Freedom with Responsibility

I look back at my college years at Cornell with great fondness, particularly as I see the current disruptions that are affecting current and prospective students who are missing the campus and community experience.  Many of the lessons and classes have become fuzzy over the last 30 years, but I distinctly recall a Cornell credo that has stuck with me:  Freedom with Responsibility.  This succinct and powerful guiding principle seems especially apt in this current environment of restricted freedom, limited activity, shutdowns, and social distancing.

The founding of our country was triggered by the tyranny of a distant and unresponsive leader, whose unilateral actions affected the cost and availability of essential products, the tax levels of our thirteen colonies, the freedom of expression of our residents, and freedom of assembly.  By our very nature, as Americans, we are driven by an implicit thirst for liberty—broadly defined as freedom from oppressive restrictions imposed by authorities on our way of life.  Patrick Henry’s life was captured by an essential declaration:  "Is life so dear, or peace so sweet, as to be purchased at the price of chains and slavery? Forbid it, Almighty God! I know not what course others may take; but as for me, give me liberty or give me death!" 

Our country has adapted to changing times, evolving social norms, technological innovations, and new cultural influences to balance community needs with individual freedoms.  While America has dealt with great societal challenges throughout our history, it is unprecedented that our citizenry has been required to stop virtually all forms of social engagement and economic activity in an effort to “flatten the curve” to accommodate our healthcare system.   A government-imposed economic depression, in response to a public health crisis, has been justified by politicians as unfortunate, but necessary, due to the transmissibility and poorly understood effects of the novel SARS-CoV-2 coronavirus.

Public policies have been hampered by a Federal delay in precautionary measures, indifference to pre-existing pandemic protocols, an inexplicable NY State order to force nursing homes to accept COVID-19 infected residents, and a botched approach to testing (including faulty reagents) by the Centers for Disease Control that cascaded into unnecessarily high caseloads, deaths, and economic consequences.

The government stay-at-home orders have largely been accepted by a compliant and technology-addicted citizenry.  Government leaders have delegated many of their responsibilities to public health officials, whose jobs are not to balance liberties, economic concerns, or legal considerations.  Their focus is on limiting the spread of diseases and moderating the effects of these concerns on the public at large.  This is certainly an unusual and conflicted public policy approach because various interests and constituencies have all been sublimated in service of a narrowly defined goal: to address the specific health concerns of an individual virus. 

There are, of course, other concerns—including those in the healthcare realm—that emanate from the “Great Suppression” we are currently enduring.  While many categories of crime have declined with the shutdown orders, most public officials acknowledge that incidents of substance abuse, domestic violence, high speed traffic accidents, bankruptcies, et.al. are rising simultaneously.  While declines in commuting and human activity are predictably reducing demand for fossil fuels and improving air quality, the service industry workers who had recently enjoyed a mini-boom in wage growth and economic opportunities have been disproportionately impacted by the furloughs, layoffs, and business closings of this current crisis. 

Our Federal Government’s four (and soon to be five) COVID-19 relief packages and efforts to promote forgivable loans for employers through the shutdowns have created an inexorable path toward a current year $4 trillion deficit that approximately equals the sum total of debt accumulated by the United States through its first 217 years of existence.  This single year deficit level dwarfs the Obama-era stimulus package, Obamacare, and even the entire cost of national healthcare spending in a year.  This spending has not created new infrastructure, border walls, missile defenses, or breakthrough programs that improve our quality of life.  Far from it.  The spending results from a national pause in activity that undermines productivity, economic security, educational development, and budgetary prudence.

These programs have slowed the spread of the virus—while also delaying the societal move toward herd immunity—to ensure our healthcare system would not be overrun by a spike in cases.  On the other hand, many former employees will never find comparable jobs again in their lifetimes.  More people will become dependent on welfare programs and government supports to survive.  Our national unemployment rate is on its way north of 20% when May numbers get released.  The Federal debt load will easily exceed our lowered Gross Domestic Product.  Social distancing will have all but eliminated public gatherings, conventions, concerts, sporting events, and many other confabs.  Hotels, restaurants, airlines, public transit systems, office buildings, and all their associated jobs and supply chains have been disrupted, in some cases, to the point of no return.

How our country responds to the next virus or airborne/water-based contaminant remains to be seen.  However, this improvised time-out has not eliminated health risks.  The most at-risk segments of our population will remain at-risk to other viruses and diseases.  The elderly remains the fastest growing segment of our population and are most vulnerable to compromised immune systems.  Those with chronic diseases—diabetes, hypertension, COPD, heart disease—are among the most susceptible to other health dangers.  Some studies attribute more than 85% of total healthcare spending on patients with at least one chronic condition.  Many of these chronic diseases are behavioral in origin, meaning that better diets, more exercise, and less substance abuse can delay or prevent the onset of many of these noncommunicable diseases.

Freedom with Responsibility.  This is not an alien concept.  This is an inherently American approach to balancing societal needs with individual rights.  Eliminating risks of any kind—health, economic, environmental—is an extremely costly and literally unattainable task.  We can pay insurance premiums, institute guard rails, enforce speed limits, buy financial options, or reinforce our security systems, but underlying risks will never be gone.  Instead, we rely on good judgment, prudent accommodations, and ultimately responsible behavior to ride out storms.

Some of those reasonable trade-offs might include limited quarantines of high risk people in high density environments, face masks in public spaces (seems to work for commuters throughout Asia), hand sanitizers and wipes in all classrooms, routine telemedicine visits for asymptomatic patients, and alternating shifts of in-office workdays.  Such adjustments may be inconvenient or awkward, but do not fundamentally impinge on the rights and liberties of individuals to communicate, gather, pray, eat, or travel.  Moreover, these behavioral changes do not force an economy and society to grind to a halt, as it has this year.  If our current experience with government-enforced shutdowns teaches us anything, it is that freedom is precious and responsible behavior is our path forward.