In the wake of the COVID-19 pandemic, Congress has already approved more than $2.4 trillion in new deficit-increasing measures, from new spending to tax relief.
Now, Congress is considering a new slush fund to exempt certain spending from budgetary restraints in the name of combating future health crises.
Instead, lawmakers should review agency missions and projects to better prioritize spending, reduce missions creep, and focus public health agencies’ activities on core initiatives.
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A bipartisan group of lawmakers from the House Appropriations Committee is reportedly contemplating a so-called health defense operations fund aimed at fighting COVID-19 and future pandemics.
Any money appropriated to the new fund would not be subject to the fiscal 2021 Budget Control Act spending caps, nor future spending caps.
On its face, that may sound like a reasonable idea. The federal government was caught unprepared for an emergency on the scale of COVID-19. Surely, unrestrained spending will leave the country better prepared for the next pandemic, right?
The answer is a resounding no.
There is no evidence that more spending on public health-oriented agencies and programs would lead to better public health outcomes.
The Centers for Disease Control and Prevention and the National Institutes of Health would be the main beneficiaries of the new health defense spending. But both entities have already received precipitous budget increases.
Between 2011 and 2020, the combined discretionary budgets of the CDC and NIH grew by 16.5% on an inflation-adjusted basis, reaching nearly $50 billion in fiscal year 2020.
The problem is that most of the additional funding went toward tangential activities, leaving the federal government no better prepared for the COVID-19 pandemic.
Instead of more spending, Congress should examine the existing missions of the public health agencies and identify where mission creep is getting in the way of a pandemic response.
The CDC, for example, is due for scrutiny for engaging in “social justice” missions over preparing to deal with serious infectious disease outbreaks. Examples include everything from prenatal oral health to obesity, to smoking and alcohol consumption, to gun control.
The NIH similarly can be criticized for funding research projects of questionable merit and those fraught with “significant design flaws,” as well as needlessly duplicating existing work.
Lawmakers should take a closer look at how public health agencies are currently allocating their funding and go through their budgets, line item by line item.
They should separate mission-critical projects from those “nice to have” initiatives that ultimately divert the agencies’ focus. Without that discipline, the likely outcome is more wasteful spending to evade budget constraints, without any concomitant improvement in mitigation of pandemic risk.
The idea for a health defense operations fund arose from the Department of Defense’s overseas contingency operations account. Overseas contingency operations are an emergency budget account that Congress developed in the aftermath of the Sept. 11, 2001, terrorist attacks.
The premise was that the Department of Defense would need a new temporary stream of funding to combat emerging threats across the globe. Emergency appropriations are historically common at the outset of conflicts, but were usually quickly incorporated into the base budget.
Overseas contingency operations funds were never intended to be permanent, yet nearly 20 years after 9/11, Congress continues to appropriate money to the fund that is exempt from budget caps every year. In fiscal 2020, a time when the military is not engaged in new operations abroad, Congress appropriated $79.5 billion for overseas contingency operations.
At one point in time, the emergency characteristic of overseas contingency operations funding was justified. However, that time has long passed.
In the era of Budget Control Act spending caps, overseas contingency operations funds have increasingly been used as a “slush fund” to increase the base budgets of the departments of Defense and State.
A 2017 Government Accountability Office report estimated that nearly $50 billion per year in overseas contingency operations funding was being used for activities that would continue even if there were no overseas conflicts.
Overseas contingency operations funds have morphed from having a clear and legitimate purpose to increasingly becoming a gimmick to evade reasonable fiscal restraints.
A health defense operations fund would likely suffer the same fate. Ultimately, the health defense operations account is a solution in search of a problem.
With its power of the purse, Congress already has great flexibility in what it can classify as emergency spending. As with military overseas contingency operations funding (and presumably health defense operations), emergency funding is not subject to budget caps or other fiscal restraints.
In other words, Congress can already appropriate additional pandemic funding if lawmakers agree that there is a need. Congress doesn’t need a special pandemic funding mechanism to provide additional money.
Creating a fund for that purpose would almost certainly guarantee additional unrestrained spending each year, regardless of whether there is a legitimate need.
Adding more spending to the nation’s credit card is not the answer to the COVID-19 crisis. Instead, lawmakers should have a serious discussion about how to reduce the risks and costs associated with a future pandemic.
When that discussion happens, Congress might find that a lack of money is not the problem; rather, it’s how that money is being spent.