How “Maximizing Shareholder Value” Minimized the Strategic National Stockpile: The $5.3 Trillion Question for Pandemic Preparedness Raised by the Ventilator Fiasco † William Lazonick and Matt Hopkins* Working Paper No. 127 July 21st, 2020 ABSTRACT With just 4.2 percent of the world’s population, the United States had, as of July 21, 2020, 26.0 percent of its confirmed Covid-19 cases and 23.1 percent of its deaths. The magnitude of the tragedy raises the critically important counterfactual question of how the United States as a nation would have fared had there been competent and committed political leadership in place when, during January 2020, intelligence indicating the severity of the unfolding pandemic became available. A partial answer to this question lies in identifying the organizational and technological capabilities to develop, produce, and deliver “countermeasures”—personal protective equipment (PPE), ventilators, diagnostic tests, therapies, and vaccines—that a prepared federal administration would have been able to mobilize to respond to the pandemic. Main repositories of the necessary † The Institute for New Economic Thinking provided the main funding for this research. Additional support to William Lazonick came from the Open Society Foundations and Canadian Institute for Advanced Research, and to Matt Hopkins from his PhD scholarship as SOAS University of London. We acknowledge comments of Tom Ferguson and Ken Jacobson on previous drafts of this essay. * The Academic-Industry Research Network. Corresponding author: William Lazonick at
[email protected]. Lazonick and Hopkins capabilities are government agencies and business firms, with the development, production, and delivery of countermeasures heavily reliant on government-business collaborations (GBCs).