The State and the People

How much will Covid-19 cost? Despite the official insistence that the NHS will get "whatever it needs, whatever it costs", there has clearly been a lot of internal debate on what constitutes an acceptable price for the UK's response to the crisis. The initial commitment to a laissez-faire strategy and the subsequent volte-face to a more stringent policy of containment were motivated by assumptions about how much ruin society could tolerate (in the form of sick-leave as much as the death rate) and how capable the NHS is of managing the consequences. Now that the focus is more on how much ruin society can tolerate in terms of economic recession, the management of public opinion has shifted to the question of what a reasonable trade-off would be between increased mortality and reduced GDP. Following the poor reception of its "get herd immunity done" slogan, the government is now wary of leading such a sensitive discussion so it has outsourced responsibility for the debate to the hardened controversialists of the media.

Toby Young has predictably been at the forefront of the discourse, and just as predictably has been held up as a fool for his inability to get basic facts right, both in terms of the actual costs of premature mortality and the health consequences of recession. But he, like Daniel Hannan dolefully insisting on the need for a "grim calculation", has served his purpose in putting the question into the public domain and his critics have happily confirmed that a human life has a quantifiable cost and economic benefit. As Sam Bowman put it when disagreeing with Young, "All this suggests that, so far, the shutdown is worth it, and probably would be worth it for some time more, depending on how badly hit the economy turns out to be." As ever, British academia can produce a paper on demand to support any case. According to the Times, "Philip Thomas, professor of risk management at Bristol University, said that keeping the economy going in the next year was crucial, otherwise the measures would 'do more harm than good'".

Jonathan Portes, responding in the Guardian to this talk of a trade-off, demurred: "So what we should be worried about – both from an economic and a health perspective – is not how much GDP falls. It’s going to fall by a lot, and that’s a good thing. If it didn’t – if people were still going to work despite being told not to – then the lockdown wouldn’t be working and we’d still see economic consequences further down the line. It’s what happens to GDP in a year or 18 months that matters." But this isn't so much a flat rejection of Professor Thomas as a difference of tactical opinion that rests on a strategic agreement. As the Times put it: "This is why [Thomas] thinks the economy is crucial — not because of a callous belief that lives can be traded for money, but because money and lives are, at some point, the same thing. 'We see this very strong correlation between GDP and life expectancy,' he said."

"Money and lives are, at some point, the same thing" is the fundamental assumption that unites conservatives and liberals. This goes beyond the marginalist idea that our preferences can be accurately priced to the utilitarian belief that all human activity can be quantified in terms of the aggregate benefit to society. This remains a powerful factor behind the symbolism of GDP and the commitment to growth. Though the climate crisis has called the latter into question, our collective response has been dominated by the calculus of limits, targets and offsets, all of which are held to have a monetary equivalent. It is perfectly reasonable - in the sense of practical and effective - for society to be managed through numbers, but it doesn't necessarily follow that all of these indicators need to be translated into a uniform system of price. That is the Hayekian premise and it springs not from a desire to know more but from a desire to hold the world at arms-length through an all-purpose abstraction.

There is a broad correlation between GDP and longevity over the long-term, but there are also examples that break the rule over the short to medium-term, from World War Two (UK life expectancy actually rose, despite wartime casualities, while GDP fell) to the negatives of pollution and workplace risk during rapid industrialisation. The truth is that longevity is a product of a number of factors influenced by GDP, including policy decisions about how the fruits of growth are shared. Most countries spend more on health as they grow richer, but this tends to operate on a ratchet - they don't spend proportionately less in recessions, in fact they may spend more as public health is one of the automatic stabilisers of the economy. The claim that "normal" recessions lead to a reduction in life expectancy isn't borne out by the evidence. Some causes of death, such as suicide, increase while others decrease. And that's without factoring in the exceptional features of this crisis, such as the huge fall in road traffic reducing air pollution and accidents.

A slightly different perspective is available from conservative commentators like Andrew Neill and Allison Pearson, who have sought to distinguish between "dies with" and "dies from", thereby lowering the death rate attributable to Covid-19. This pedantry is obviously not motivated by a desire to accurately tabulate causes of mortality (both were predictably sceptical of the claims that austerity led to an increase in avoidable deaths). After all, people die all the time from complex pathologies that we simplify as "cancer" or "heart disease" but very few newspaper articles are written to complain about this. The purpose is clearly to undermine the case that Covid-19 is exceptional and thus call into question the exceptional public health measures. This is a strategy of dismissiveness that appears to be motivated equally by antipathy towards the "nanny" state and a fear that disruption will undermine the economic order.

In contrast, self-styled libertarians like Young appear to be motivated less by a sincere concern for economic trade-offs, as evidenced by their sketchy workings-out and crucial ommissions, and more by the exciting intersection of bioethics and utilitarianism that the crisis raises. In other words, the proximate thrill of our old friend, "life not worthy of life". The same dodgy reasoning is all too familiar from Young's previous musings on heredity and "progressive eugenics". Proposals for the betterment of the stock invariably reduce over time to a demand that everyone should justify their right to existence - that they should "pay their way" through their positive contribution to the herd. The difference between these two conservative camps, which is easy to miss if you simply attribute their separate claims to the instinctive denialism or callous indifference of the right, is that the mortality sceptics insist that certain deaths don't count while the eugenicists insist that certain people don't count.

The view from the liberal centre and centre-left is more humane. Sarah O'Connor in the Financial Times suggests that "the chancellor should pay a 'national gratitude bonus' to every key worker who is risking his or her own health to keep the rest of us comfortable at home. Once the economy has recovered, these jobs need to be made better. Insecure contracts and loopholes should be replaced with permanent jobs, better wages and more training and accreditation. This would not be costless." The latter prescription is fine, but without a frank discussion about means the ends remain merely aspirational. Are we talking about the mass-unionisation of gig-workers or a slightly higher minimum wage? But what stands out here is the proposal of a bonus, which looks all too clearly like putting a price on life, or at least on a risk that few are in a position to avoid without jeaopardising their job.

Adam Ramsay at openDemocracy has criticised the recent tendency to blame the people rather than scrutinise the government's dilatory response: "Of course we should support each other to stay safe. But we shouldn’t forget that that’s the first responsibility of the state. Of course we must all play our part in preventing the spread of this virus. But we should also be clear about who has the most power, how they have failed us and what they must do differently – now." The idea that the state's first responsibility is the safety of the people is not one that's borne out by history. Even in the immediate aftermath of the Second World War, and the clear expression of a popular demand for social security, politics was driven by the competing demands of welfare and the economy, most obviously in the concern over the escalating cost of the fledgling NHS and the consequent introduction of prescription charges. Coming on the back of a decade of unnecessary austerity, the insistence on a principle that has rarely if ever been adhered to strikes me as naïve.

The lack of preparedness and the discordance between the expectations of the state and the people evident in the current crisis is par for the course, not some atypical failing that can be laid at the door of Boris Johnson alone. There is also ample evidence of institutional discrimination, from Matt Hancock seeking to shame footballers while studiously ignoring the idle rich to the police instinctively using their greater disciplinary powers against those already deemed socially problematic. Ramsay makes a good point about this incidence: "Even more dangerously, though, when responsibility is cast onto an atomised population, it doesn’t land evenly. It is channelled down the social structures which already exist. Race, class, gender, sexuality: blame is always mobilised against the already marginalised." When the people are blamed en masse, you know that behind this charge are beliefs about varying degrees of culpability, and it is that discrimination that also lies behind the conservative questioning of value.

The crisis has revealed three truths. First, that the state does not take its responsibility to protect the population seriously, beyond a cynical concern about public opinion and poll ratings. This is not a particular failing of conservative administrations but a more profound institutional commitment to the notion of a supra-party national interest (raison d'Etat), which could also be seen in the calamity of Iraq. Second, that decades of the neoliberal erosion of the state's capability to intervene in society and the economy, in favour of its narrower role as a creator and guarantor of markets, have left it with a reduced capacity to respond to large-scale threats beyond public order, from pandemics to flooding. Third, that the idea that the economy serves the people - that it is the medium of aspiration and self-fulfilment - was always a con intended to hide the truth: that the people are expected to serve the economy - in other words, that labour must serve capital. The "grim calculation" of Young and Hannan is one of those rare occasions when a corner of the veil is lifted.