Does Proposing a 20 Percent Budget Cut for the CDC Disqualify Rand Paul From Being a Serious Critic of the Ebola Response?

Sen. Rand Paul (R-Ky.) proposed
a budget for FY2014 that included a 20 percent cut to the CDC. Does
that disqualify him from being a serious critic of the Obama
administration’s reponse to the Ebola outbreak?

Henry Olsen at National Review seems to think so. He
says he doesn’t believe “spending equals competence,”
but:

Paul’s proposal to reduce CDC spending is symptomatic of a large
problem with his thinking.

Paul clearly has a theory of non-government. In his view,
government is generally a bad thing and we need to reduce it as
fast and as deep as we can. However, cases like the CDC/Ebola
crisis call for a theory of government. No serious politician, not
even the quasi-libertarian senator from the Bluegrass State, thinks
that the federal government ought to have no role in public health.
 

When the federal government is spending a trillion more dollars
than it collects in revenue (44 percent), a 20 percent cut at a
federal agency shouldn’t be dismissed off-hand as unserious.
Considering government to be “generally a bad thing” is a theory of
government. 

Rand Paul is not a libertarian, but neither are most
libertarians anarchists. In any case, in the article Olsen cites
Paul doesn’t dismiss preventing the spread of infectious disease as
a legitimate goal of government and the CDC. Instead he insists the
CDC’s had enough, saying the agency’s budget for epidemics
(National Institute of Allergy and Infectious Diseases) has gone up
220 percent. CDC spending has doubled
since 2000.

Olsen says he has “no idea” whether $4.8 billion a year (the CDC
budget if a 20 percent cut were instituted) is enough for the
agency to carry out its mandates, which is fine, and then claims
neither would Paul’s staff. Those kinds of arguments are generally
deployed to demand more spending by government, because they tend
to settle around the idea that the top men at the agencies in
question know best how much taxpayer money they need to spend to do
their job.

How much might the CDC need to get the job done? Getting less
money could certainly focus the agency on a core mission of
preventing the outbreak of highly infectious diseases. I may have
no idea how much the CDC needs either, but here’s how they spent
their money in Fiscal Year 2012:

• Public Health Preparedness and Response – $1.329 billion
• Chronic Disease Prevention/Health Promotion – $1.167
  billion
• HIV/AIDS, Viral Hepatitis, STIs, TB Prevention – $1.109
  billion
• Immunization an Respiratory Diseases – $814 million
• Cross-Cutting Activities and Program Support – $659
  million
• Public Health Scientific Services $461 million
• Global Health – $342 million
• Emerging/Zoonotic Infectious diseases – $304 million
• Occupational Safety and Health – $292 million
• Environmental Health – $139 million
• Injury Prevention and Control – $137 million
• Birth Defects, Developmental Disabilities, Disability – $130
  million

The breakdown’s included in the Department of Health and Human
Services’
justification of estimates (PDF) for the House and Senate
Appropriations committees, a good place to start to get an idea of
what the CDC’s mandate should be and how much it might cost.