Compromise before or after the election
In a discussion of the two-party system, Lee Drutman told Bob Zadek that politics is about building coalitions and making tradeoffs, and that nobody gets everything they want. The real difference between a multi-party and a two-party system, he argued, is when those coalitions and compromises form: before the election in the two-party case, or after the election in a multi-party system with coalition government. Drutman said it is much better for them to form after the election, because otherwise voters cannot send clear signals about what they want most and have to make an awful lot of tradeoffs before the election. In a multi-party system, by contrast, parties can point to how much support a set of positions has and then bargain on that basis. He added that the two-party system makes compromise and coalition building harder by making them part of pre-election campaigns, locking both sides in and turning them against each other Breaking the Two-Party Doom Loop (2020).
The value of a life
Bob Zadek opened an episode with a direct quotation from Andrew Cuomo, then Governor of New York: “You can’t ask the people to choose between lives lost and dollars gained.” Zadek asked Alex Tabarrok how government makes the decision between economics and health, and whether it is being made for the public rather than by it FDA (2020).
Tabarrok, an economist, said economists are often criticized for trying to estimate the value of life and put a dollar value on it, and that the number often used is about $7 to $9 million. He said that figure is what economists think is pretty good when government decides how much to spend on highways or other safety improvements, and that because the value of life is so high, a lockdown was probably a pretty good idea at that moment. Zadek drew the conclusion that government does, and probably has to, assign a value to human life, because without one it is impossible to decide how much economic loss to accept in exchange for lives; he called the objection “How can you assign a value to human life?” naive. Tabarrok agreed that rational choices cannot be made without tradeoffs, and said the alternative to pricing life explicitly is to close one’s eyes, pretend the tradeoffs do not exist, and make some judgment implicitly — deciding how many ventilators to buy, how large the medical care system should be, how many fire trucks and ambulances are needed and how close the fire department has to be FDA (2020).
In the same episode, Tabarrok said that any country with a national healthcare system imposes limits on what it will buy, and that free medical care would produce infinite demand. He described government as good at a clampdown decision — one decision everyone must follow — but not good at making subtle tradeoffs, which individuals are better at; young people, he said, would find it much safer to return to work than older people would. Zadek observed that even under what was called a total lockdown, large parts of the economy continued to function, and that the “essential” versus “inessential” distinction was a false dichotomy left to local administrators and states FDA (2020).
Tradeoffs are everywhere
Ryan Young told Zadek that the first thing taught in economics is that tradeoffs are everywhere, and that what was being seen during the pandemic was not exactly a strict tradeoff between the economy and health, since a little of both is possible. He described the “Never Needed” campaign at CEI, where he works, highlighting rules government got rid of during the crisis that did no good, including regulatory bans against telemedicine that were removed early after COVID hit. Young said that at state, local and federal levels about 850 such regulations had been eliminated, including permit regulations for restaurants and rules against remote learning for schools, and that occupational licenses required for nearly a third of all American workers were eroding, perhaps permanently. He noted that there are 1.1 million regulatory restrictions in the Code of Federal Regulations, with state and local rules on top of that Reversing the Ratchet (2020).
Public health officials and practicing clinicians
A practicing physician, Jeffrey Singer, described a structural difference between public health officials and clinicians. Recommendations from public health officials, he said, do not take tradeoffs into consideration because those officials are in a narrow silo whose mission is to advise on controlling or eradicating a particular public health threat — and, Singer conceded, that is their job. Clinicians, by contrast, deal with patients every day and help them make decisions, and every decision involves weighing risks and benefits for that particular patient. Singer said the clinicians’ mindset is much more tuned to the tradeoff involved, and that many practicing doctors find the recommendations passed down from public health officials unworkable or too broad a brush but feel pressure not to deviate openly, partly because of malpractice risk Vaccines & the Totalitarian Principle (2021).
Singer also described the Great Barrington Declaration, authored in October 2020 by Jay Bhattacharya of Stanford Medical School, Martin Kulldorff, then at Harvard Medical School, and Sunetra Gupta of Oxford University’s Center for Evidence-Based Medicine, and signed by thousands of medical scientists. The declaration, he said, argued that with more known about the virus, efforts should focus on protecting the most vulnerable — people with certain immunodeficiencies and elderly people in nursing homes — while the least vulnerable, for whom the virus is relatively harmless, resume as normal a life as possible. Singer framed the declaration as an argument that public health policy must take tradeoffs into account, including mental health and the socioeconomic determinants of health, not only control of a virus. He said the authors were attacked in the mainstream press rather than in the scientific literature, and that Freedom of Information Act requests later showed Francis Collins, then director of NIH, emailing that there had to be a rapid takedown of these fringe scientists questioning policy, with a reply that people were already about to write pieces Free Speech & the Scientific Method (2022).
Across episodes: the same question, different arenas
The excerpts show the tradeoff question argued in more than one episode, with the treatment shifting by arena rather than by position. In February 2020, before the pandemic episodes, Lee Drutman located tradeoffs in electoral design, arguing that the two-party system forces voters to make them before the election instead of after Breaking the Two-Party Doom Loop (2020). In April 2020, Alex Tabarrok and Bob Zadek located them in the pricing of life and in the bluntness of government clampdowns FDA (2020). In August 2020, Ryan Young counted deregulation as evidence that some tradeoffs were false ones Reversing the Ratchet (2020). In April 2021 and April 2022, Jeffrey Singer located them in the gap between public health officials and clinicians, and in the Great Barrington Declaration’s argument for focused protection Vaccines & the Totalitarian Principle (2021) Free Speech & the Scientific Method (2022). The later episodes do not revise the earlier claim that tradeoffs are unavoidable; they apply it to a new set of decision-makers.
What the sources do not cover
The excerpts do not state how any of the named cases, statutes or bills were resolved, nor do they give the legal holdings or constitutional provisions behind the policies discussed. They do not supply the full text of the Great Barrington Declaration, the identity of the Nobel laureate Singer mentions, or the outcome of the Freedom of Information Act requests beyond the emails he quotes. The excerpts also break off mid-thought in places — Zadek’s monologue on mandates, Young’s sentence on the regulatory state, and the section break after Singer’s account of guidance becoming mandates — and nothing beyond those points is reported here.