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Side Effect of a Public Health Crisis: Bigger Government

By Raymond J. March

A side effect of never-ending declarations of “public health emergencies” is a consequence few people notice at first: an expansion of government known as the “ratchet effect.”

Consider the last two years. COVID-19 is likely endemic and will remain with us for the foreseeable future. Fortunately, it is also becoming milder. Some medical research argues that current dominant variants are less deadly than the flu. Hospitalizations have also steeply declined in recent weeks. Regardless, President Biden recently announced he is extending the COVID-19 public health emergency for another 90 days.

This will place the country under a public health emergency for COVID-19 into early 2023. The United States is also under a public health state of emergency for monkeypox.

The extended public health emergency comes at a surprising time. On October 21, 2022, there were about 7,100 new COVID-19 cases. Ten months before that, there were one million new COVID-19 cases, according to data collectors at Johns Hopkins University. This reduction occurred despite COVID’s continual mutation into more contagious variants and dramatic curtailing of recommended public health guidelines to prevent disease spread.

So why extend the state of emergency? Sadly, the answer likely has more to do with power than public health.

The Ratchet Effect

Robert Higgs’ masterful book Crisis and Leviathan explains that governments rapidly expand their size and power during crises. Through a mechanism called the ratchet effect, governments rarely return to their pre-crisis size and often retain their newly granted powers. Higgs’ chilling conclusion is that government growth allowed by a concerned public to end a crisis far outlasts the actual crisis.

One of the simplest ways for a state to expand and extend its control during a crisis is to extend the crisis—even when it is unwarranted. Government responses to COVID-19 provide one of the clearest losses of liberty in recent memory. As the economist Benjamin Powell writes in Real Clear Markets, “U.S. economic freedom fell 3.5 percent in 2020—to its lowest level since 1975.”

Many of these losses to our freedom show signs of becoming permanent. Consider some of the following examples.

Student loan payment moratoriums have been extended continuously since 2020. Most public discourse has transitioned from when to resume payment to how much to forgive.

The emergency use authorization process for medical goods transformed from a “test now, approve later” approach in early 2020 into a way to grant favors to politically connected drug producers.

According to the Committee for a Responsible Federal Budget, the federal government has authorized about $14.1 trillion in COVID-related spending. Recent estimates indicate only $11 trillion has been spent, with most remaining funds categorized as “administrative.”

When COVID-19 vaccines became available, the government assumed an unprecedented role in distributing vital medical goods across the country. Without significant pushback, it took the same position in distributing monkeypox vaccines (and failed just as spectacularly).

President Biden has signed 102 executive orders since taking office. President Trump signed 74 in the last year of his presidency. The previous two presidents signed 276 and 291 over both terms.

Governments tasked with deciding when to end a crisis have ample opportunities to expand their influence. The Biden administration granted itself three more months to prolong and extend the ratchet effect to secure more power and less freedom. Tragically, the longer government extends the crisis, the less likely they are to relinquish control.


Raymond J. March (raymond.j.march@ndsu.edu) is a research fellow at the Independent Institute and an assistant professor of agribusiness and applied economics at North Dakota State University. A version of this article was published on the Independent Institute blog on October 31, 2022. Reprinted with permission


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