Ebola Is Not a Reason for Increased Centralized Power

The spread of the disease might be halted by increased centralized power, but it also might be spread faster.

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The assumptions in this USA Today story are rather obvious:

As Thomas Eric Duncan’s family mourns the USA’s first Ebola death in Dallas, one question reverberates over a series of apparent missteps in the case: Who is in charge of the response to Ebola?

The answer seems to be — there really isn’t one person or agency. There is not a single national response.


“One of the things we have to understand is the federal, state and local public health relationships,” says Michael Osterholm, director of the Center for Infectious Disease Research and Policy at the University of Minnesota. “Public health is inherently a state issue. The state really is in charge of public health at the state and local level. It’s a constitutional issue. The CDC can’t just walk in on these cases. They have to be invited in.

How refreshing! But the implicit criticism continues:

Murphy says some of the issues in Texas stem from a “system problem” in the way public health care is managed in the USA. The Centers for Disease Control provides only guidance for infection prevention and management. “What they do in Texas, what they do in Illinois, it’s up to the state,” he says.

“The question is, who’s in charge?” Murphy says. “The states can follow all the guidelines and take the advice, which they usually do, but they don’t have to. It’s not a legal requirement. So there really is no one entity that’s controlling things.

First of all, is the CDC always right? Have they never made mistakes or errors? If we all had some kind of centralized control that would be great as long as the central authority never made a mistake. But if it did make a mistake, then the nation would be worse off.

[See also, “Private, For-Profit Company Fighting Ebola Successfully.”]

The fact is that the CDC hasn’t dealt with Ebola before and it is learning from the mistakes made in Texas just like all the states are doing. We have medical experts all over the country; not just in the CDC. How do we know that one group should be “put in charge” of all the rest? Putting all the authority to make decisions in the hands of a relatively small group of people for the entire nation would suffocate the learning process.

Furthermore, no one wants to die in a plague. People are already plenty motivated to follow the CDC’s guidelines. What would make a centralized system more prone to do the right thing?

Federalism has more to offer than what the writer of this story seems to think.