Competitive federalism has the potential to produce a "race to the top" in vaccination roll-outs. This has been witnessed in both Canada, and the United States, where public health decisions for administering the vaccines is left to their states, provinces, and territories. In both of these federal countries, like Australia, it is the federal government who is responsible for both procuring, paying for, and supplying vaccines, but unlike Australia, not in administering them. Compared to all of the OECD federal democracies, Australia is last with 7.09 per cent total coverage, with the U.S. leading at 47 per cent, and Mexico above Australia at 15 per cent. European federations are hovering around 30 per cent.
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So why do Australian politicians, the media, and a good chunk of the public keep scapegoating federalism?
The vaccine data tracker for the U.S. and Canada's race-to-the top roll-outs, per state/province, is fantastic. Residents can track daily "how is your state doing?". Data also shows how well their province/state has done at distributing, compared to how many doses were centrally administered - full transparency on both of those indicators. As a scholar of comparative federalism, based on this data, the sub-national patterns of the vaccine roll-out in the US and Canada are as we would expect. Canadian provinces and territories absent national rules and national distribution criteria show similar coverage - the territories are leading the way with 134,000 doses administered per 100,000 population, with the rest of the provinces hovering around 100,000 per 100,000. Provinces in Canada tend to share best-practice lessons horizontally because of a non-integrated party system within a dual federal model that separates the two levels quite distinctly.
In the U.S., where partisan polarisation drives vaccination policy and politics, Maine and Vermont top the charts with approximately 137,000 per 100,000 doses each, as is similar for most Democrat Party states, while the Republican Party dominant south is lagging behind, with around 75,000. According to the data on national delivery rates per state, none of the U.S. laggards are short of vaccines, only citizens willing to receive them. So how does Australia compare to these competitive federal systems that are racing-to-the top to provide vaccines in their state/provinces? We don't.
Why? First of all, there is no comparable data. This is because Australia, unlike it was quoted in the media as a "competitive federal system that doesn't work for the whole" is actually not competitive. Rather, Australia is currently behaving as a "coercive federal system". This is a system where the Prime Minister, using his federal and financial powers, coerces the states and territories to follow his lead, and his directives, over who should be vaccinated, when, and with which vaccines, regardless of state decisions and priorities - sometimes they are following expert medical advice, but there have been discrepancies. How is this possible when public health is a state jurisdiction?
Well, it is and it isn't, which is the second point. GPs are paid for and regulated by the Commonwealth, and as of last Monday, they have Commonwealth provided indemnity over all vaccinations, freeing them up to deliver any available vaccines in consultation with their patients. While this point does not imply the Commonwealth can tell doctors what to advise their patients, or, intend to question the new regulations to GPs from a public health perspective, politically, it does give the Commonwealth a hand in both controlling and credit-claiming for the roll-out, in competition with state vaccination hubs and state directives. Which is why, we don't have data to compare how Australian states are performing.
Available state-level data only shows how many vaccines were administered in state hubs and centres, while the Australian totals aggregate and includes all the "Commonwealth" doses administered by GPs, or in aged and disability care. And, we have no publicly available data on where the vaccines per type are being distributed, to which centres, Commonwealth, or state hubs, or GPs. Therefore, we cannot examine whether it is a Commonwealth located vaccine distribution problem, or a state administration problem, or, a citizen hesitancy problem as in some states in the U.S. Without this data, we cannot empirically examine what is causing the roll-out to be so slow. Most importantly, we cannot compare the states roll-out performance to evaluate how our federal system is performing.
Australia is not engaged in a competitive race-to-the-top in vaccination delivery. Rather, premiers and territory leaders are having to compete vertically with the Commonwealth on unequal grounds. Vertical competition in the distribution of vaccines means the PM can credit-claim if the roll-out goes well, and blame avoids if it doesn't, scapegoating federalism as a system along the way. It is rather politically ingenious, but not very good for our roll-out or our federal system.
- Dr Tracy Beck Fenwick is the Director of the ANU's Australian Centre for Federalism and a Senior Lecturer in Comparative Federalism at the School of Politics and International Relations. The view and opinions expressed are her own.
