Toward a More Strategic National Stockpile

Abstract

The COVID-19 pandemic has uncovered major deficiencies in the United States’ approach to stockpiling for emergencies. States, cities and hospitals across the country had inadequate stores of critical medical items on hand when the pandemic reached US soil, and the federal government’s Strategic National Stockpile proved far too small to fill this inventory gap. As nationwide shortages worsened, many state governments began bidding against each other to procure scarce medical supplies — a distribution approach that inherently disadvantaged low-income and minority communities and left countless health care professionals and staff ill-equipped to protect themselves against a potentially deadly virus. These failings have generated an unprecedented push to reform the nation’s stockpiling policy structure. This Article uses a simple stockpiling cost-benefit model to highlight shortcomings in the existing US stockpiling policy regime and to identify specific new policy strategies capable of addressing them. Among other things, US stockpiling policies need to better account for important differences in the rotatability of supplies and should more aggressively incentivize private stockpiling of the most rotatable emergency items. Reshaping commandeering laws and price-gouging restrictions could also do much to strengthen private incentives to stockpile and could even help to clarify how states and the federal government share responsibilities in the nation’s stockpiling effort. Additional federal support is likewise needed to incentivize the build-out and maintenance of domestic supply chains for the least-rotatable emergency goods. These reforms and certain related policy changes could help to ensure that the nation is far better equipped to respond the next time disaster strikes.