If you're wondering if New York City Mayor Bill de Blasio really means "draft" when he calls for drafting medical personnel from around the U.S. to care for COVID-19 patients in his hard-hit city, the answer is an unequivocal "yes." He really does want to drag doctors and nurses from their jobs elsewhere to assigned positions in New York City.
Bill de Blasio isn't alone as a government official who sees in the crisis an opportunity to go full commissar. New York Gov. Andrew Cuomo is stealing ventilators from upstate hospitals to give to facilities downstate. New Jersey Governor Phil Murphy is similarly snatching medical supplies from private firms and facilities to use as he sees fit. And President Donald Trump has invoked the Defense Production Act to force medical equipment manufacturers to abandon customers beyond the borders—and even to sell to only the federal government.
In context, de Blasio's insistence that medical providers are playing pieces to be pushed around a game board at his whim is the next logical step down the path the political class has already chosen.
"Mayor de Blasio today called on the federal government to institute an essential draft of all private medical personnel to help in the fight against COVID-19," de Blasio's office announced on April 2. "The United States must mobilize a national response to meet the rapidly growing demand for medical personnel—first in New York and then other localities throughout the country."
Debate ensued as to whether the mayor meant actual involuntary servitude for doctors treating patients in locales not called "New York" or whether he wants a voluntary national service. So, I asked.
"Just to clarify, is the mayor explicitly calling for conscription of medical personnel around the United States, to be deployed to COVID-19 hotspots?" I queried New York City Hall.
"Yes, that's correct," city officials responded.
So, the mayor does intend to attempt to force doctors and other health care providers to leave their own responsibilities behind if the government determines them to be less pressing than those of New York.
As it turns out, the skeletal structure of a medical draft exists as the Health Care Personnel Delivery System, administered by the U.S. Selective Service System which oversees the country's vestigial conscription apparatus. "If needed it would be used to draft health care personnel in a crisis. It is designed to be implemented in connection with a national mobilization in an emergency, and then only if Congress and the President approve the plan and pass and sign legislation to enact it," according to the official description.
At least de Blasio has a basis in law—albeit, coercive and immoral law—for his conscription plans. Andrew Cuomo just seems to be testing the limits—if any—of New Yorkers' willingness to let him rule by decree.
"If they want to sue me for borrowing their excess ventilators to save lives, let them sue me," the governor responded to protests about the state's plan to send National Guard troops to seize 20 percent of ventilators from hospitals in upstate New York for redeployment to facilities in New York City.
Oddly, even as New York officials call for coercing people and equipment into state service, the governor's website boasts of over 1,000 donated ventilators and 85,000 volunteer health professionals—including 22,000 from out of state. Maybe they don't count without the threat of prison.
The same taste for the whip prevails in New Jersey where Murphy authorized officials "to commandeer personal services and/or real or personal property. This includes medical supplies and equipment from private companies and institutions…"
Do private firms and local facilities have that equipment earmarked for their own communities? That won't matter if state officials have different priorities.
For his part, Trump invoked the Defense Production Act in recent weeks in a rage that medical supply companies are working overtime to meet demand from customers who aren't on his personal list of folks who should be at the front of the line.
"The Trump administration quietly invoked the Defense Production Act to force medical suppliers in Texas and Colorado to sell to it first—ahead of states, hospitals or foreign countries," reports Kaiser Health News. "Firms face fines or jail time if they don't comply."
That was before the White House told American companies to stop exporting N95 respirators and other protective masks manufactured in the U.S. to overseas customers.
The likes of de Blasio, Cuomo, Murphy, and Trump engage in gratuitous 1930s-style total-state reenactments at least in part because that's who they are and a pandemic is as good an excuse as any to push beyond the boundaries of a free society. But politicians go full commissar also because they win praise for "exercising leadership," especially in its distilled, strongman form.
"Many governors and health officials have been pleading with President Trump to use his authority under the Defense Production Act to get the federal government more directly involved in the buying and distribution of items like ventilators and face masks," Politico reported at the end of March.
Cuomo, for his part, wins lavish praise for his camera-hogging and his authoritarian posturing. "If a media darling has emerged during the coronavirus crisis, it's Cuomo," says Alex Shephard of The New Republic. The press devotion is so unseemly that a recent Columbia Journalism Review piece suggested that journalists might want to bring just a little more perspective to their coverage of a very flawed politician.
Naturally inclined, as they are, to treat people as pawns, it would be a shock if government officials were to resist loud, public demands that they be true to their inner authoritarian nature. But authoritarianism isn't some magic solution to our problems. Dictatorial actions paper over competing needs, rival priorities, and the likelihood of unforeseen consequences.
"The Buffalo Niagara region needs everything it has, said local elected officials and health care leaders," the Buffalo News noted of responses to the New York governor's ventilator grab. "Kaleida Health, Catholic Health, Erie County Medical Center and two smaller hospitals in Niagara County last month reported having a total of 363 ventilators," which might make a difference for the local community but would be lost amidst the demands of the downstate metropolis.
Likewise, there are "significant humanitarian implications of ceasing respirator supplies to healthcare workers in Canada and Latin America, where we are a critical supplier of respirators," warned 3M after the president's restrictive order. "In addition, ceasing all export of respirators produced in the United States would likely cause other countries to retaliate and do the same, as some have already done."
Forcing people to do what you want does not mean you've made the situation better.
As for de Blasio's plan to conscript medical providers… it's worth noting that a proper draft begets proper draft resistance.
"I wouldn't go," my wife, a pediatrician, told me when I asked what she'd do if she received a draft notice. "My family and my patients are here."
My wife spends part of her week these days masked, goggled, and gowned so she can screen patients in her clinic's parking lot, determine appropriate treatment, and minimize further infections. Yes, COVID-19 is in rural Arizona and so are many other ailments requiring care, even if people and concerns here aren't on the radar of far-away officials.
Bill de Blasio and other members of the political class may think the pandemic empowers them to enforce their priorities on people everywhere, but what they think is right and important isn't the final word. The rest of us can and should push back. We must be willing to say "no" at least as forcefully as bullying politicians issue their commands and invoke their thuggish laws.