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Jessamy: Hi, you're listening to another special episode of The Lancet Voice. I'm Jessamie Bagganor. And
Gavin: I'm Gavin Cleaver.
Jessamy: And today we're going to be talking about how the role of the state has increased in all of our lives since COVID 19. What do we mean by the role of the state?
Gavin: You can look at it in a couple of different ways.
There is, of course, the imposition of greater state control over individual freedoms, and of course by that we mean lockdowns enforced social distancing, the extra rules regarding people's personal freedoms that have been brought in since the pandemic began began to hit countries. But you can also look at it in terms of greater state intervention into the markets and in people's employee, employer relationships.
So obviously the states across Europe and indeed to a more limited extent in America has propped up people's wages, it saved businesses that have had to shut down due to the social distancing rules. It's done many more interventions than that. So Those are the two major ways that the state is taking a larger role in people's lives.
And it's a big change from the politics of the last few decades in most in most countries.
Jessamy: It's interesting, isn't it? Because my view of politics and sort of philosophical politics is that there's always sort of two sides and people want one thing or want the other. Where do you stand on how much the state should be involved in our lives?
Gavin: I think it's always important that the state has to strike the right balance. I think that's important across all of philosophical politics. With so much political debate we always hear about two polarized sides of the debate, whereas actually pretty much every state is trying to end up somewhere on the continuum.
There are almost no examples of a state that is fully in control of the market and a state that fully leaves the market up to itself in terms of the market. And there's almost no examples of a state that fully controls people's everyday lives or a state that completely leaves people to do what they want.
So every state really ends up on some kind of continuum. And it's just interesting that pretty much every state has a response to this coronavirus outbreak. has become more interventionist. I guess you could frame the debate quite easily there in terms of both people's lives and the markets as interventionist versus hands off, laissez faire, whatever you want to call it.
And my impression is That we'll be seeing interventionist state in both people's freedoms and in the markets for a very long time after this is over. But I am not an expert by any means, so that's why I wanted to speak to Professor Philippe van Parijs from Leuven University in Belgium, who is a very prominent political philosopher with many publications about the role of the state in people's everyday lives in both of those spheres.
Phillippe: My name is Philippe van Parijs, I'm a philosopher, I live in Brussels, and I teach at universities of Leuven and Leuven.
Gavin: I really appreciate you joining me today, Philippe. Obviously in the midst of this COVID 19 crisis across Europe and across the world, we've seen this kind of massive expansion of the state, the moving of state apparatus and generosity and support into places where it wouldn't normally be expected.
Is this a kind of really notable expansion? And is this kind of a moment of opportunity for a first to change tack, do you think, as a society?
Phillippe: It's important to distinguish different interpretations of what an expansion of the state may mean. So if one means by that, uh, nationalization of industry, expansion of bureaucracy, this is not exactly what is happening.
During the crisis, there are even many bureaucrats in some countries that are out of work. And in some sense, the state apparatus is, shrinking being, albeit temporarily. But because there are two other senses in which you could say there is an expansion of the role of the state. First of all, there are massive transfers things that would have been regarded as totally irresponsible financially.
Just a few weeks or months ago I've done everywhere and these things I've done all over the place in in all countries. So there is a sudden expansion of the state budget, which is meant to be largely temporary. And there is a further sentence, which is an expansion of the role of the state, which is that the state has become or the government or various levels of government in some countries have become incredibly intrusive, even in war times, I don't think there ever was.
This degree of micromanagement of people's behavior, the fact that children cannot go and visit their grandparents, the fact that you have to wear masks in the street, the fact that you have to keep distances, that you cannot go to the cinema. All these things are a massive restrictions of our freedom by the government, and this is indeed something very new.
It's certainly unprecedented in my existence.
Gavin: So I think you're right to talk about it in terms of a transfer of goods rather than So this transfer of goods obviously you've spent a lot of your career talking about the universal basic income greater government support, greater freedom for the individual but supported in that way by the government.
Do you think this moment provides a greater opportunity for that than normal times? For us to change tack, as a society?
Phillippe: I believe that there are a number of things that will stay and some of them may be for the good, but some not so much for the good. So certainly I believe that some of this micromanagement, which I don't regard as a nice role for the state, for the government to play, but sometimes it's a necessary role, I think.
That will stay as long as not only as long as the crisis persists, but as long as we'll feel there is danger that something analogous will start again. And so that will be something long term but not exactly desirable. It's rather part of a dystopia of a state that is forced, for good reasons to.
Micromanage people's behavior rather than some sort of beautiful ideal of the government finally being able to play the role which which roles in which it has been displaced by the market unnecessarily or illegitimately over, over the last years. So that, uh, in terms of seizing it as an opportunity, it is at least ambivalent.
Because it may also be a moment where something was triggered that will not go quickly and that is not all that positive.
Gavin: Is it your sense that this crisis has redefined the role of the state?
Phillippe: For people who doubted that the government had an important role to play, this has certainly been a wake up moment.
Because there are things which the market is better at than the state. But whatever the economy is it is well known, whatever the economy is called externalities, whether positive or negative the things for which the market is very badly equipped so that the state or the government.
Various level has to intervene. Sometimes it can do that by correcting the market, by imposing some taxes in order to internalize the externalities as the economists put it or on the country. Give subsidies when the po, when the externalities are are positive. But in cases like contagion and contamination an epidemic a pandemic, it's not, you can't really try to control these externalities by taxing and subsidizing you do some of it, but you have also to impose certain behaviors and prohibit other behaviors.
And so this protective role of the state. As certainly regarded now, when you look at the public opinion surveys in most countries, there's a massive support for this sort of active role, sometimes repressive role of the government. So I think this this is a major difference, but of course.
This is one thing of which the crisis has made us more acutely aware, but there is another thing of which The mark, the crisis has made us acutely aware is the incredible importance also in terms of social justice of the public space, because now due to the confinement, to the lockdown many people in many countries are stuck in their private spaces, but these private spaces are very unequally distributed between the people.
And so for people who have a nice home in a big garden being confined Involve some costs in terms of what that can do but it's far less painful than for someone who's stuck in a very small space with a large family. So that makes us aware of the fact that a public space, a high quality public space where, which is not only a space for sustainable mobility, but also for enjoyable immobility.
That this is a major factor in a major equalizing factor, a major component of people's real freedom. And so it's universally accessible to everyone. But of course, it is of far greater importance for people who have a private space that is very limited. And so that I believe among the things of which we've become aware there is also then this aspect, it struck me in fact, as it had never struck me before which is the immense importance of the public space.
And there, of course, there is again an important role for public authorities that public space is also Massive realm of negative externalities in terms of the pollution of all sorts is created by the vehicles we use and a sort of a very active role played by the government. At that level, which is not may not need many bureaucrats, not know many much redistribution at that level, but you need a strong regulation in order to to create this public good for everyone, which is of particular importance for the people who are least well off.
Gavin: Yes, I think it's important, of course to bear in mind throughout this crisis that it does. tend to strike, though, as we say with almost all of health research, it does tend to strike the least well off, the hardest. Moving specifically on to health, would you say the health of citizens has now formed a more central part of the responsibility of the state?
Phillippe: Our health will always be a shared responsibility between us and the society at large. And that is for two main reasons. The first reason is that health is a public good. Again, it's a matter of positive and negative externalities. The state many. Contagious illnesses forces people to take vaccines from an early age.
This is meant to be good for the people who have to accept the vaccine, but it's also good for the people who they won't contaminate if they never get the illness. But more broadly, of course, having a healthy workforce not to have too many burnouts not to have too many professional illnesses of various sorts is also probably good.
It's something that's good for the immediate beneficiaries and people who don't get the burnout who don't get ill because of working conditions. But it's also good for society at large because A healthy workforce is important for everyone. So this is the first reason why health is also in part the responsibility of the government.
But there is a second reason, which is that our healthcare systems in various ways, are a very important part of our mechanisms for greater social justice. Those are we have in some countries very developed healthcare. Insurance system in other countries like United Kingdom, you have a healthcare system that is to a large extent nationalized that is public, but in one way or another these systems try to implement some form of solidarity that goes beyond it.
self interested insurance. And that means that the health care and the, in all forms of the medicines, et cetera of everyone are paid to various extents by everyone. But. We know ex ante that there will be redistribution. That means that we know in advance that some people are high risk people, and we also know in advance that some people will contribute less to the whole of the system because they are poor.
So it's part. Of a redistributive system. So it's part of solidarity organized at the level of society at large. And of course, some people may be expensive for that system because of some choices they make because they are mountain climbers or because they are smokers or because they expose themselves too much to the sun or And and that means that the.
And the behavior the chosen behavior, not bad luck, but the chosen behavior of every beneficiary of the whole system will affect the cost of the whole system and therefore the burden to be borne by the people who contribute to it. And that is practically everyone, but to very different extents.
And there we have a second way in which you could say the state needs to take some responsibility for the health of the people because you can't just allow people. Through their own choice to free ride on the solidarity of the others. So what should we do about smokers? Should we say if you smoke and get cancer too bad society won't pay for it?
Or will you try to do it, to organize it differently by saying we need to charge people if charge them more if they smoke, don't have to. Paying an additional contribution to the healthcare system. But however we organize this, there is there unavoidably a sort of tension between on the one hand solidarity, which is very important for social justice reason.
And on the other hand the idea of toleration, of respect for the diversity of the conceptions of the good life, there is a tension between the two, and the more important we regard solidarity with respect to or compare to this equal respectful conceptions of the good life, the more there will be a tendency on the part of the government to dictate it.
how people should behave. So in these two ways, so the internalization of externalities on the one hand, and secondly, and the sort of the management of of a solidarity system that also give us some create some obligations on the part of the beneficiaries in these two ways. I think there is an important role and to some extent an increasingly important role to be played.
by the government in our the management of our health.
Gavin: Yes, I think those are very important points to make, that the health of citizens is already so important to the state. Finally then, these measures, this transfer of goods that we've seen in so many economies around the world, to what extent do they meet the criteria for universal basic income?
And do you think this is a kind of meaningful progress towards a universal basic income? There
Phillippe: are, and so certainly the current crisis has created yet another unprecedented upsurge of interest in basic income throughout the world and from India to California, but the proposals come in very different versions.
And so there are some people who advocate a temporary basic income, an emergency basic income, as it was called in the UK, where Over 150 members of parliament I saw supported a letter asking for the introduction of such an emergency basic income. And that's meant to be to last only for the length of the crisis.
As a result of a lockdown, a number of people are suddenly deprived of their usual source of income. Something needs to be done very urgently. You could try to do that in a targeted way, you don't need to, in principle, you don't need to to to. Distribut income to everyone, to the people who don't need it and wouldn't know how to spend it anyway.
But but there are many people who are suddenly deprived of all income. If you try to do it in a targeted way, it may take time to identify to and to specify the criteria to identify the people who satisfy this criteria. And by the time you, you've done that the crisis may be over, but the people need.
The money straight away and therefore you have this first set of proposals where people say we know we'll be giving the money to people who don't need it, but it's being needed now temporarily one month, two months, three months by very badly by some people and to make absolutely sure they get it.
And then I get it in time. Let's give it to everyone. And then yeah. We'll make it taxable, and we'll claim it back from the people who are rich enough at at a later stage. So that's one type of proposal, but that applies only for the duration of the lockdown. Then you have a second type of proposal that applies then to the period after the lockdown, when you have to reboot to kickstart the economy.
And the shops are open again economy, the economy should start moving. And there and some people have been arguing also in other contexts, also in the context of the earlier the earlier recession, people have been arguing for so called quantitative easing for the people. quantitative easing, just a monetary policy that consists in creating more money, usually in the form of cheap loans by private banks.
Then given that The interest rates are already so low not only in the European Union, but so far beyond. Many people have been arguing for direct transfers to people. You do that once, you do that perhaps a second time, 500 euros or pounds, and then the second time, probably a thousand euros.
At the moment where you need to increase purchasing power. So that businesses can regain confidence that there will be consumers who buy that product. That's the second set of proposals where the funding is through is through money creation. And again, if you think, well, what's the point of distributed, distributing money to people whose propensity to spend the marginal euro, the marginal pound is very low because they're already so rich.
Yes. Okay. But again, make it taxable make it part of the people's taxable income and you'll be able to claw it back from people who anyway, wouldn't have spent that that money. So there's a second sort of, of proposal. Both of them are just temporary. That's not a genuine basic income, but the crisis has also fueled again, the pleas for a permanent basic income.
Part of the argument that applies specifically in this case had we had a basic income as a sort of floor below all other income people's subsistence would have been secured without needing any emergency measure. So it would have been there, would have been modest income, no doubt, and some, it wouldn't have made unemployment insurance redundant, but all these.
All the rest would have been less urgent and less voluminous. It would have couldn't have been needed at the size at which it was needed. Now, if one could rely on basic security for everyone, everyone could count on it. And that would help us would have helped our societies and our economies to be more resilient faced with that situation.
Also, if you. Go back to the second proposal I mentioned before had you had, if you have in place something like basic income then it's very easy when you don't have enough inflation just to increase the flow in in the pipeline. So instead of giving on a regular basis, say 500 pounds or 600 pounds, whether you Increase the amount for one month when it's needed for by the economy, you increase that amount by 300 euros or 500 euros or whatever is needed and more generally of course, argument for basic income doesn't only apply to the context of of pandemics and so more generally having them.
This this unconditional floor is meant to help us address and to help our societies and our economies address the specific challenges of the 21st century. And so we have increased polarization due to to technological change And the type of globalization we've had and will keep having, certainly for services.
So we have an increased polarization of people's earning power. We have an increasing precariousness of many jobs related to that. Having this floor is something. That is an essential component of the institutional structure we need, with one essential complement, which is lifelong blended learning which is lifelong learning that is facilitated by the existence of this flow.
But that, and that will enable you to adjust and keep adjusting throughout your lives to the economic and technological context. And there is a complementarity between these two measures because the floor is what makes it possible to have a fast, smooth back and forth between employment.
Training, education in the broader sense, and then voluntary activities of all sorts in particular, but not only within the household. And basic income is an essential component, not the only one, of course which we need in order to face these specific challenges in order to secure both of those.
economic efficiency in that context and greater social justice by giving more options, more bargaining power, more real freedom to those with least of it.
Gavin: Philippe, it's been a real pleasure speaking with you. Thank you so much for taking the time today to chat with me. Yeah, I think it was clear there from my chat with Philippe that state intervention has increased.
It could be here to stay for a while, but also that, in a number of ways, it's nothing particularly to be scared of.
Jessamy: No, and I think that, a lot of governments, the UK government at least, has described it as putting a hug around people so that they don't feel, lost and on their own and, when we compare it to the financial crisis, this feels like a much better way to, to deal with it.
Gavin: Yeah. And I think the difference that has to be emphasized between this and the financial crisis, which, only applies if this doesn't go on for too long in terms of the impacts on economics is that there should be an immediate bounce back. And that is another really important difference between this and, for example, the Spanish flu, to emphasize, is that it's not a particularly deadly virus like the Spanish flu was.
So actually, the labor reserves, in terms of the operation of the economic engine, shouldn't be too damaged. It should be a relatively quick bounce back. Obviously that depends on an innumerable amount of factors. But I think that's definitely the hope amongst most economies, which is why you see these kind of periods of intervention, like the for instance here in the UK, the intervention related to propping up people's wages, furloughed workers is being renewed every three months, and I'm sure there are a lot of people in government who are pushing the government to open them.
And, I hate that phrase, honestly, opening up the markets, it doesn't really make much sense. I'm sure there are a lot of people in government pushing the government to open up quicker than they're doing, but they're doing it in this kind of slow, staged way, and they're doing that to strike this balance between preserving the economic power that's there, because you wouldn't want to see something like 36 million unemployed.
That currently have in the U. S. But also obviously as you put it throwing this hug, but presumably a socially distanced one around exactly around workers
Jessamy: And I guess Gavin what it made me think about was this concept of immunity passports, nothing really such an intervention as to stop people from moving around unless they've had COVID 19 or haven't and there's a lot of different views about whether this is something that's going to happen or Whether it's not, what do you think, just very briefly, are the sort of ethical things that we have to consider?
Gavin: I think there's been a lot of chats about it, to the extent where we will see at least some form of immunity passport or some people returning to work because they are immune to COVID 19. Now, aside from the scientific unknowns, as we always talk about, we don't actually know. The levels to which presence of COVID 19 antibodies give people immunity, which I think is a huge problem up front.
Jessamy: We almost have to take the science out of it and just say, perhaps assuming that people do have some form of immunity for say months. Two years and that immunity, passports were to be floated. What are the things that we would have to think about?
Gavin: Yes. There's a perfectly put philosophical question because we've removed all the real world concerns,
Jessamy: Exactly. And that's why I thought you'd be so well placed to answer it. .
Gavin: Thanks. So it's a really extraordinary concept because what you're really saying. Is that this negative thing that happened to you, you got COVID 19, you recovered, maybe you're asymptomatic, at least the antibodies are present there.
Then actually rewards you with all of these freedoms that other people aren't able to have. Through no fault of their own, say 10 percent of the country has antibodies and in fact I think the government figure yesterday was their estimate was 17 percent of London for example. Say 17 percent of London can get back to work and actually the pubs can open up again and the restaurants can open up again and they can go back into offices as if nothing ever changed.
Look at that from the point of view of the other 83%. 17 percent of people in London can suddenly live a completely normal life, one that is forbidden by law for the other 83%. So you then get yourself into a situation I would assume where the other 83%, especially those who would be less affected by the virus.
I think there would be a situation where those people would actually try to get themselves infected and develop the antibodies because that would enable them to return back to life for what they perceive as a very small as a very small bump in the road, so to speak.
Jessamy: The old chicken pox party theory.
Gavin: Pretty much. Yeah, but in this case having the chicken pox allows you to completely go back to normal and off all of these shackles that we've all been living under for the last few months. So I think the question of immunity passports has to be really carefully dealt with. You would really struggle, I think, to to visibly give anyone who had immunity to COVID 19 suddenly all of their freedoms back because you would you would have an awful lot of unhappy people on your hands, especially If, as we've seen from these kind of early studies, under 20 percent in pretty much every country that's had a widespread COVID 19 infection have present antibodies.
Looking at the remainder of the population, being put into an extraordinarily difficult situation and made to sit there in their house, not able to see their loved ones, not able to see friends, not able to go anywhere under the same restrictions. 20 percent of people through absolutely no design or anything necessarily positive that they've done.
Are allowed to completely live their lives as normal again. I think it really throws up massive ethical implications
Jessamy: It does and maybe it's something that we need to talk a bit more about on a future episode
Gavin: Yeah, I think so. I think potentially getting a Philosopher who's thought a bit harder about it than I have would be a good idea.
It would be an interesting chat you can contact us at podcast at the lancet. com and you can listen to our whole archive back on Apple, Spotify, Stitcher, any archive that you want to thanks for listening. See you again
next time.