Politics. Often forgot except by Charleston’s local historians – of which there are many – is the fracas at Fort Sumpter in the spring of 1861 was precipitated, in part, by the federal government’s indifference to the installation’s condition.
(If your mind is already making that leap, yes, the Civil War was fought over the despicable enslavement of humans with one side seeking its abolition and the other trying to preserve a heinous economic system dependent on nearly free labor.)
After the English were dispatched in 1812 and no new threats emerged in the east, the federal government turned its attention to its manifest destiny and left the unfinished fort to rot in Charleston harbor.
Until, of course, the election of Abraham Lincoln triggered secession, tensions rose, and finally boiled over when federal troops moved from Fort Moultrie to Fort Sumpter in early 1861, something the Governor of South Carolina viewed as a hostile act.
Incorrectly, South Carolinians felt a certain ownership of the defensive outpost. After all, the federal government had seemed indifferent to its proper maintenance and construction. That line of thinking was, of course, necessary to mount an offense against federal forces that threatened to upend – rightly – the agrarian economies of the south.
Had the federal government been lead, until the fall of 1860, by someone other than the feckless and generally incompetent James Buchanan, would it have completed the fort and adopted a more deterrent posture relative to the restive southern states? We will never know.
The lesson, one that must be re-learned, is that power abhors a vacuum. Into it ran the rash sons of the south who bled the region dry for over 100 years.
Policy. Governor Ron DeSantis of Florida does not have civil war on his mind. Notwithstanding silly polls and Nostradamus-like prognostications, domestic divisions in the U.S. are probably no worse than the period 1. Plus, DeSantis wants to be president and presumably of all 50 states.
What Governor DeSantis also wants is to fill a vacuum created by the nearly unimaginable incompetence of federal health bureaucracies, particularly the Food and Drug Administration and the Centers for Disease Control.
Last week he announced the formation of a public health advisory group that will examine the evidentiary support for approved drug products and make recommendations to Florida providers.
A mini-FDA, if you like.
The announcement, made in close proximity to his request for impaneling a grand jury to examine claims of safety and efficacy made by Covid vaccine manufacturers, has been met with what has become a regular refrain of anti-vax-ness.
If, however, you look beyond some of the issues associated with Covid vaccines, especially in young people, the FDA and the CDC still look rather incompetent and feckless.
The AP and others have reported concerns about the cost of Amylyx’s ALS drug, which consists of an old drug for a liver disorder and a supplement favored in traditional Chinese medicine. In other words, AMLX isn’t selling a cure for ALS. It is selling false hope on the order of 19th century snake oil.
Other examples are legion. Accelerated approvals, twisted into a shape necessary to meet the economic demands of often unimaginative pharmaceutical companies and their shareholders, have created a vacuum into which leadership and competency can stroll.
And so, it shall.
Florida is the first, but it probably will not be the last.
Power. The health policy apparatus in Washington is bracing for years of gridlock supported by continuing resolutions that fund an increasingly inadequate status quo, dooming itself to irrelevance.
The long, slow march of the federal government’s dominance began with the defeat of the Confederacy. It grew exponentially when rare and nearly uniform consensus was developed under the watchful eye of a mere three television networks. It ends with a Federalist Society fueled court system, a cacophony of media sources, and more attractive uses of time for ambitious public servants.
The assertion of states’ power is not likely to be challenged in the near term. Governor DeSantis will begin to run what is a de facto drug and device approval and recommendation process. Governor Greg Abbott will continue to erect as many barriers as possible to stem the tide of illegal immigration in his state. Other issues, as they arise will be met with state-based solutions.
It sounds like a bad thing, and it is for all the NGOs, media organizations and corporate interests that have been obsessed with federal politics since Ted Turner turned on CNN.
But it is the American system. Operating as designed. Power centers ebbing and flowing as circumstances demand it. Talented people rising to the occasion. For all its flaws, far, far better than the alternative.
Have a great rest of your weekend.
Emily Evans
Managing Director – Health Policy
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