Legislative AIDS

Eugene Volokh and Clayton Cramer are having a set-to on the subject of NIH funding for HIV/AIDS. Cramer observes that the federal government spends 10 times as much money on HIV/AIDS than it does on heart disease and cancer, when measured on a per-victim basis. Cramer takes this as evidence that the government “cares more about homosexuals and IV drug users than it does about everyone else.”

Eugene defends disproportionate funding for HIV/AIDS because it’s a communicable disease with the potential to spread and affect much larger numbers of people in the future. (I think an even stronger defense can be made on different grounds – but I’ll save that for a separate post.) Eugene also takes on Cramer’s claim that the government “cares more about” homosexuals and IV drug users, noting that those two groups “are only a tiny share of all voters … lots of voters dislike IV drug addicts, and quite a few still dislike homosexuals.” Cramer responds by arguing that small, well-organized groups – also known as special interests – regularly get greater government assistance than larger, less well-organized groups.

Cramer is presumably correct that the level of HIV/AIDS funding is attributable to the logic of concentrated benefits and dispersed costs that rules our political system. Yet Eugene wins the overall debate, for two reasons. First, as Eugene notes in an update to his original post, the power of a special interest to get legislative favors hardly shows that the government “cares more” about that interest. I would add that the phrase “cares more” shouldn’t even be applied to a collective entity like Congress, because groups don’t have preferences as individuals do. Institutional incentives, such as the need to win elections and collect campaign funds, drive the body’s choices in directions that may have little to do with personal preferences. It may well be true that each member of Congress cares less about homosexuals and drug users than other people, yet legislators are led to favor these groups through legislation because of their strength in the lobbying process.

Second, while legislative choices do reflect the power of special interests, that’s just as true of funding for heart disease and breast cancer as it is of funding for HIV/AIDS (and steel tariffs, and agricultural subsidies, ad infinitum). The more interesting question is whether the results, whose seedy origins are no surprise, can be rationalized. And that’s where Eugene’s argument about the communicability of HIV/AIDS, which Cramer never refutes, enters the picture. Even if it’s true that HIV/AIDS gets disproportionate funding because of the lobbying power of homosexuals, it might still make sense to fund it more.

Similarly, we all know that national defense spending is driven, at least in part, by the lobbying efforts of defense contractors. Nonetheless, national defense is a public good, and therefore federal funding for national defense is more justifiable than funding for most other things (which can be provided more easily by the private market). In other words, it’s reasonable to enquire into the justifiability of the results, even while recognizing their origin in a flawed legislative process.