POLITICAL, LEGAL, AND
SOCIAL ISSUES IN A NATIONAL
DURING THE DARK WINTER EXERCISE OF JUNE 2001, one of the questions the unscripted participants had to grapple with was: who is running the show in a nationwide health crisis? Is it the federal government, or individual states? If it’s a joint effort, who’s responsible (and has the authority) for what? Would it matter whether the crisis was precipitated by a natural outbreak of deadly disease or by a terrorist attack interpreted as a hostile action against the United States?
These are not questions that would arise in other modern industrialized nations, all of which have centralized, dominant governmental public health structures. It is a question in the United States of America in the twenty-first century because of our unique origin as a confederation of independent states that happened to occupy a common continental land mass. It could possibly become a question one day in the continually evolving European Union. They will have the advantage of having watched us struggle with questions of this type for over 200 years.
In the United States, it is generally agreed that preservation of the public health is a power granted to individual states, as an exercise of their constitutionally guaranteed policing powers.