Does Proposing a 20 Percent Budget Cut for the CDC Disqualify Rand Paul From Being a Serious Critic of the Ebola Response?

KTXA

Sen. Rand Paul (R-Ky.) proposed a budget for FY2014 that included a 20 percent cut to the CDC. Does that disqualify him from being a serious critic of the Obama administration's reponse to the Ebola outbreak?

Henry Olsen at National Review seems to think so. He says he doesn't believe "spending equals competence," but:

Paul's proposal to reduce CDC spending is symptomatic of a large problem with his thinking.

Paul clearly has a theory of non-government. In his view, government is generally a bad thing and we need to reduce it as fast and as deep as we can. However, cases like the CDC/Ebola crisis call for a theory of government. No serious politician, not even the quasi-libertarian senator from the Bluegrass State, thinks that the federal government ought to have no role in public health.  

When the federal government is spending a trillion more dollars than it collects in revenue (44 percent), a 20 percent cut at a federal agency shouldn't be dismissed off-hand as unserious. Considering government to be "generally a bad thing" is a theory of government. 

Rand Paul is not a libertarian, but neither are most libertarians anarchists. In any case, in the article Olsen cites Paul doesn't dismiss preventing the spread of infectious disease as a legitimate goal of government and the CDC. Instead he insists the CDC's had enough, saying the agency's budget for epidemics (National Institute of Allergy and Infectious Diseases) has gone up 220 percent. CDC spending has doubled since 2000.

Olsen says he has "no idea" whether $4.8 billion a year (the CDC budget if a 20 percent cut were instituted) is enough for the agency to carry out its mandates, which is fine, and then claims neither would Paul's staff. Those kinds of arguments are generally deployed to demand more spending by government, because they tend to settle around the idea that the top men at the agencies in question know best how much taxpayer money they need to spend to do their job.

How much might the CDC need to get the job done? Getting less money could certainly focus the agency on a core mission of preventing the outbreak of highly infectious diseases. I may have no idea how much the CDC needs either, but here's how they spent their money in Fiscal Year 2012:

• Public Health Preparedness and Response - $1.329 billion
• Chronic Disease Prevention/Health Promotion - $1.167 billion
• HIV/AIDS, Viral Hepatitis, STIs, TB Prevention - $1.109 billion
• Immunization an Respiratory Diseases - $814 million
• Cross-Cutting Activities and Program Support - $659 million
• Public Health Scientific Services $461 million
• Global Health - $342 million
• Emerging/Zoonotic Infectious diseases - $304 million
• Occupational Safety and Health - $292 million
• Environmental Health - $139 million
• Injury Prevention and Control - $137 million
• Birth Defects, Developmental Disabilities, Disability - $130 million

The breakdown's included in the Department of Health and Human Services' justification of estimates (PDF) for the House and Senate Appropriations committees, a good place to start to get an idea of what the CDC's mandate should be and how much it might cost.

Comments

[Pro Libertate]

I'm sorry, what has the CDC done to stop the spread of Ebola? It's total crap that they don't have the money to do anything. They just choose to allocate resources to politically charged, non-epidemiological matters rather than, you know, disease.

When does the constant buzz of government incompetence finally break through to a majority of voters? Why on Earth would you trust this organization or any other with anything of importance?

[Restoras]

^This, thanks ProL.

[Invisible Finger]

^This, ProL.

The CDC didn't stop the spread of AIDS either. The spread of AIDS stopped like most viruses stop spreading - natural causes.

Note that we have the CDC in place getting massive increases in budget every year and yet the number of people who refuse to have their children vaccinated keeps increasing. The CDC is a bureaucracy that is no longer capable of doing its core function anymore. Anybody expecting the CDC to be a force in stopping the spread of Ebola is delusional.

[John]

The CDC's behavior at the start of the HIV epidemic was appalling. The let politics keep them from admitting it existed and was an STD, even when it was obvious that it was though they hadn't found the actual virus yet. And then they refused to get cities to shut down the gay bath houses and start telling gay men to use condoms. As a result, a whole bunch of people died who shouldn't have.

[MegaloMonocle]

The let politics keep them from admitting it existed and was an STD,

Fun fact: Ebola is also an STD, and can apparently be transmitted sexually for 90 days after you recover.

[Bardas Phocas]

Where do they fund the Plague Bunkers?

[Restoras]

Black Ops?

[Bo Cara Esq.]

Since most of what the CDC spends its money on would not address it at all, of course not.

[Restoras]

It'd be interesting to see what these numbers represent of the CDC's budget for the period.

[Bo Cara Esq.]

National Review?

When I first glanced at the article I thought, oh, some liberal NYT or Salon writer taking a stupid shot at Paul again. National Review?

[Hugh Akston]

Team Red hates Rand more than anybody on Team Blue.

[John]

National Review is to the GOP but Reason is to Libertarians. Generally in agreement but utterly and totally emersed in the beltway culture. For Reason that means publishing the shit Chapman and Dalmia write.

For National Review it means carrying water for the GOP establishment by publishing idiotic shit like this. The establishment hates Paul and don't want to see him getting in on the beat down the Democrats are getting over Ebola. That is really all this is.

[Restoras]

NR is as ideologically straight-jacketed as any Team Blue vessel.

[Idle Hands]

They have some interesting writers. Williamson finds a nut every once in a while. Jonah Goldberg and George Wills descent to the dark side has been interesting as well.

[Marty Comanche]

Williamson's rant about homeschooling the other day was epic.

Does George Will write original pieces for NRO, or does he just republish his WaPo columns?

[John]

They can be. Jonah Goldberg is still good. But after they ran off Derbyshire, they got a whole lot less interesting.

They have fired both Derbyshire and Coulter. NRO is supposed to be a "conservative magazine". What problem do conservatives have with those two other than the fact that they are not very polite and say controversial things that drive the left into convulsions?

[Idle Hands]

Coulter is a joke at this point. At one time she was interesting but have gotten incredibly stale is the writer version of a shock jock. I don't think she believes anything she writes at this point.

[Notorious G.K.C.]

She may, but she focuses on shock value.

Like, "how can I exploit the soccer tournament to get some outrage going?"

[Idle Hands]

Dude this Olsen guy is a complete rhino hack. Look at his published history.

[Brett L]

Ever since Buckley died, they've become the official organ of the RNC.

[Hugh Akston]

Rand Paul is not a libertarian, but neither are most libertarians anarchists.

Eddie, I'm not clear on what you're trying to say here.

[MJGreen]

Took me a while too. I think he is saying, "Most libertarians are not anarchists."

[Joshua]

Rand isn't a libertarian, but even if he was a libertarian, he wouldn't necessarily be an anarchist.

[Paul.]

I know what the CDCs position on obesity, salt and guns in the home is. What's their position on Ebola?

[Drake]

Stay calm, don't panic...something, something...under control...

[Almanian!]

...something something something....LOOK! A CHICKEN!

[Almanian!]

Also, flying while you're starting to run a temperature after you've treated someone with Ebola is totally OK. Don't worry. No problem.

LOOK! A RAINBOW!

[MegaloMonocle]

What's their position on Ebola?

Huddled in the corner, sobbing?

[Invisible Finger]

More like standing on the corner with their palms out.

[BakedPenguin]

What's their position on Ebola?

The same as their position on everything else - "we need more money."

[Idle Hands]

Good lord those two posts about republicans and democrats take up an annoying amount of page space. Also that article's criticism of Paul is so ridiculous:

In the CDC's case, that means having a clear idea of what the CDC's mandate should be and what resources are needed to carry out that mandate. Is $4.8 billion enough to carry that mandate out? I have no idea; it might be more than enough, or it might be woefully inadequate. Given that what is primarily at stake in the Ebola case is the CDC's existing authority to initiate travel bans and isolation orders for people with "highly contagious diseases," it's pretty laughable to argue that proposals to cut funding for more research on gun-violence prevention or HIV caused Ebola to come to Dallas. But I would guess that Senator Paul and his staff also have no idea if that figure is appropriate for a properly designed CDC, or whether the amounts he proposes to spend for most items in his model budget is enough to meet each program's objective ? and that's a problem for someone who wants to lead our nation.

He essentially admits he's arguing from complete ignorance and than assumes Paul is to with 0 evidence to support his assertion. Talk about projection.

[MegaloMonocle]

Shorter:

I don't have a clue what the CDC should be doing or what it might cost, so I can state with absolute assurance that Rand Paul doesn't either and that his budget for the CDC is way too low.

I'm convinced.

[Idle Hands]

Shorter version: I am scared Rand Paul has a shot at winning the primary.

[Brian D]

What the hell would a doctor know about disease anyway, right?

[Ted S.]

Good lord those two posts about republicans and democrats take up an annoying amount of page space.

Don't you realize how fucking important infographics are?

[MikeP]

Public Health Preparedness and Response - $1.329 billion
Public Health Scientific Services $461 million

It looks to me like their constitutional mandates can get by on $2 billion.

[MegaloMonocle]

What you don't know is what's under those nice-sounding titles.

I could easily see the CDC's gun control budget being filed under either of those.

[MikeP]

I must admit, I am using the economic definition of public health -- a definition that hasn't changed in 150 years.

[Paul.]

I must admit, I am using the economic definition of public health

PUT THE SUGARY DRINK DOWN AND STEP AWAY FROM THE COUNTER!

[Gray Ghost]

Apt, considering the CDC Director's previous employment as Bloomberg's Health Commissioner.

Which, now that I think of it, was probably your point. Sorry.

[MikeP]

By the way, was anyone else surprised and frankly unnerved that the first statement on ebola in Dallas came from Texas health officials and the CDC was nowhere to be seen?

I mean, what the hell is the CDC for if it isn't to front this? Does every single county health official have to be an expert on every contagious disease in the world that might one day need controlling?

The CDC should be to unusual disease outbreaks what the NTSB is to unusual plane crashes.

[John]

The CDC does prog politics like studying obesity in lesbians (a real CDC program I kid you not) not control of disease. They pretend to control disease so they can get down to the serious work of studying fat lesbians and pushing for gun control. Normally no one notices since people do a pretty good job of controlling diseases themselves. When something like Ebola breaks out, people start to notice that the CDC doesn't spend much or any time actually controlling the spread of diseases.

[MikeP]

The NTSB is able to be a busybody on various non-accident-investigation tasks on a budget of only $100 million.

And they still manage do a good job at their primary task.

Money is pure poison for a bureacracy's competence.

[John]

No one ever got promoted in government claiming they could get by on a smaller government. The people who go to the top of the civil service are generally bullshit artists who tell their bosses what they want to hear and are forever convincing them they need more people and a bigger empire.

[Gray Ghost]

See Pournelle's Iron Law of Bureaucracy.

[Paul.]

The CDC should be to unusual disease outbreaks what the NTSB is to unusual plane crashes.

If you don't mind, I'd like to use this in the future. I'll give credit.

[MikeP]

Please do. It really is striking seeing that the NTSB can also be a nosy nanny as well, yet gets by on a 60th of the budget.

[John]

The problem with the CDC is that it does all sorts of moronic shit like that listed and much much more instead of its actual mission. A properly run CDC would have its budget cut more the 20%. Since it would see its mission shrink dramatically, however, it would still be better funded to do its actual mission than it is today.

Shame on NRO. This is some real beltway Conservative bullshit here.

[Tman]

Yeah, I don't get why NRO is pushing this piece. If there ever was a poster child for Government Incompetence in Real Time it would be the CDC and their response to this crisis.

Had they not been wasting their time and money on fat lesbians, fruit fly sex, the effects of hang-overs on 25 year old men, determining if video games make violent children or a host of other completely pointless studies we might actually have a competent response in the works.

Instead they look like a bunch of monkeys trying to fuck a football.

Big time fail NRO.

[John]

It is the author carrying water for the GOP establishment and beltway conventional wisdom. The fact that the water he is carrying is a big bucket of stupid doesn't matter. He was told to carry it and that is what he is going to do.

[Paul.]

To the best that I can tell, the socons are a bit all over this Ebola thing because it plays into some traditional fears they have. You can possibly make references to blind squirrels finding nuts here, but I think in their flailing, the definitely missed the point here.

[Notorious G.K.C.]

"They cut our budget 20%!"

"Oh, no, now we'll have to stop our work with diseases associated with lifestyle choices! We'll have to focus on dangerous communicable diseases!"

"Pull yourself together man, we just follow a Washington Monument strategy, cut funding for Ebola, and we'll scare Congress into restoring the funding."

[MegaloMonocle]

An organization's heart follows its wallet. If most of your funding is for lifestyle issues like obesity, guns, and diet, then the entire organization is oriented that way, and the rest (communicable disease) is an afterthought. Even if the CDC's current budget for communicable disease is fine, its being spent by an organization that doesn't really care much about communicable disease.

And we can see the results unfolding before our eyes. Oh, and that other epidemic, which is killing and crippling children right now? Not a peep.

Time to trot out an underused Iron Law:

If everything is a priority, nothing is a priority.

[John]

The other thing is that lifestyle issues are always current and get you press. There is always someone out there doing something that the scolds think is harmful. Actual disease control in contrast is not always on the front page and rarely very glamorous. Most of the time we don't have a potential pandemic going on. So the bureaucrats don't want to do the disease control part. That doesn't get their names in the paper and get them funding. Lifestyle issues do.

This is why a competent Congress would be loath to expand any agency's mission. Once you let them start doing other things, they will always forget their original purpose.

[The Late P Brooks]

Money is just like fairy dust. Just sprinkle liberally, and PRESTO! happiness.

The more the better.

[widget]

Barbara Streisand has already covered this.

By the way, if not for Republicans austere budget cuts, the NIH could have possibly had an Ebola vaccine by now. Unbelievably, I never thought we'd see the day when contraception was once again controversial, but this is what is happening.

http://www.huffingtonpost.com/.....74398.html

OT, who the hell opposes contraception these days? American Roman Catholics are having about 2.1 births per woman.

[Idle Hands]

Babs should stick to her night job.

[John]

A very small group of very devout Catholics. That is it. No one else. You really have to be a complete retard to convince yourself there is any danger of contraceptives ever becoming unavailable in this country. They get around that by convincing themselves that the government not paying for them is the same as the government making them illegal.

[Paul.]

Oh shit, props to Streisand for illuminating. I forgot we have multiple "health agencies". The CDC, the National Institutes of Health. Jesus, how many health agencies whose mission it is to stop disease do we have?

If we can't (according to Streisand) have a reasonable response to a real and ugly communicable disease, we have unintentional proof that we're doing it wrong.

[DK]

It all comes under HHS.

[Invisible Finger]

Don't forget CDC stands for "CenterS for Disease Control".

[MegaloMonocle]

By the way, if not for Republicans austere budget cuts, the NIH could have possibly had an Ebola vaccine by now.

Oh, and the half-billion dollar contract for anti-virals that went to an Obama crony (and thence down the toilet as that company has gone bankrupt), rather than to the company that was actually working on the only drug that seems to work?

We don't talk about that.

[Roger the Shrubber]

In his view, government is generally a bad thing

Not only in his view but in the view of the people who, you know, actually created our system of government.

[John]

And since when does "generally" mean always? Yes government is generally a bad thing except on the rare instance its not. And in my mind at least doing real public health protection like stopping the spread of infectious disease is one of those times.

[The Late P Brooks]

Shorter National Review:

"Small(er) government sounds nice *in theory* but come on. It might work, this time."

[Spock]

"It might work, this time."

Famous last words.

[The Late P Brooks]

Those kinds of arguments are generally deployed to demand more spending by government, because they tend to settle around the idea that the top men at the agencies in question know best how much taxpayer money they need to spend to do their job.

Those arguments are deployed because it is inconceivable to those who deploy them that the Top Men of whom they are so enamored are competent to prioritize the various missions assigned to them. Everything they do is of the utmost urgency. You cannot expect the people responsible for making the anti-bullying public service ads running on the Cartoon Channel to be cast aside in favor of researchers in the Contagious Epidemic Catastrophe lab.

Otherwise, the bullies will have won, and there will be no civilization worth saving.

[The Late P Brooks]

If not for the vast right wing conspiracy, disease and hunger would be nothing more than footnotes in the herstory books.

[[e-mail]]

The federal government is not spending $1 trillion more than it takes in. 2014 defect is just over $400 billion. So, your calculations are off by over 50%.

[happel]

I've been unnerved for well over a year and long before Ebola was the headline of the day occupying everyone's thoughts and criticism of the CDC regarding their "800-QUIT-NOW" campaign. This is a perfect example of government largesse, in my opinion. If anyone that lives in America today does not realize that there are HUGE signs posted as clear as day on the side of the pack that those are bad for you, you deserve to die of whatever diseases you contract from smoking. What offended me is that the CDC is wasting valuable budget funds on this ad campaign and have received zero feedback from anyone at the CDC for their justification. If you read the PDF, this is a perfect example of a government pretending to be a for-profit entity, but never actually generating an actual profit, just justifying its bloated budget: "Because medical
care of smokers costs, on average, $2,000 more than non-smokers and about $1,000 more than ex-smokers, the campaign will more than pay
for itself." - the key takeaway, 'more than pay for itself.' Think about that logic and how they use this meme to spend millions of dollars that could EASILY be used for better use. This is the true malice of government run amok thinking we are all morons and do not acknowledge decades of anti-smoking campaigns, many run by other non-profit, non-government entities, that have awakened the public to the perils of smoking.

[LaKeisha]

Of course it doesn't disqualify him for legitimate criticism. The problem is NOT that the CDC hasn't had enough resources...the problem is what they've done (and NOT done) with the resources they have.

[John]

There is a place in the world for bomb throwers. I wouldn't want a whole magazine of Coulters. But I would want any political magazine to have one.