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. 2023;195(1-2):169-191.
doi: 10.1007/s11127-022-01002-3. Epub 2022 Oct 21.

The pox of politics: Troesken's tradeoff reexamined

Glenn L Furton  1   2
Affiliations

The pox of politics: Troesken's tradeoff reexamined

Glenn L Furton. Public Choice. 2023.

Abstract

In The Pox of Liberty, Werner Troesken details the tradeoff between liberal institutions and communicable disease. According to Troesken, individual freedom presents a danger to the public health in the face of infectious disease, while constitutional constraints restrict the government's ability to implement effective policy. Contra Troesken, I argue that decision-makers, amidst a crisis of contagion, neglect intertemporal tradeoffs, thereby discounting long run costs while favoring short run policies. These policies, once implemented, are difficult to reverse due to the path dependent nature of political institutions. Irreversible and self-reinforcing growth in political institutions established to enhance health can have an unintended negative impact on health during future crises, where political agents must operate in a more cumbersome and error-prone institutional environment. Using events from the history of public health in the U.S. as support for my theory, I conclude that Troesken's alleged tradeoff ought to be met with greater skepticism.

Keywords: Bureaucracy; COVID-19; Crisis; Disease; Government failure; Government growth; Interest groups; Pandemics; Path dependence; Public health; Rent seeking.

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Figures

Fig. 1
Fig. 1
Critical junctures and institutional change {replace the footnote with “Source:”; all tables and figures should be moved to separate pages at the manuscript’s end and replaced by callouts indicating proper placement in page proof}. Adapted from Mahoney (, p. 113)
Fig. 2
Fig. 2
Intertemporal tradeoff comparison
Fig. 3
Fig. 3
Net cost comparison
Fig. 4
Fig. 4
Institutional path dependence in US public health
Fig. 5
Fig. 5
National public health expenditures* Source: Centers for Medicare & Medicaid Services, Office of the Actuary, National Health Statistics Group; U.S. Department of Commerce, Bureau of Economic Analysis; and U.S. Bureau of the Census, https://www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-andReports/NationalHealthExpendDat
See this image and copyright information in PMC

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