Needed: a post-Frieden CDC

cdc_ebola2x

Bloomberg’s nanny-in-chief was never the right choice to lead the Centers for Disease Control, much less with an actual epidemic in sight, argues the New York Sun:

…it was the former mayor of New York City who gave the nation Thomas Frieden, who is one dangerous doctor and is the middle of the catastrophe. … Because of the government’s blunders in the Ebola emergency, people are starting to look a harder look at Bloombergism.

… the CDC budget has soared more than 200% since 2000 to $7 billion. The Centers, moreover, are squandering this lucre (which was seized from the American public via taxes) on regulating motorcycle helmets, video games, and playground equipment, as if any of that has anything to do with diseases. No wonder that when Ebola hits, the CDC seems to be staggering….

Mr. Bloomberg is enormously invested in this through the school of public health at Johns Hopkins. Do Americans want a cabal of left-wing, government doctors in Atlanta engineering our playgrounds, motorcycle helmets, and video games? No one plays a video game or rides a motorcycle for his health….

It is important that the Ebola emergency is starting to get people thinking about the first principles of the Centers for Disease Control.

Read the whole thing. Related: Heather Mac Donald and Steve Malanga, City Journal; Jacob Sullum.

While we’re at it: I’ve got a new post at Cato about the international aspects, including the U.N.’s World Health Organization and Prof. Lawrence Gostin’s article “Healthy Living Needs Global Governance.”

20 Comments

  • Yeah, how dare the CDC director work on reducing the leading causes of death in America, heart disease, cancer, and accidents, instead of preparing for a difficult to transmit virus that has never gone epidemic in a developed nation? Personally, I would like the CDC to devote is resources to how scary something is rather than how deadly it is.

  • It’s a case study: the larger the government becomes, the worse it gets at fulfilling its core functions. And the CDC is set to grow even more ineffective. I read recently that here in Atlanta, the DOT is beginning to study installing a light rail line through the CDC/Emory U. corridor to accomodate a planned major expansion of the CDC campus, with an expected growth in CDC headcount of approximately 30%. But hey, when you’ve expanded your mandate to policing darn near every aspect of everday life, you can never have too many employees, amirite?

  • Well, OK, Dr. Frieden deserves to be dumped, but replacing him with another physician-nannycrat will only give the illusion of change. That’s what happened when Eric Shinseki was fired a few months ago as Secretary for Veterans Affairs after the VA scandal. The leaders get switched, but nothing really changes – the bureaucracies just keep on rolling along, with few or no actual improvements. The army will never rise above its general, who, in this case, lives in the White House.

  • James, the six items listed in the cartoon are all matters of personal choice where the government can’t really do much that’s effective without encroaching on people’s liberty. And that’s even assuming their efforts don’t have unintended consequences. While bicycle helmets enhance safety in certain types of accidents, bicycle helmet laws discourage so many from riding at all that their impact may actually be making health worse.

  • James,

    What part of Centers for Disease Control do you and the people currently in charge not understand?

    The CDC was created to control contagious diseases, and they should stick to that mission.

    Does that mean that the government should ignore major causes of death such as heart disease and cancer? Not at all, but that is what the NIH (National Institutes of Health) and HHS (Health and Human Services) are for.

    The only thing the CDC accomplishes by sticking its nose into other agencies’ business is creating wasteful duplication of effort.

  • PS

    Accidents likely belong to TSA and or DOT

  • Congress long ago expanded the CDC’s original narrow focus well beyond communicable diseases, which is why it is called the Centers for Disease Control and Prevention instead of the Communicable Diseases Center. For instance, 42 USC 280b et seq. requires the CDC to support research into the “causes, mechanisms, prevention, diagnosis, treatment of injuries, and rehabilitation from injuries.”

    Reasonable people can disagree about whether that’s a good idea, but the CDC’s attention to matters other than communicable diseases has more to do with Congress than the director. It also happens to coincide with the things that are actually killing Americans, which doesn’t really seem like a bad idea to me.

  • James, if I choose to drink an extra glass of wine, knowing it might not be the best thing for my health, that is my choice. I am not livestock, I am a free man, and my decisions harm no one else.

    If I am infected with Ebola, that changes. I can be forcibly quarantined if necessary, not for my benefit, but to prevent the spread of infection to others.

    See the diff? I suspect you do, and always have, but your tribalism outweighs your judgment.

    Said tribalism is, like my glass of wine, a choice that you can freely make, however mistaken. So let us each enjoy our own: I will sip Cab Sauv with my beloved this eve while you put on your bike helmet and a CDC-approved aerobics video, all in perfectly sterile isolation, safe at last. Salud!

  • “It also happens to coincide with the things that are actually killing Americans, which doesn’t really seem like a bad idea to me.”

    Bike helmets are killing Americans? And lack of sleep? School lunches? Sexual assault? The CDC has spent time and rescoures on all of these.

    If your response is to say, well, those DO cause deaths and injuries, I’d ask, where is the CDC’s task force on shark attacks? Bungee jumping accidents? Kitchen knife accidents? Train derailments?

    The point is of course that the it’s the CDC, not Congress, that decides exactly where to place its focus.

  • While we’re at it: I’ve got a new post at Cato about the international aspects, including the U.N.’s World Health Organization and Prof. Lawrence Gostin’s article “Healthy Living Needs Global Governance.”

  • And the CDC stops you from drinking your wine how? The CDC doesn’t regulate anything. It conducts research. Should it not research heart disease and let us know that drinking alcohol is a significant contributor?

    I’m opposed to paternalistic regulations, such as Bloomberg’s absurd large soda ban, but that’s just not what the CDC does. It researches the diseases that Congress tells it to, diseases that happen to kill large numbers of Americans. If that causes the CDC to be marginally less prepared to handle a rare and hard to transmit virus, I’m okay with that.

  • “The point is of course that the it’s the CDC, not Congress, that decides exactly where to place its focus.”

    While the CDC decides which individual studies take place, Congress exercises considerable control. For instance, the CDC researched sexual assault because 42 USC 280b-4 requires it to research “sexual and domestic violence by and against adults, youth, and children.”

    If you think the CDC has been given too much discretion, the answer is to give it less. If you think its mission is too broad, the answer is for Congress to narrow it.

  • James,

    If I said to you that “a rolling stone gathers no moss,” what would you think I meant?

  • On a more fundamental level, the way money is appropriated to the CDC makes it effectively impossible for the director to divert resources from communicable disease research to other research. For instance, the 2014 appropriations bill gives a certain amount to “emerging and zoonotic infectious diseases,” another amount to “chronic disease prevention and health promotion,” another to “injury prevention and control,” another to “public health preparedness and response,” and so on. The party ultimately responsible for setting the overall relative priorities is Congress.

  • What I find unusual is that Thomas Frieden, MD gave up his NYS medical registration, and I do not believe he is registered to practice medicine anywhere:
    http://www.nysed.gov/coms/op001/opsc2a?profcd=60&plicno=173139&namechk=FRI

    Verification Searches

    The information furnished at this web site is from the Office of Professions’ official database and is updated daily, Monday through Friday. The Office of Professions considers this information to be a secure, primary source for license verification.
    License Information *

    10/24/2014

    Name : FRIEDEN THOMAS R
    Address : NEW YORK NY
    Profession : MEDICINE
    License No: 173139
    Date of Licensure : 12/02/87
    Additional Qualification :
    Status : NOT REGISTERED
    Registered through last day of :
    Medical School: COLUMBIA UNIVERSITY Degree Date : 05/14/1986

  • ras,

    I would think you probably meant that someone who does not settle one place is unproductive. And I’d wonder what that has to do with the CDC. As a large organization, the CDC is perfectly capable of handling both infectious diseases and other kinds as well. The National Center for Emerging and Zoonotic Infectious Diseases (one of the CDC’s centers) is focused entirely on diseases like ebola.

  • […] (H/T: Overlawyered) […]

  • While not an American citizen I cannot help feeling that t the CDC and health authorities in the US seem to have been caught out just a little by introduction of Ebola into the CONUS. As others have noted here, as the CDC’s remit has grown it seems less able to focus on threats inherent in this communicable disease, this symptom is of course common to most expanding governmental bureaucracies. It is not a good trend when having to assess and deal with dangerous diseases. Perhaps the dedicated staff of the CDC would be better just dealing with what they used to do, instead of being asked to assess the judgements and decisions of individuals social behaviour.

  • Although I agree with the sentiments of the posting, that the CDC is not the right place to study many of these issues, I have to agree with James that the problem with with the Congress, and not with the CDC. As a former federal bureaucrat, I learned about how money from Congress comes in all sorts of “colors” – red and green and yellow, etc, and each color is designated, BY LAW, for only a particular usage. So, the Congress decided to put money into these studies, probably to reward some group of supporters or a local university for a particular congressman.

    And it is not easy to “re-program” (technical federal budget term) “green” money to spend on “yellow” issues. It only gets done occasionally (maybe only onces, in fact) during a year, only with permission from the Congress, and only if the agency can make a showing that it REALLY needs to do this. If they don’t spend the money, normally it goes back to the Treasury, which is why you see massive spending activities in September.

    Our political system was set up to make it hard to get anything done, so the politicians have developed this system of mutual fiscal backscratching where everyone gets to reward their favorite supporters, and since we are such a rich country no one gets hurt or angry.

    The issue is the activists and their publicists, who make the politicians look cruel if they don’t support the activist causes. And with our First amendment, nothing can be done about it. And I am not advocating that anything SHOULD be done about it. It is like gravity – it is there – deal with it. Probably the only way to suppress it would be to have every line item appropriation tagged with the name of the congressman who sponsored it, but that will never happen, either.

  • Walter, I would be interested to know where you sit on the issue of this nurse. I’m not a liberal non-libertarian. So I’m more than happy with Governor Christie decision to put her in isolation as long as there are tons of safeguards in place to make sure she is treated like a queen while in isolation. The conservatives agree with me. Liberals, on the other hand, seem to be applauding all of her bike rides and everything else she does to thumb her nose at the restrictions that have been suggested.

    My feeling is we can temporarily take away her liberty to make sure she does not infect the rest of us even thought the science is weak that she poses any real risk. Where do you stand on this?