Health or the economy? A dangerous dichotomy

Charity Tyne // 13 August 2020

During the first of two briefings on Covid-19 in his state, New York governor Andrew Cuomo stated: “If it is public health or the economy, the only choice possible is public health.” This division has created a false dichotomy. Governors promised that if enough economic output were sacrificed, more people would survive. But positing these two variables in opposition to one another, as if there were a straightforward trade-off, is erroneous.

Some of the deaths that have occurred during the Covid-19 crisis were caused by economic factors (in the broadest sense) rather than the virus. Some have died because of a lack of medical resources or a prohibition of “optional” surgeries”. Others represent “deaths of despair”, a phenomenon that was also observed after the 2008 recession, and which includes suicides and the effects of spikes in substance abuse. These specific causes increase drastically as a result of economic hardship and are exacerbated by forced isolation and uncertainty.

A study conducted by the review Social Science & Medicine revealed that, for every 1% increase in unemployment, there is a 3.3% increase in reported deaths from drug overdose. Based on data from 2008, analysts estimate that in the United States, there will be 96,273 additional deaths for these reasons between 2020 and 2029, assuming that there is only a 1% increase in unemployment. The statistics show that, by and large, prosperity leads to better health, and a reduction in prosperity leads to worse health. While the initial shutdown of the economy in response to the virus may well have been a net life saver, balancing the costs and the benefits has become more complex since then.

Prosperity improves health

Currently in the United States, during the enforced lockdown, amidst incidents of police brutality, controversial Supreme Court rulings and polarising electoral campaigns, the majority of arguments and/or legislative actions were focused on the “wellbeing of society”. These situations exacerbate tension, which politicians exploit by dividing issues into “good” and “bad”, or dividing people into “us” versus “them”, appealing to people’s innate sense of justice. The Dutch political scientist Cas Mudde described this mentality as populist, defining it as an “ideology that considers society to be ultimately divided into two homogeneous and antagonistic groups: the pure people and the corrupted elite.” Complex issues, such as a double public health and economic crisis, provide the perfect terrain for populism: workers begging the government to reopen the economy are stigmatized as cruel and selfish people who hate the elderly. The media have often stigmatised those who “rebel” demanding haircuts and other non-essential services, instead of delving into the arguments of those who ask to go back to work. This dichotomy of “us versus them” provides a quick and convenient solution and encourages a fight for “justice” instead of a thorough analysis of the situation. In a few years, we may well see that tens of thousands have suffered more from the severe economic breakdown and have died of desperation (drug overdose, suicide, and others) following the rise in unemployment.

Friedrich A. Hayek wrote: “emergencies have always been the pretext under which the guarantees of individual freedom have been eroded.” Most have embraced Governor Cuomo’s narrative of “one or the other”, driven by the emotional image of someone accidentally killing their own grandmother which places an enormous responsibility on the individual. Never has the younger generation experienced a pandemic of this magnitude, and in the face of such pain and uncertainty, it is natural to look for solutions that seem fair. However, the populist dichotomy has engendered great disdain towards those who “choose the economy over people”. Ironically, it was this sentiment that led Governor Cuomo to opt for empty hospital beds at the expense of lives he had sworn to protect. Presenting black and white solutions for complex problems is dangerous: the media’s opposition to reopening the economy is based on previous information, but a deeper understanding of both crises (health and economic) is now necessary to make informed decisions. The growing number of deaths of despair has revealed the frightening truth that many lives will be lost anyway.

We cannot allow the memory of this crisis to fade away without establishing principles for the future, so that when the next crisis arises, governments do not repeat the same mistakes. As we heal and begin to move forward, we must move beyond the populist dichotomies that have negatively influenced our societies, and hold leaders such as Cuomo accountable for the hypocritical and prejudicial actions they have taken. Hayek’s warning does not recommend us to choose the “right side” of the dilemma but to remain vigilant and informed as the availability of health resources and economic stability continue to have health impacts. In light of these precedents, we must be attentive to protect individual freedoms, reject false dichotomies and panic reactions, and substitute them for more comprehensive policies.

The original article was published by Civismo and the translation was written by Ombeline Lemarchal.

EPICENTER publications and contributions from our member think tanks are designed to promote the discussion of economic issues and the role of markets in solving economic and social problems. As with all EPICENTER publications, the views expressed here are those of the author and not EPICENTER or its member think tanks (which have no corporate view).


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