Life, death and politics

November 7, 2022

There are things the federal government can directly control, through laws or policies. The price of gas or groceries aren’t among them. So I don’t understand how inflation has become the top issue in the midterm campaign, especially since neither party has put forward specific and credible ideas for how Washington can fix a global economic phenomenon.

There are issues on voters’ minds that government can directly control, most prominently abortion rights, tax rates, election policies and government spending. But I’m struck by the near-total absence from the campaign of two issues that are basic government responsibilities: making war and protecting public health. America has seen historic failures in both these areas since the last election, but nobody seems to want to talk about them.

The first is Afghanistan. Since the last election, America lost its longest war. The retreat, negotiated by a Republican president and executed by a Democrat, marked a sorry end to the “Global War on Terror” that was launched as the smoke rose over the ruins of the World Trade Center. A comprehensive Brown University study pegged the cost of that war at $8 trillion and 900,000 lives.

For a few weeks after Kabul fell, there was media coverage of whatnwas invariably called a “chaotic withdrawal,” the reporting focused on the “optics” of desperate Afghans trying to escape the advancing Taliban. The final exit, though scheduled,  was ugly, mostly because the Taliban advanced, and the Afghan government collapsed, more quickly than the Pentagon expected. But poor intelligence and unreliable allies have been the hallmarks of this 20-year misadventure.

Biden’s approval ratings took an undeserved hit, as mainstream media obsessed on the final month of the war and ignored everything that preceded it. Then everyone just dropped the subject, as if there are no lessons to be learned from the defeat, no accountability expected for its authors. Losing a war ought to have consequences, or at least prompt serious consideration by the body politic, but the body politic doesn’t seem interested.

The second government failure is the response to Covid 19. For all the numbers cited in American media’s extensive coverage of the pandemic, some stark facts have gone nearly unreported. First, more Americans have died from Covid – 1,072,594 and counting – than residents of any other nation. Second, the rate of Covid mortality is higher in the U.S. (3,170 deaths per million population), than in 199 countries. Our death rate is higher than Egypt (223 deaths), New Zealand (408), Taiwan (552), Canada (1,220), Israel (1,245), South Africa (1,709), Germany (1,853), Mexico (2,591) and Italy (3,039).

The U.S. has the most expensive health care in the world. We had vaccines, in plentiful supply, earlier than almost any other country. So why did we do such a lousy job of keeping Americans from dying?  

That’s a question academics, historians and health statisticians will be examining for years to come, and they will have mountains of data to work with. Covid response was an experiment played out in real time; it shouldn’t be hard to determined what policies worked and what ones didn’t, at least in terms of the most basic goal of reducing mortality.  I suspect one thing we’ll find is that, unlike other developed countries, public health responsibility in the U.S. is confused and dispersed. The Surgeon General wears a uniform and the CDC gives advice, neither wields much authority. Decisions about lockdowns, quarantines, mask-wearing and vaccines are made by governors, city boards of health, school committees and employers.   

Mortality data can indicate how well state and local decision-makers managed the pandemic, and which policies worked. Mississippi, for instance, had a mortality rate of 436 deaths per 100,000 population, which is more than twice as high as Oregon’s rate, as of Oct. 24, 2022. You’d think that scorecard would have some impact on state politics. I live in Vermont, which is tied with Hawaii for the lowest mortality rate, 121 deaths per 100,000 population, which is the main reason I voted to re-elect Gov. Phil Scott, a moderate Republican. But pandemic response hasn’t been a hot topic on the campaign trail, except for a few governors bragging about how they didn’t close down businesses to prevent its spread. Florida’s mortality rate of 384 doesn’t seem like anything to brag about, but is anyone holding Ron DeSantis accountable for that dismal record?

It's not just diffused authority and inconsistent messaging that are behind America’s Covid failure. It’s that we made the deadliest global pandemic since the black plague a political football. A new study of county-level mortality in Ohio and Florida found substantially higher excess death rates in Republican-leaning counties than in Democrat-leaning ones, largely because Republicans turned against vaccines.

This is where politics becomes a matter of life or death. You’d think it’s something people would want to talk about in a political campaign. But politics is a strange business. It seems some political questions – the loss of thousands of lives and trillions of dollars on a misguided war, or the death of millions in a botched pandemic response – are too serious to even talk about.