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New York COVID-19 Vaccination Program: Over-Centralization and Bureaucratic Overreach

by Insuredwell
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New York Governor Andrew Cuomo speaks during a daily briefing following the outbreak of the coronavirus in New York City, July 13, 2020. (Mike Segar/Reuters)

Command and control is no way to run an economy. And the more centralized it is, the worse it becomes. We will doubtless be getting a taste of just how bad a system it can be if too many of the promises/threats contained in the Green New Deal are implemented in the next few years, but in the meantime, New York’s COVID-19 vaccination program is showing signs of the damage that over-centralization and bureaucratic overreach can bring in their wake.


ALBANY — County officials who have for years been planning for a mass vaccination said they are seeing that training and preparation — much of it funded by millions of dollars in federal grants — pushed aside as the administration of Gov. Andrew M. Cuomo has retained control of the state’s coronavirus vaccination program, including having hospitals rather than local health departments administer the doses.

Interviews with multiple county officials over the past week confirm that many are unclear why the governor’s administration has not activated the county-by-county system, a plan that included recent practice sessions in which members of the public received regular flu vaccines at drive-thru sites.

In Albany County, officials have privately said they could vaccinate the population of the southern half of the county in a few days if they were given the coronavirus vaccines and allowed to mobilize their plan . . .

And then there are Cuomo’s fines. Reason’s Billy Binion sets out the New York governor’s latest cunning plan in all its bullying stupidity:

New York Gov. Andrew Cuomo has given hospitals a conundrum. Fail to use all of your COVID-19 vaccines within seven days of receipt? That’ll be a $100,000 fine. Vaccinate someone out of the state-designated order? That’ll be a $1 million fine.

Damned if you let your vaccines expire, damned if you don’t let your vaccines expire — by using them on anyone outside of the approved hierarchy. . . .

Veronique de Rugy, writing for us today about the situation nationwide:

[W]e shouldn’t have been surprised by the slow rollout. It isn’t the first time that top-down institutions have failed to roll out whatever products they were designed to get out. Remember the rollout of Obamacare’s website?

Veronique links to a Bloomberg article by Virginia Postrel:

For too many people, it’s a knee-jerk reaction: Blame the slow U.S. rollout of Covid-19 vaccines on too little central planning by the administration of President Donald Trump. Demand tighter control from the incoming administration of President Joe Biden. Limit the number of vaccination sites! Bring in the military! Put somebody in charge!

But the problem with the rollout of Covid-19 vaccines isn’t that no one is in charge. Far from the answer, tighter federal control would probably be a disaster. It would only amplify the problem.

By guaranteeing large purchases, the federal government gave manufacturers strong incentives to produce the vaccines. It was a smart move, and it worked. But now we’re experiencing the downside. Buying up the supplies and bestowing a vaccine monopoly on state governments blocked the normal distribution channels connecting producers with vaccinators.

Whether you’re laying fiber optic cable or delivering packages, that last mile is the tricky, labor-intensive, expensive part. To reach individuals, the system has to go from centralized operations to decentralized ones. That’s why we have retailers rather than ordering our toilet paper from Georgia-Pacific, and why they, in turn, often rely on distributors. “Cutting out the middleman” is a catchy slogan, but intermediaries make the system work…

The Reason Foundation’s Marc Joffe and Vittorio Nastasi have also weighed in:

The delays in vaccinating Americans have partially resulted from overly complicated prioritization schemes that come with uncomfortable tradeoffs. Health care workers and vulnerable populations, like the elderly and immuno-compromised, should clearly be given the highest priority, but hesitation among priority groups and a number of other issues could further delay distribution.

Ultimately, widespread vaccination is the best solution for containing the coronavirus pandemic. Rather than getting too caught up in prioritization, state and federal officials should focus on delivering vaccines as quickly as possible to those that want them. Here are a few proposals that could help achieve that goal.

Rely upon existing vaccine distribution mechanisms to the greatest extent possible.

Millions of Americans go to CVS, Walgreens, Rite-Aid, Walmart and many smaller pharmacies to get flu vaccines each year. These pharmacies have the infrastructure, staff, and logistical processes needed to rapidly immunize the general public—they just need doses of the vaccine.

Keep prioritization rules simple to reduce confusion over who is eligible.

Once health care workers and nursing home residents have been immunized, it would seemingly be easiest to base eligibility for vaccinations on age. States and counties simply have to inform distributors and the general public of the latest birth year eligible to receive shots. Pharmacies would just need to check the driver’s licenses for each customer’s birth year before administering the vaccine, as some do when selling alcoholic beverages and cigarettes. Individuals who are immuno-compromised or have other chronic vulnerabilities that would put them at increased risk of contracting a severe case COVID-19 could present a doctor’s prescription at the pharmacy to receive an early dose of the vaccines.

Avoid wasting doses of the vaccine.

Distributors in possession of doses that are within 24 hours of expiring should be free to administer the vaccines to anyone—regardless of eligibility since a wasted, expired dose of the vaccine is worse than vaccinating an individual with less need. States should not, for example, impose criminal penalties on health care providers or vaccine recipients who ignore prioritization schemes as New York Gov. Andrew Cuomo has….

Joffe and Nastasi also make this point:

Extend “right-to-try” laws to allow anyone to receive a vaccine approved in other countries.


There are times (clearly) when governments can help with this process — and they have. But there are also times when governments would do better to get out of the way, a reality that, as in so many other instances, does not appear to be sinking in. The failure to accept that there are things which governments do not need to be controlling is something that we have seen repeatedly during this pandemic, and it’s a failure that has made things even worse than they were always going to be.

The quicker vaccines are distributed, the more rapidly (obviously) this nightmare comes to an end, as both deaths and new cases ought to decline at an exponential rate. That’s too big a prize to sacrifice on the altar of micromanagement, even if it leaves some bureaucrats and politicians feeling that they no longer have the degree of control that is their comfort zone.

Please read the articles I have linked to and see what you think. Meanwhile, I continue to enrich the manufacturers of Vitamin D, zinc tablets, and the like — and, yes, I wear a mask.

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