can immediately get permission to practice in Colorado. Massachusetts has enacted similar “emergency” measures. Good on us. It’s absolutely the right thing to do.
But why is freedom of cross-state movement for medical professionals only permitted in an emergency? If the rules protected the public when we were healthy, do they somehow not protect the public when we are sick? By what possible rationalization will these rules be restored once the corona pandemic is over? When the virus disappears, would the social benefits of cross-state licensure disappear as well? I’d suggest the answer is a resounding and obvious “no.”
Might I suggest another target of opportunity? Most states in the U.S. have “Certificate of Need” laws for hospital construction. Surprise surprise, existing hospitals work very hard to stop such certificates being issued, assuring the public that more competition in health care is “not in the public interest”. That’s anti-capitalist, cronyism at its worst.
China, believe it or not, built a hospital near the center of the virus epidemic in less than two weeks. I defy any state with a CON law to do that. My prediction? If a state with a CON law needs a hospital built fast, there will be an “emergency” streamlined approval process. But again, why wait for the emergency? The fastest way to get a certificate of need is to not require one. That’s what 14 states, including Colorado, already do.
The next few weeks are going to be tough. But a lot of good will come out of what we’re going through. We’ll see how people can help each other in a crisis.
We’ll get even more testimony to the power of science. We’ll get a vaccine; the anti-vaxers will run away with their tails between their legs.
And hopefully, some of the streamlined, pro-freedom “emergency” measures we’ve adopted will stick around. They’ll save more lives that way.
Barry Fagin writes frequently about politics, technology, and public policy, and has won national awards for teaching and political activism. Readers can contact Fagin at barry@faginfamily.net.
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