The Biomedical Empire: Lessons Learned from the COVID-19 Pandemic

tions of undemocratic (or semi-democratic) institutions. In this regard, the book is best understood as opening the door for future investigations. For instance, none of the essays grapple directly with the question of why these various systems came into existence and gained popularity. There are hints at rational reasons alongside purely partisan ones. For instance, the editors reference the fact that city governments are ‘‘strapped for resources to cover budget shortfalls’’ (p. 272)—suggesting one possible motivation for privatizing public land and/or engaging in public-private partnerships. Some chapters do attempt to understand motivations (such as the Weber, Kass, and Hinkley chapter), but much of the discussion—too much, I would argue—is based on theory and normative concerns rather than empirical analysis. The descriptive case studies provide excellent evidence that these governing bodies exist and matter. Data such as interviews or archival documents written by key players would help us better understand how and why these quasi-public institutions developed and proliferated, as well as the material consequences on the ground. There is also an open question regarding city governments’ acquiescence (or resistance) to these processes. An unstated assumption in the volume is that city governments would prefer to have more democratic control. But it’s not entirely clear to me that city officials care all that much; many seem perfectly happy to cede authority. Appointed boards and commissions are nothing new in cities in part because they are shielded from direct electoral accountability. City governments willingly outsource social service provision to the private nonprofit sector. While no city government would welcome a state takeover, there is even evidence that, when given the chance, city governments offload the responsibility of governance to private actors. Take the Boston City Council’s 2020 zoning code amendment to ostensibly promote fair housing. The council’s amendment built on the Obama administration’s Affirmatively Furthering Fair Housing (AFFH) rule. Yet instead of penalizing state and local governments for failing to adequately ensure fair housing, as the AFFH rule stipulated, city councilors outsourced the responsibility to individual private developers. Specifically, the amended zoning code forces developers, project by project, to complete the necessary analyses to ensure housing equity in the region. This is a far cry from the federal AFFH rule, which required local governments to examine and develop plans to combat housing discrimination. In other words, the AFFH rule required local governments to govern equitably. But in Boston, private developers have now in a very real sense gained more control over fair housing governance in the city—at the government’s request. These remaining questions should be understood as a productive contribution of Private Metropolis. The volume exposes a world largely hidden to the average citizen (and scholar). It invites new lines of inquiry and gives us much to consider. After reading the book, it will be hard to think about cities the same way again.