One-Dimensional Healthcare COVID-19 Policy

Policy is always curious in many ways and it tends to be quite economically illiterate too, likely by design. But what we have seen throughout this pandemic is the convergence of all political discourse around one single topic with one single measure of interest: health or rather deaths followed by so-called cases. What is curious about this is that other things matter too and they matter a lot but they have been all but excluded from the discussion. The pandemic and the fear that it has brought has completely done away with an immensely important concept – the trade-off – the balancing act between different valuable outcomes. This has allowed politicians the world over to use only one measure to guide policy and assess its success.

What this means of course is the facilitation of power and central planning. In the real world, we’re always experiencing trade-offs. For lunch, I can choose to have a hamburger, a pizza, or a salad but I cannot have all three. There’s no time for all three during my lunch break. I may not have money for all three and I certainly have no room in my stomach for three lunches. So I choose one but doing so means I lose the opportunity of choosing the other ones. The trade-off pinpoints a super important state of our being and the fact that everything comes at a cost. Economists call this the economic cost of choosing opportunity cost, the loss of other opportunities that can no longer be chosen. It applies to our everyday lives in every situation. You are reading this when you could be doing something else. That something else is lost because you choose to read this. Maybe you can do it later but only at the expense of the other things, you could do later instead.

It applies also to society and policy. Had society been about only one thing then it would be a much lesser problem but it would still be a problem. A corporation can have as its sole goal to maximize profits, which certainly helps in coordinating resources, efforts, employees, and so forth. But nothing exists in one dimension only. In real life, even the only goal of maximizing profits becomes a trade-off: maximize profits now or over time in the longer term. They’re not the same and they also are not compatible. You can maximize profits right now by using resources in a way that is crazy if you were maximizing profits over the course of the next 10 or 20 years.

That is the situation where there is one goal. Then imagine a society that has so many values that it in effect has no goals at all. We’re all part of society and we value different things and want different things. We enjoy and are better off from many different things. If someone else chooses for us with our best at heart then it means we are unlikely to get the best outcome because they don’t know the trade-off. They don’t know exactly how we value things because it is personal. Imagine that if someone else chooses for us without having our best at heart. That is the effect of focusing on one outcome only as has been the bitter fact in this pandemic. Virtually all decision-makers have focused exclusively on the novel coronavirus and how to limit its spread limit its effect and protect people from getting infected and dying from the virus.

Don’t get me wrong, those are noble goals and are valuable outcomes and they should certainly be part of the mix. The problem is that the focus has been solely on the virus. No other goals have been part of the discussion. This means lockdown and even letting the police and the military use brutal measures to enforce the quarantine. One obvious other value is our right to freedom to lead our own lives and be with our loved ones who have been sacrificed, sometimes to what it seems eagerly by many political leaders around the world.

One does not have to even leave the realm of public health to see the disaster that follows from ignoring the trade-off. Public health is not only about shielding the population from the coronavirus. It is so much more. Public health experts juggle many different measures of health and well-being but when they and the policymakers advise focusing only on the one virus our loss is that we do not pay attention to the other goals. Consequently, in many countries screenings for other types of disease including cancer and heart disease have been postponed or canceled. This means many of those people who are ill but are unaware or have only recently begun to experience symptoms will remain undiagnosed and therefore without treatment. Many of these conditions are so serious that a late diagnosis and postponed treatment might make it too late to save them. So they may die unnecessarily from their disease because they were advised, rather ill-advised, to not seek care, not see a doctor and not visit a hospital, or the hospital would not welcome them and doctors would not see them.

Similarly, by asking people to stay home policymakers and public health officials have created a mental health crisis. We are social animals and need contact with other people. There is a reason why solitary confinement is considered to be a form of psychological torture. It has very bad long-term consequences on people’s psychological well-being. This too is a loss from not considering more than one variable. We also know that people get on each other’s nerves when they are forced to remain in each other’s vicinity for too long. Lockdowns and curfews have had terrible effects on marriages and relationships and we have yet to see just how bad those effects are. Perhaps much sadder is how children have fared in this pandemic as they have been locked up together with their parents. Not only have they not been able to go to school, which means they have not learned much of anything, they have also not been stimulated, neither physically, intellectually, nor socially and they have been exposed to ever more frustrated parents whose health, both psychological and physical has deteriorated. We have, therefore, as sad as it was expected, seen a spike in cases of domestic violence and children are the ones hurting the most.

This is made even worse by the fact that lockdowns, curfews, and closings by political decree have killed many private businesses. They will not return. Others have barely stayed alive but only because they swiftly cut costs including employees. The unemployment caused by the lockdowns and other policies inspired by public health concerns focusing on only one variable has an enormous cost. Unemployment puts strain on government budgets but that is a relatively minor problem here. The greater problem is the impact on families who have no income, children who now live with depressed, perhaps alcoholic, and violent parents.

The economic problem is that those businesses that are now wiped out were part of the production structure that society depends on. You cannot pause a business. You cannot pause a supply chain. They go under. And they do not simply grow back at will. It takes a lot of effort, time, and resources. Many of them will be gone forever and with them the value they created and the jobs they provided. But while all of these issues are terrible, the greatest is that it was all in vain. The very reason for trying to stop the virus and limit its impact is what was sacrificed because public health officials and politicians did not do their jobs. The reason is that we want to live.

The point of stopping the virus was to try to protect people’s lives. But life is not simply a beating heart. It is so much more. To live is not simply to breathe but to be alive well beyond the medical definition. Life is about experiences, interacting with people, learning, and seeing new things, it is about love and friendship, and laughs but also about intellectual stimulation and experiences. It is to find oneself and flourish in one’s sense of the word and by one’s means. Life is about taking risks and avoiding them when need be. It is about the freedom to be whoever you want to be. What is so sad is that what is precious about life is everything that was lost when the authorities focused on only one variable: the virus the tragic deaths it caused and the infections that ravaged populations.

Everything we do is a trade-off which means the choice to do one thing means all other things are lost. In politics, the stakes are always much higher because the choices are not only for one person but for everyone. When we focus on only one thing and to such a degree that nothing else is even considered then we lose everything else. Ironically we lost, sacrificed even, all that matters about life because not one of those things that make life worth living mattered to the officials in their hell-bent quest on saving lives.

To be perfectly clear this does not mean that nothing should have been done. Doing nothing is not the lesson to learn here. On the contrary, the lesson is exactly the opposite: that something should indeed have been done, that the pandemic should have been addressed, that measures should have been taken, but not at any cost. Every decision has a trade-off. The real cost should have been considered in each and every decision made but it was not. This was an utter failure and it was entirely unnecessary.