Cato: An Epidemic of Red Tape

 Among the many lessons of the COVID-19 pandemic is how cumbersome one‐​size‐​fits‐​all regulations, administered by an impersonal bureaucracy, hamper a rapid and flexible response to an evolving public health emergency. The U.S. Navy Medical Corps provides us with the most recent example.

On March 30, the naval hospital ship U.S.N.S. Comfort arrived in New York harbor, with 1,000 hospital beds and 1.200 staff, ready to assist in the management of the epidemic which has taken a heavy toll on New York metropolitan area inhabitants. Yet, as of April 3, only 20 patients were being treated on the hospital ship. Three days earlier, the 1,000 bed U.S.N.S. Mercy arrived in Los Angeles, and as of April 2 treated 15 patients.

Both hospital ships were intended to take on and treat patients who are not infected with COVID-19, which serves the dual purpose of sheltering such patients from contagious COVID-19 patients in metro area hospitals while freeing up space in those hospitals for more COVID-19 patients.

But why are there so few patients aboard these hospital ships, considering the ships’ patient capacity and the size of the metropolitan areas they are serving? The answer lies in military protocols and bureaucratic rules that stand in the way.

Patients are not allowed to be directly admitted to the hospital ships and ambulances are not permitted to take them there. They must first be taken to a civilian hospital for evaluation and be tested for the virus before being transferred to the ship. Of course, this requirement does nothing to unburden crowded emergency rooms and their overworked staff.

Read more at https://www.cato.org/blog/epidemic-red-tape

Cato: Governments Should Rely More on the WTO in the Fight Against the Coronavirus

 Yet another sign of the marginalization of the World Trade Organization is the omission of any mention of it in the recent G20 statement on COVID-19. At a time when more international cooperation is urgently needed to control and conquer the spreading coronavirus pandemic, including in trade, the international institution established to oversee trade is increasingly shunted to the sidelines.

The G20 leaders acknowledged the importance of trade to addressing the pandemic in their statement at the conclusion of their emergency video conference on March 25. They promised to use “all available policy tools to minimize the economic and social damage from the pandemic.” Shockingly, however, they neglected to refer by name to the only global institutional tool they have for achieving that goal in trade. Six other international institutions were specifically cited – but not the WTO.

Going into this global fight for survival, the WTO was already badly damaged by the corrosive combination of Trumpian unilateralism and intensifying global economic nationalism. Now, because of the coronavirus, all WTO meetings have been suspended until at least the end of April. Those who see the WTO as necessarily central to world trade are left wondering what its role is now and will be going forward.

Among trade experts, ideas abound for using the WTO to help fight the pandemic. At the top of the list is the pressing need to roll back and refrain from export bans on medicines and medical supplies. At last count, 35 countries have imposed such bans. While these measures, depending on how they are applied, may be legal under WTO rules, they are inconsistent with the G20 aim to “coordinate responses in ways that avoid unnecessary interference with international traffic and trade.” They prevent limited drugs and supplies from going to where they are most needed to conduct effective coordinated global combat against the global virus, especially in the poorest countries where the outbreak may ultimately be the worst.

Read more at https://www.cato.org/blog/governments-should-rely-more-wto-fight-against-coronavirus

Cato: How the Telephone Consumer Protection Act Unconstitutionally Privileges Government Speech

 In this time of crisis, the Supreme Court still soldiers on … somewhat. The Court cancelled its March oral argument sitting and will likely cancel the April one too. But petitions are still being filed–deadlines have been extended–and there are still cases to be decided. 

One of those cases concerns the Telephone Consumer Protection Act, a statute that is appreciated by many because it helps stop robocalls. The law makes businesses who violate the many consumer‐​oriented provisions liable to private lawsuit. This is no idle threat, either; in the last ten years 21 TCPA cases have settled for over $10 million. It is also a favorite of states’ attorneys general, who earn popularity for targeting the sources of unwanted calls.

The 1991 law was all‐​encompassing. Auto‐​dialers and pre‐​recorded calls were prohibited for political activists, local businesses, debt collectors, and charities alike. Unless a consumer has released their number willingly, they could not be called by such annoying methods. But in 2015, Congress passed a budget that contained an amendment exempting from the statute any calls made “solely to collect a debt owed to or guaranteed by the United States.”

Read more at https://www.cato.org/blog/how-telephone-consumer-protection-act-unconstitutionally-privileges-government-speech

Cato: The Census Is Too Intrusive

 Signs have popped up all over my neighborhood in Arlington, Virginia, urging us to respond to the census – so that the 8th wealthiest county in America won’t miss out on funding collected from taxpayers across the country.

Census Bureau materials stress to local officials that census data will help them get “their fair share of funding” from hundreds of federal programs. Obviously this is a zero‐​sum game. If my neighbors and I all fill out the form, then you and your neighbors will get less from the common federal trough. But at least we’ll be getting our “fair share.”

But where does the government get the authority to ask me my race, my age, and whether I have a mortgage? In fact, the Constitution authorizes the federal government to make an “actual enumeration” of the people in order to apportion seats in the House of Representatives. That’s all. Not to define and count us by race. Not to ask whether we’re homeowners or renters, or involved in a same‐​sex marriage or partnership. Just to ask how many people live here, so they can apportion congressional seats.

I’m not interested in getting taxpayers around the country to pay for roads and schools and “many other programs” in my community. All the government needs to know from me is how many people live in my house.

Through the American Community Survey, the Census Bureau asks 3.5 million Americans a year many more questions, including your citizenship, your income, your marital history, whether you’re on food stamps, and how many bedrooms you have. All very interesting to sociologists and planners, of course, but hardly what Madison anticipated when he and his colleagues provided for an “actual enumeration” of the constituents of Congress.

The bureau explains that this information “can be used in planning and funding government programs” and “to enforce laws, regulations, and policies.”

Read more at https://www.cato.org/blog/census-too-intrusive

Cato: Health Care Scope of Practice Laws Reveal Another Weakness in Response to COVID-19 Pandemic

 On March 24 Arizona Governor Doug Ducey issued an executive order allowing CRNA’s (Certified Registered Nurse Anesthetists) to practice independently of physicians or surgeons, thus adding needed personnel to the health care work force during this public health emergency. Guidelines issued by the Centers for Medicare and Medicaid Services state that nurse anesthetists should be “supervised” by a physician, thus preventing these well‐​trained specialized nurses from providing anesthesia independently while freeing up physician anesthesiologists so more patients can receive care. Because these CMS guidelines are listed as “optional,” the Governor decided that Arizona will opt out. The press release from the Governor’s office stated:

"“Arizona’s hospitals and medical professionals need all the help and resources they can get right now,” said Governor Ducey. “I am confident that this exemption will enhance access to high quality care, provide additional options to our rural hospitals, and is in the best interest of the citizens of Arizona.”"

Arizona joined 17 other states that have already opted out of these federal guidelines.

As we are seeing so frequently as the COVID-19 pandemic unfolds, regulations on the state and federal level stand in the way of needed care, equipment, drugs, and tests. In our federal system states have power over occupational licensing and determining the scope of work in which a licensee may engage. In the matter of the licensed health care professions, this is referred to as “scope of practice.”

For decades state legislators have witnessed turf battles among the various health care professions. Nurse practitioners and physicians’ assistants, for example, seek to practice independently of physicians and to expand their scope of practice to meet their level of training. This is usually met with resistance from medical doctors who argue NPs and PAs lack the necessary training to safely provide care beyond a narrowly‐​defined scope. The degree to which the scope of practice of NPs and PAs has been widened varies from state to state. Broadening their scope would help address the current health care crisis. But once the crisis passes, maintaining the broadened scope would give people more health care options and access, particularly in underserved rural areas.

Similarly, state capitals witness battles between optometrists, who seek to expand their scope to include prescriptive authority and simple surgical authority, and ophthalmologists who believe such expansions are dangerous.

Read more at https://www.cato.org/blog/health-care-scope-practice-laws-reveal-another-weakness-response-covid-19-pandemic

Cato: Congress Set to Pass $2.2 Trillion Coronavirus Bill

 The Senate has passed a $2.2 trillion aid bill in response to the coronavirus crisis. The bill is expected to be passed quickly by the House and signed by the president.

Members of Congress stuffed a vast array of subsidies in the 880‐​page legislation, ranging from $454 billion for big businesses to $25 million for the Kennedy Center in Washington, D.C.

Here are the main spending buckets:

• $454 billion to finance loans to businesses and the states.
• $46 billion in loans and grants to airlines and other specified businesses.
• $377 billion in loans and grants to small businesses.
• $290 billion in stimulus checks for all individuals below an income cutoff.
• $260 billion in expanded unemployment benefits.
• $175 billion in grants to state and local governments.
• $180 billion in health‐​related spending.
• $154 billion for education, agriculture, food stamps, housing, and other programs.
• $290 billion in business and individual tax cuts.
  

Read more at https://www.cato.org/blog/congress-set-pass-22-trillion-coronavirus-bill