Health officials say part of the problem with the vaccine is the rigidity of the guidance.
“I would strongly encourage that we move forward with giving states the opportunity to be more expansive in who they can give the vaccine to,” said FDA Commissioner Stephen Hahn during a recent policy event.
Changes in the rules might help. But it will not fundamentally fix the problem. The vaccine roll-out will be unavoidably dysfunctional so long as it is controlled by government bureaucracy. That is because the most a bureaucracy can do is replace one set of highly arbitrary rules with another.
“You will never understand bureaucracies until you understand that for bureaucrats procedure is everything and outcomes are nothing,” economist Thomas Sowell once observed.
That is inescapably true, because bureaucrats are fundamentally disconnected from the social outcomes of their actions. Those social outcomes are extremely complex. Every decision about the distribution of a vaccine has innumerable impacts on the public. Prioritizing young health workers over the elderly will have many public benefits (more COVID patient care, etc.), but also many public costs (more direct risks to the most vulnerable population). There is no non-arbitrary way to balance the manifold public costs and benefits, or to incentivize bureaucrats to strike that balance.
Sowell is right. For bureaucrats, outcomes literally are nothing, because they have no way to make meaningful judgments about them. And for bureaucrats, procedure is necessarily everything, because it’s all they have to give their activity any kind of coherence.
“Public administration,” wrote Ludwig von Mises in his book Bureaucracy, “the handling of the government apparatus of coercion and compulsion, must necessarily be formalistic and bureaucratic.”
“Bureaucratization,” Mises added, “is necessarily rigid because it involves the observation of established rules and practices.”
The Entrepreneurial Alternative
Thankfully, this is not the case for private business and entrepreneurs.
For entrepreneurs, outcomes are everything, and procedure is, at most, a distant second. That is because the incentives of an entrepreneur have a tight and meaningful connection with social outcomes: namely, profit and loss.
Profit is often denounced as “selfish,” but it is actually a powerful and subtle way to tie private interest with public benefit. In fact, it is the only way to do so, given the extreme complexity of public benefits and costs discussed above.