Researchers at the University of Toronto
have recently raised interesting issues about political implications of effective pandemic disease control. In federalist states, like the United States and Canada, there is a decentralization of political power to regional governments. Part of what regional governments are empowered to do is make health care system decisions, including the management of health-related patient information . The devolution of powers may have its virtues in other contexts, but in cases of deadly epidemics like SARS, the structure of federalism may hinder rapid and coordinated public health responses.
So one question is: how much are we willing to let the threat of global pandemics (like bird flu, perched on the horizon) shape longstanding political arrangements that we may value? The threat of terrorism has already made inroads on civil liberties, and now emergent diseases may have us making still more difficult political tradeoffs.