8. Invest more in pandemic preparation. By now it should be obvious how critical this is. It’s fine to say “Obama is already working on this issue” but the fiscal constraint apparently binds and at the margin this should get more attention than jerry rigging all the subsidies and mandates and the like.
I say think probabilistically…A one percent chance of one hundred million deaths is, in expected value terms, one million deaths and that is a big deal. Probably the United States is less vulnerable than it was in 1918, but how many people would die in China, India and many other locales? How much disruption to trade, travel, and the world economy would take place? Even in the United States, our public health systems would break down quickly and render many modern medical advances useless (e.g., when would the Tamiflu run out?). Having lots of living space is wonderful, but it pays off only if people stay home from work and that means dealing with massive absenteeism. Not pretty. Better safe than sorry.
Oddly Stephens never mentions that we are living in a raging epidemic now, namely AIDS, which has run for several decades. For all the virtues of retrovirals, the modern world was quite slow in combating or even checking the disease and still many people, including U.S. citizens, engage in very risky behavior. Our collective response was not terribly impressive. Greater wealth does help, but greater wealth also means we should spend more to limit the problem…
The main thing we should do — invest in public health infrastructure — is in any case a good idea with many possible payoffs, whether a pandemic comes or not. It is a better investment of money than pursuing the ideal of universal health insurance coverage. I might add that one of the better arguments for universal coverage is simply that it could lead to better monitoring of some public health issues.
See also my text with Alex. And here is me on pandemics and local public health infrastructure, November 2018. And here are my earlier writings on avian flu.