The sheer weight of executive branch incompetence, that has led to an entirely uncontained pandemic in the United States, borders on the incomprehensible. Yet, here we are. The question is whether the federal government has meaningful tools available to turn a terrible situation into one that is meaningfully less terrible.
The good news is that many useful ideas exist. Here is a partial list of ideas to help inform the policy conversation as we move forward.
Facilitating Our Medical Capacity
A. Inject immediate economic stimulus to develop the expansion of physical space dedicated to urgent medical care. That includes both the conversion of appropriate spaces as well as, where applicable, adding tents, trailers, and other temporary adjuncts.
Given the need for both stimulus and to save lives, cost should be no object.
B. Inject immediate economic stimulus to increase the number of people with the skills to provide urgent medical care. As much as possible, we need to supplement the number of people who can take relatively simple responsibilities off the overworked shoulders of nurses, medical technicians, and doctors.
We also must supercharge funding for training efforts across the country, including accelerating nursing and medical programs, as well as bringing retired medical professionals back into the mix.
Given the need for both stimulus and to save lives, cost should be no object.
C. Immediate action to ratchet up domestic production of scarce medical equipment at every step necessary — from respirator masks, to ventilators and reagents, to beds. Everything we need to increase the ability to generate new ICU beds domestically needs to be undertaken immediately.
America should not be wholly dependent on overseas sources for these products. Nonetheless, as better prepared countries like Taiwan, China, and South Korea stabilize their populations, we should also import needed materials as fast as possible.
Given the need for both stimulus and to save lives, cost should be no object.
Stimulus that Facilitates Government Serving Its Necessary Role
A. General aid to state and local governments: One of the signature failings of the federal response to the Great Recession was vastly inadequate aid to state and local governments, largely due to ideological extremism by Republicans. This is one reason that many state and local governments were forced to make cutbacks to their public health departments in the last decade. The federal government ought to award states and localities 10 percent of their fiscal year 2020 budget before October 1st, with no strings attached.
Ten percent of the most recent budget reflects a floor, rather than a ceiling, of needed support. Minimizing austerity at the state and local level by filling late-breaking gaps will be necessary as tax revenue collapses (e.g., there is widespread state and local government reliance on sales taxes).
B. Child care concerns for doctors, and especially less well-paid critical medical staff (nurses, technicians, aides, cleaners, custodians, etc.) is definitely causing dangerous and needless stress for public health officials. Immediate funding for efforts so that medical workers and other first responders can focus on saving lives rather than worrying about how their kids will be cared for seems urgently needed. That’s a big reason some public health experts have been surprisingly open to keeping schools open, or are at least conflicted by their recommendations to suspend schools. And that’s despite schools being a real worry, as frequently asymptomatic children cross-pollinating across otherwise quarantined families is dangerous!
The need for child care also may extend to other essential jobs, including sanitation and the people who keep municipal water flowing, the power grid functioning, etc. We need lights on, water flowing, and the internet flowing to generate maximum social distance compliance. We need to keep the people who do those jobs available to work overtime in order to maximize social distancing and minimize death.
C. We should also look to train and hire tens of thousands of new health care workers to do superficially mundane tasks, like taking patients’ temperatures, blood pressure, changing bedding, and cleaning surfaces. Within 2-3 weeks, we can train additional people to perform the already critical role of keeping hospitals disinfected of not only coronavirus, but nasty bacteria.
Adding to the people trained to do this work can free up time for nurses and other highly trained health care professionals to deal with tasks that require more skill.
D. The federal government can directly fund mechanisms to get municipal workers to deliver groceries in lieu of school lunches, as well as the women, infants and children (WIC) food programs. We want fewer people shopping or congregating at food centers. Municipalities generally have access to municipal vehicles. Federal funding of both the costs of food and municipal distribution would keep people fed for those who are isolated but lack the means to purchase from the food delivery apps the upper middle-class takes for granted.
E. Fund the scaling up of tele-education to public school systems, including potentially getting technology, like simple laptops or Chromebooks, to children already identified as eligible to receive reduced-price or free meals at school.
Extensive evidence indicates that lengthy time without formal school tends to exacerbate gaps in academic achievement by socioeconomic status. Thus schools likely will need funding to add additional days to their summer and other breaks to catch-up on school time that was missed and/or less effective (sporadic tele-education) so at risk kids do not fall behind needlessly.
F. Funding to all state and local efforts to provide additional funding for the homeless, which suffers from eternal underfunding. The need for housing for the homeless and assistance for strapped low-income renters and homeowners has never been greater than during a devastating pandemic.
G. Provide mortgage and rent assistance to families with members unable to work for reasons associated with the coronavirus pandemic. Halt all evictions during the pandemic, including evictions in process. ) Fund a substantial match to all state and local public health systems’ typical annual budget by 50 percent, as a solid starting point. It’s better to get money to people with an eye toward figuring out how to save lives than create a time consuming process of specific requests for aid from the federal government or private charity.
As this crisis is revealing, decades of austerity has weakened public health departments. Greater federal funding for public health is not only required after an emergency will pay humanitarian dividends down the line.
Even Donald Trump recognizes it.
H. Immediately suspend work requirements in TANF and SNAP (food stamps), including the restriction implemented in the middle of the pandemic by the Trump administration on states’ ability to waive SNAP restrictions on eligibility for unemployed and underemployed adults not caring for children. Provide a temporary cash benefit on top of SNAP for households receiving SNAP. Suspend measures like the expansive “public charge” rule recently adopted by the Trump administration that make immigrant families, including U.S. citizens in these families, wary of using public assistance that they are eligible to receive.
Guarantee that ICE will not raid medical facilities to deport undocumented immigrants. It is important to everyone that we are all able to get medical help.
I. Provide a well-staffed hotline to answer questions about what public benefits are entitled to during the pandemic. This will vary by state, depending on what benefits the state provides, in addition to temporary benefits that Congress seems likely to legislate.
J. Unemployment benefits should be substantially enhanced above normal levels, for example a 40 to 50 percent increase. This will ensure that workers can maintain their standards of living and aren’t forced to look for new housing in the middle of this crisis. In addition, eligibility for unemployment benefits should be extended to contract and “gig” workers. This system could rely on 1099 forms to verify a person’s earnings in prior quarters. Such workers should be able to go to an unemployment insurance office, show their 1099 forms as proof of their prior income and then sign an affidavit that they no longer have work available to them.
Investments that Facilitate Social Distancing
A. Make paid sick leave expansion both real (scathing NYT editorial here) and permanent. A minimum number of paid sick days should be no less than 80 hours for full-time workers, pro-rated hours for part-time, and should be a federally-mandated employment standard, similar to minimum wage.
A social insurance scheme should provide an inclusive paid family and medical leave program with adequate wage replacement rates (possibly progressive), a modern definition of family and family-like relationships, and with a guaranteed right of return to an old job or similar job protection. That ensures the system is usable by single moms, communities of color, disabled people, LGBTQ individuals, and others. It also needs to be made permanent so that we minimize both future pandemics and even the “run-of-the-mill flu” which kills thousands annually.
B. Distribute $1,000 to every adult and child residing in our borders.
C. Inject massive investment into a public option for internet access. Effective pandemic response basically presupposes good access, and it’s a good excuse to level-up inequities. The fact that many children across the country lack solid internet access makes the idea of remote teaching a bit cruel.
D. All levels of government should begin developing Green New Deal-style plans for public works and infrastructure maintenance now. Wide-scale construction efforts may or may not be consistent with maximizing social distancing, but the economy will be slow to rebound even after the pandemic’s direct effects lessen. That’s why planning and engineering efforts that can take place via telework now will be a good down payment on additional stimulus spending this fall or winter.
Avoid Bailout for Highly-Concentrated Industries that Could Have Taken Out Insurance Policies
If the current cruise ship industry couldn’t foresee health issues, given its history, its shareholders deserve to be cleaned out on their investment. Bankruptcy law exists for a reason — a bankrupt cruise industry does not mean additional unemployed cruise ship workers, it means they will be working for new owners who, in theory, have the foresight to buy insurance that includes pandemics.
The same applies to other massive businesses. If airlines go bankrupt, the retirement benefits of tens or maybe hundreds of thousands of workers could be damaged through no fault of their own. It is not a worker’s job to make decisions on insurance! We recommend ensuring a prepackaged bankruptcy policy that protects these benefits, which are often the lowest priority under bankruptcy law, as was done with the auto industry. Some federal money as an inducement might be necessary, but that’s significantly less money than if shareholders were to be made whole for investing in imprudent management.
Never a Bad Time to Reduce Corporate Welfare
It is nuts that governments are not cooperating with open research into a vaccine and treatments and placing all findings immediately in the public domain. Doing this in competition, when so many lives are at stake, is very backward policy. Federal funding should be contingent on all results being posted as quickly as possible, so that researchers throughout the world can benefit from them. Any vaccine that is developed will then be in the public domain and sold as a cheap generic from the day one.
Good Governance
Congress should use spending needs as a tool to ensure oversight of not only that spending but overall pandemic response. As the Revolving Door Project’s Eleanor Eagan and Jeff Hauser argued in The Daily Beast last week:
“Even after the administration chose to acknowledge that there was a problem, the response has been pitifully slow and weak. While other countries have successfully tested hundreds of thousands of people for the disease, the U.S. has tested a few thousand. Without widespread testing, we can’t know how it’s spreading or how fatal it is.
“Congress has failed to force this information into the public eye. Sure, lawmakers sent letters, but they did not use their real power—the power of the purse—to force compliance. Emergency funding could have been contingent on assurances of greater transparency. Instead, House Democrats helped hand the administration a win without concessions that would have ensured they weren’t just throwing good money after bad.”
In short, to do the oversight necessary to align the administration’s practices with the broad public interest, Congress needs to have the inside scoop on what the government is doing.