By not supplying New York the necessary ventilators it needs to help during the coronavirus outbreak, the government is failing to uphold its social contract with citizens, says Nicole Hassoun, professor of philosophy at Binghamton University, State University of New York.

In 2015, the New York State Department of Health and the New York State Task Force on Life and the Law came up with guidelines for rationing ventilators in a pandemic. They found that, in a severe pandemic, New York might need 16,000 more ventilators. Some suggest Governor Cuomo could have overcome the estimated shortfall for $576 million. Today Cuomo is desperate to bridge the gap. Within two weeks he predicts that New York will need 30,000 ventilators, and he has only been able to find 7,000 so far. He appealed to the government to provide more aid. President Trump replied that Cuomo was “complaining,” and said the government was “doing probably more — definitely more for [New York] — than anybody else." So although the government will continue to help New York, Cuomo “is supposed to be buying his own ventilators.

“This kind of rhetoric is not only divisive, it is inappropriate,” said Hassoun. “The government has a social contract with its citizens to protect them all and to respect their fundamental moral equality. That is, the government is equally beholden to all citizens. They cannot blame state governments for the fact that many of their citizens will suffer and die young from lack of basic health services.”

Although the US has not signed on to the United Nation's International Covenant on Economic, Social and Cultural Rights, Hassoun believes everyone has a moral right to decent health care and protection from pandemics and other emergencies. 

“This pandemic did not come out of the blue. The WHO has been warning countries to prepare for a resurgence of virulent flu and other potential pandemics for years,” she said. “Moreover, the coronavirus threat was apparent since the start of the year, and the first case arrived in the US on Jan. 19. Even though community transmission was not apparent until early March, decisive action at that point might have saved tens of thousands of lives.”

People are dying who could have lived if our government had done its job, and soon health care workers will make tragic choices about who lives and who dies, said Hassoun. New York rationing guidelines suggest helping those who can most likely benefit from access to a ventilator and even withdrawing ventilators from patients who have received access during the crisis (but not those who were already using the machines before the pandemic). 

“Other states will do things differently, but we are all in this boat together,” said Hassoun. “Our leaders should take care of and protect all of their citizens.”