The Singapore government seems to have done a good job getting on top of the coronavirus problem. They have incredibly detailed websites (here, here, and here) with all the information you could possible want about all 112 cases in Singapore, including what type of person was infected, how they related to other infected people, and whether they have recovered been cured. (Most have been cured, including all of the first 33 cases.)
In contrast, the effort in the US has been almost comically ineffective. Here’s Noah Smith:
In South Korea, the number of people who are confirmed to have been infected with Covid-19, the pandemic disease commonly known as coronavirus, has ballooned to over 5000 as of the time of this writing and will certainly continue to rise. In the U.S. the official number infected is only 118. But much of this difference may be an illusion, due to differences in how many people are getting tested. South Korea has made a concerted effort to identify all the people infected with the virus, creating drive-through testing stations. The U.S.’ testing efforts, in contrast, look almost comically bungled.
The list of ways that U.S. institutions have fumbled the crisis reads like something out of a TV comedy: The number of test kits issued in the U.S. has been a tiny fraction of the number issued in South Korea. An early testing kit from the U.S. Centers for Disease Control and Prevention (CDC) contained a faulty ingredient and had to be withdrawn. Regulatory hurdles have slowed the rollout of tests, with officials from the CDC and the Food and Drug Administration only now discussing what to do. There are stories of possible coronavirus patients being denied testing due to maddeningly strict CDC limits on who can get a test. Some cities may have to wait weeks for tests to become widely available, during which time the populace will be left in the dark. Worst of all, the CDC has now stopped disclosing the number of people being tested, a move that seems likely to spread panic while reducing awareness.
Smith points the finger at a lack of “big government” in the US. But that’s not really the problem. The US government spends a far higher percentage of GDP than does Singapore. More specifically we spend far more on public health than does the Singapore government, and we have far more bureaucrats dealing with these issues. The real problem is a lack of what Tyler Cowen calls “state capacity” in the US. Our government’s ability to do almost anything, from space travel to building subways to dealing with public health problems has been deteriorating over time. This isn’t an issue that can be addressed by throwing money or people at the problem. Rather, we need an entirely different approach to governance.
We need to dramatically cut back on government activities that are better left to the private sector (which is most activities), so that we can focus on the few issues that actually require government competence, such as global warming and global pandemics. The quality of our effort in these areas will be higher if we focus almost all of our government resources on dealing with these “externality-type” problems.
The image below doesn’t even come close to showing the detail provided by the Singapore government, as there are many embedded links that can be clicked for more detailed info:
READER COMMENTS
Christophe Biocca
Mar 4 2020 at 3:36pm
I believe that first page is actually run by an individual unaffiliated with the SG government. The whois records for the domain (vid19.sg) look like those of an individual, not at all similar to those you get for moh.gov.sg
It does means the data is available in sufficient detail for interested third parties to be able to turn it into these kinds of dashboards, so that’s still a point for competence.
Philo
Mar 4 2020 at 4:39pm
“We need to dramatically cut back on government activities that are better left to the private sector (which is most activities), so that we can focus on the few issues that actually require government competence . . . .” Not quite: We do not actually need to do this, it simply would be better if we did. If most of the voters wanted this—and agreed about which matters should and which should not be directly addressed by government—we would get this desirable outcome. But the voters think otherwise, and so long as that is the case we will rub along as we have been doing, with pathetically low “state capacity.”
(I do wonder, though, if American governments’ inability to deal with epidemics and to build roads and subway systems is really primarily due to their being distracted by the many other matters that would better have been left to private initiative. Surely there are other contributing factors.)
Scott Sumner
Mar 4 2020 at 5:29pm
I don’t think it’s helpful to talk about “what voters think”. If I talk to the average voter for 10 minutes I can get them to change their minds on a host of issues. Voter beliefs are very fluid, and not well defined.
Philo
Mar 5 2020 at 12:10am
I’m talking about the beliefs that are uppermost in their minds as they cast their ballots.
Floccina
Mar 6 2020 at 4:34pm
That has also been my experience.
Alan Goldhammer
Mar 4 2020 at 5:42pm
Scott, just a minor quibble; it’s not correct to say that patients suffering COVID-19 infections were cured. What they have done is recovered from the viral infection. A cure implies a medical intervention that cures the disease. We do not have a cure at this point in time. Patients who are in respiratory distress from the disease are being treated just as they would be with an infection from the more traditional influenza virus.
Scott Sumner
Mar 4 2020 at 6:33pm
Thanks, I’ll fix it.
zeke5123
Mar 4 2020 at 6:29pm
I think this post is one of your best. You tackle the problem of state capacity suggesting that (at least in democracy) it might be negatively correlated with the size of the government. This, at first glance, appears counterintuitive but I think it makes sense.
If the general thesis behind failing government (i.e., lack in capacity) is to fund it with more money, you incentive failure and likely attract the kind of grifters who would operate well in such settings. Alternatively, if your reaction to failing government is to privatize (i.e., close) the relevant government function, then the incentive becomes to steward your resources wisely. This attracts a different kind of person.
I don’t know if it is right, but makes sense.
Scott Sumner
Mar 4 2020 at 6:34pm
Good point.
P Burgos
Mar 5 2020 at 2:26pm
I am not sure that is consistent with Singapore’s history. Lee Kwan Yew claimed he wanted his civil servants to be highly paid, so that he would get a competent and honest public administration. That said, good management always seems to be in short supply, so maybe the key is to limit the number of things the government tries to do, but to amply fund those things that the government does do.
Mark Z
Mar 4 2020 at 6:44pm
I find it unfathomable how Smith reaches the conclusion that this is a problem of insufficiently big government. This is an open and shut case of government regulation causing harm. I was actually thinking yesterday, facetiously, that somehow this would be spun into: “this why the CDC and FDA need more funding.” I’m curious how much more Smith thinks we ought to pay such agencies to get out of the way and let hospitals test people.
Alastair
Mar 6 2020 at 4:03am
My thoughts exactly. Noah’s observation is right; our institutions bungled this stress test because they have decayed. But his diagnosis and cure are wrong; a key problem in our response was overregulation – too much government, not too little.
His graph is also misleading. It show a declining share of US federal employment, but 1) this doesn’t account for the rise of government contractors, and 2) the relevant comparison is cross-country at a point in time, not within-country over time. And as Scott says, the US spends much more on public health than Singapore does yet has demonstrably worse results.
US government incompetence is better explained by our kludgeocracy, lack of institutionalized cost-benefit testing and sunsetting, laws that make it easy to hire but hard to fire, and salaries that fail to attract and retain talent. In other words, accretion, incentives, and selection. If there’s major institutional decay, we need major institutional reform.
ChrisA
Mar 5 2020 at 12:47am
The prime minister of Singapore was the top mathematics graduate in Cambridge in his year, and had the potential to be an eminent mathematician. This is a level of state capacity I don’t think the US system could ever reach.
Mark Z
Mar 5 2020 at 9:20pm
Interesting. I can imagine all the professional mathematicians lamenting, “what a waste of talent, he could’ve been something!”
Hui-chieh Loy
Mar 5 2020 at 3:08am
The dashboards were created by the folks from here: https://www.upcodeacademy.com/ The outfit seems based in Singapore.
Scott Sumner
Mar 5 2020 at 1:31pm
Thanks.
Hui-chieh Loy
Mar 12 2020 at 12:55pm
Nice write up in the latimes on the dashboard https://www.latimes.com/world-nation/story/2020-03-11/a-singaporeans-view-of-the-coronavirus-its-surprising-to-see-the-u-s-so-messed-up
Thaomas
Mar 5 2020 at 10:08am
I agree, but it’s not clear how not doing some things that might be better left to the private sector — airport security? — or fewer income transfer programs would have helped CDC have more and better test kits available and not have restrictions on hospitals using their own tests, or more transparency.
Scott Sumner
Mar 5 2020 at 1:32pm
It’s easier to focus your best talent on the really important issues, if they are not spread around trying to do 1001 things that they have no business doing.
Mark Z
Mar 5 2020 at 9:28pm
It may be a stretch to call hospital systems the private sector, but it certainly makes the case for the federal government letting local organizations – whether private, public, or non-profit – do things without their (the federal government’s) approval. The concentration of decision-making with a central authority was a failure. I don’t think this principle is peculiar to public vs. private sector.
Comments are closed.