Small states, big shots

By | March 12, 2021

In the race to vaccinate their populations, Israel and the United Arab Emirates are leaving the rest of the world in the dust. The Republic of Seychelles, a small island group in the Indian Ocean, is also an unheralded leader in the effort. One thing these nations have in common is that they are all small. They are reasonably wealthy, too, but wealth alone does not correlate with vaccination rates, as the dismal efforts in the European Union and Canada show.

The United States is vaccinating its people at a higher rate than any nation its size, but looking at the numbers broken down by state, we see a similar pattern. The most recent data show that the state with the highest vaccination rate is Alaska, followed by New Mexico, North Dakota, South Dakota, West Virginia, and Connecticut. These states are scattered across the country and the political axis. Some of them are rich and others are poor. What they have in common is that their populations are all smaller than that of the average state.

It is not a novel concept to say that government works better when the state is small. As the United States debated the ratification of the Constitution in 1787 and 1788, one of many criticisms from anti-Federalists was that the country was too large to function properly as a republic. Big nations, such as the European powers, tended toward tyranny in the age of absolutism, and many Americans feared the same would happen to their country.

In The Spirit of the Laws in 1748, Montesquieu claimed that vastness was fatal to a free republic. “It is natural for a republic to have only a small territory,” he wrote, “otherwise it cannot long subsist. In an extensive republic there are men of large fortunes, and consequently of less moderation: there are trusts too considerable to be placed in any single subject; he has interests of his own; he soon begins to think that he may be happy and glorious by oppressing his fellow-citizens; and that he may raise himself to grandeur on the ruins of his country.”

Skeptics of the proposed Constitution echoed that point. The pseudonymous author known as the “Federal Farmer” (probably Melancton Smith) wrote that a powerful federal government would drain the resources of the country toward the center. “Wealth, offices, and the benefits of government would collect in the centre: and the extreme states and their principal towns, become much less important.” People near the capital would support the enlarged republic on principle, but in the hinterlands, the laws “must be executed on the principles of fear and force in the extremes. This has been the case with every extensive republic of which we have any accurate account.” Force, not trust, would rule the day. Although the Constitution did not propose elimination of state governments, the Federal Farmer predicted that “the balance cannot possibly continue long; but the state governments must be annihilated, or continue to exist for no purpose.”

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In the minds of anti-Federalists, bigger was worse. The Articles of Confederation, America’s first constitution, governed the country more like an alliance than a nation. States controlled nearly everything. The federal government had no independent means of raising revenue and no independently elected officeholders, and could do almost nothing without the unanimous consent of the states. This kept power close to the people but also made any concerted action extremely difficult. Anti-Federalists thought this system was nonetheless the best safeguard of their liberties. A nation strong enough to act as a world power was necessarily strong enough to act against its own people.

In the Federalist Papers, Alexander Hamilton responded to these concerns by explaining that the system of government the Constitution prescribed, known to us today as federalism, squared the circle. Writing under the pen name “Publius” that he shared with James Madison and John Jay, Hamilton explained that the government proposed in the new Constitution was a confederated republic, a form explicitly endorsed by Montesquieu.

“So far are the suggestions of Montesquieu from standing in opposition to a general Union of the States, that he explicitly treats of a confederate republic as the expedient for extending the sphere of popular government, and reconciling the advantages of monarchy with those of republicanism,” he writes in Federalist No. 9. “‘It is very probable,’ (says he) ‘that mankind would have been obliged at length to live constantly under the government of a single person, had they not contrived a kind of constitution that has all the internal advantages of a republican, together with the external force of a monarchical government. I mean a confederate republic.’”

The Constitution’s federal system, in Hamilton’s view, would bring about just such a “confederated republic.” It would keep the nation united on the world stage to afford protection from foreign enemies but would not force the kind of unity that would override the state governments that came together to form it. The United States would be small and local in most ways but big and powerful where it needed to be. States would be left “in their possession certain exclusive and very important portions of sovereign power.”

Two hundred thirty-three years later, we have not become the despotism that anti-Federalists prophesied, but we have also clearly forgotten the importance of federalism. Anti-Federalists, like Montesquieu, were concerned about geography as well as population. Modern technology has conquered much of the first part of the problem — witness Alaska’s place at the top of the list — but the second part still plagues populous states and nations. Small nations outpace large ones, and smaller states lead their bigger neighbors. In this and other governmental efforts, we see the lessons of Montesquieu, but with a new twist: Large states become more despotic, but they also become less efficient.

This could be considered counterintuitive. Most of us believe that despotism, while odious, is at least efficient. It is this belief that leads frustrated small-d democrats to fantasize about being despots, only briefly, just to get some important project done. Thomas Friedman of the New York Times is the best-known advocate of the “ China for a day” fallacy, but he is far from the only one.

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The lesson can also be extended to the corporate world. In the 1990s, business leaders preached synergy. Large companies would buy up small ones and even merge with each other. The result would be economies of scale, increased efficiency, and lower costs for the consumer. The new corporate behemoths would be lean and fast, working steadfastly to bring their services and products to markets. It was “China for a day,” but for businesses. Forever.

Again, we see in the vaccination efforts that synergy served no one’s interest but the short-term shareholders. Whether big pharmacy chains are “despotic” in the way big governments are is debatable. What is not is that they cannot get the job done, at least as far as COVID-19 vaccines are concerned. Who did get the job done? Independent pharmacies.

In an NPR news report in January, Yuki Noguchi explained: “West Virginia has been charting its own path to vaccine distribution. All 49 other states signed on with a federal program partnering with CVS and Walgreens to vaccinate long-term care and assisted living facilities. But those chain stores are less common in West Virginia, so the state instead took charge of delivering its vaccine supply to 250 pharmacies — most of them small, independent stores.”

Small businesses in a small state mean that West Virginia, the 48th-richest and 47th-youngest state in the union, is currently fifth-best at vaccination. The Trump administration encouraged the consolidated effort that West Virginia eschewed, and Democrats’ only problem with that was that it was not consolidated enough. It reflects something deep within our political psyche that demands, in an emergency, that a strong man in a distant capital tell us what to do. Yet those strongmen consistently fail us. The problem is not that they don’t care. It is more basic than that: They don’t even know us. They may have the best plans, but their ideas never reach the people.

That is not to say that having the best plan does not matter. The best of the big states, Florida, has distinguished its effort by keeping things simple and keeping politics out of it. “My job at the division is to get shots in arms as fast as possible for people that qualify. That’s my job,” Jared Moskowitz, the director of the state’s Division of Emergency Management, told the Miami Herald last month. The Herald questioned the system and whether other demographic considerations should have entered the equation, but Gov. Ron DeSantis’s program has his state ranked 25th, the best of any large state.

Contrast that with New York (ranked 39th), where Gov. Andrew Cuomo announced the state’s intention to “ further strengthen fairness and equity in the vaccine distribution process” rather than just get to herd immunity as quickly as possible. Or Pennsylvania (ranked 41st), where the state’s lackadaisical efforts were harmed by the news that in its largest city, Philadelphia, officials rigged the bidding process for vaccine distribution in favor of a company run by a 22-year-old graduate student with no public health experience.

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Both failures harm the bottom line of getting people vaccinated, but they also degrade public trust, which is the cornerstone of achieving compliance in any large public health effort. Focusing on secondary priorities, as New York is doing, or participating in outright corruption, as witnessed in Pennsylvania, undermines that trust and sows doubt that the government truly has its citizens’ best interests at heart.

Trust goes hand in hand with the debate over federalism. People trust those whom they know. DeSantis understands this and has directed his state to work through local groups. Again, quoting from the Herald: “DeSantis said he believed that distributing vaccines through Black churches was effective ‘because it’s not some wild-eyed public health bureaucrat shaking their finger at them telling them to get it. It’s someone that they trust.’” Florida may be a big state and may have to work through big pharmacy chains, but it is doing its best to build a local effort that capitalizes on that public trust to achieve the goal, the only goal, of increasing vaccination rates.

Hamilton believed that the federal system would make for the best of both worlds, giving us the “confederate republic” that embodied Montesquieu’s happy medium. Instead, we have become enamored with bigness and anonymity, not the trust of local institutions. We have supplicated ourselves to a cult of efficiency that is economically efficient (it saves money) but not practically efficient (it does not deliver).

Governments and large corporations grow bigger and more powerful, but the services they deliver have been degraded in quality. We no longer see them as worthy of our trust or esteem, and everything they try to do suffers because of that. There is a feeling in 21st-century America that everything is failing. That is perhaps an exaggeration — we are still better off than most nations of the world — but doing better by comparison does not equal doing well. There is something amiss when the most powerful, most advanced nation on Earth stumbles on basic tasks of public health.

Saturday Night Live gave voice to this nebulous dread in its cold open on Jan. 31, when Kate McKinnon played the host of a show called What Still Works? The answer: nothing, except Tom Brady. America is still the biggest and strongest, but that bigness, of government and of business, has become a hindrance. Our search for efficiency and standardization has left us unable to help a people who are not similarly uniform. The answer, the federalism of Hamilton and Montesquieu, has been in front of us the whole time.

Kyle Sammin is a lawyer and writer from Pennsylvania and the co-host of the Conservative Minds podcast . Follow him on Twitter at @KyleSammin.

Healthcare