This is the story of so much of what went wrong last year. Doctors and nurses were left without basic protective equipment because the United States lacked the manufacturing capacity to produce it. Efforts to track and contain the virus were delayed by bottlenecks in test production and shortages of supplementary equipment like swabs. Once tests could be administered, a nationwide scarcity of test-processing equipment prolonged the delivery of test results.
The reason: More than a decade into a hospital-closure crisis, the United States faced a shortage of beds and medical facilities necessary to manage an emergency. Hospitals overrun with Covid-19 patients turned away ambulances. Vaccine distribution, while steadily improving, has been hampered by shortages of both staffing and supplies. The poverty of local government infrastructure has disgraced the rollout further. Websites crash, phone lines are busy, parking lots are full.
These are not only public health failures but also economic failures — an inability to marshal resources to solve a problem. And the often-toxic incompetence of American political leadership has obscured the structural causes of this failure.
The United States once maintained a robust commitment to public investment in things like spaceflight, medical research, the interstate highway system and the development of the internet, backed by Republican and Democratic administrations alike. Staying at the cutting edge is expensive: Between 1965 and 1980, federal expenditures on scientific research, physical capital and education regularly amounted to about 2.5 percent of G.D.P., more than $500 billion today.
But that number plummeted in the 1980s. By Mr. Trump’s first year in office, Washington was spending less than 1.5 percent of G.D.P. on public investment, according to an analysis of Office of Management and Budget data from the Progressive Policy Institute, a center-left think tank. Before the pandemic, this plunge meant bridge collapses, Amtrak derailments and other disasters that Americans had come to see as inevitabilities. During the pandemic, that same chronic underinvestment invited mass death. Even the typically conservative U.S. Chamber of Commerce has spent years lobbying unsuccessfully for major increases in federal infrastructure spending.
Yet despite this persistent inability to mobilize resources, the U.S. government proved reasonably adept at summoning and allocating money. The Federal Reserve sustained the financial system and big business. Congress salvaged thousands of small businesses with its $660 billion Paycheck Protection Program, while preserving the finances of millions of Americans by boosting unemployment benefits and writing checks to households.
Of course, expanded unemployment aid should have kept flowing through the final five months of last year. And aid to state and local governments to fight the pandemic was insufficient. But where the problem was a shortage of money, the government delivered. Cash constraints have not hindered its rescue efforts, at $5 trillion and counting. Even the loudest moderates of Joe Biden’s Democratic Party did not balk at the $1.9 trillion cost of the Covid-19 relief bill he signed into law Wednesday night.