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framing the US as the world's "richest country" is a disservice here. a few people are very rich, and many people are well off. but the institutions of this co

framing the US as the world's "richest country" is a disservice here. a few people are very rich, and many people are well off. but the institutions of this country are, despite being the product of the "richest country", entirely poor and weak. public institutions have been hollowed out by decades of intentional neglect and austerity. the CDC has no help to offer hospitals in need and is still like a deer in headlights, months into the crisis. before their weakness was exposed, the national stockpile was mostly empty. the cracks in the system were never filled, and many were barely papered over. private institutions have been optimized to extract profits rather than to serve their stated social purpose. hospitals are now on the brink of going out of business and closing down as the pandemic starts to ramp up. their readiness was low beforehand, too, as there's no money to be made in being prepared for a public health emergency. so, how did the world's richest country run out of face masks? easy: we organized our society around the idea that buying them and keeping them around was too expensive to bother with.

danans 7y ago
I've been thinking along the same lines, that our lack of public preparedness for this is reflected in concentration of returns to capital at the top of the wealth distribution. But that said, there are things the US stockpiles: corn, petroleum, and weapons.
- quietthrow 7y ago
  We over index on preparedness for war. Bill gates has a great ted talk on this who basically called this corona virus situation a few years ago. https://www.ted.com/talks/bill_gates_the_next_outbreak_we_re_not_ready?language=en https://www.ted.com/talks/bill_gates_the_next_outbreak_we_re... When I look at the whole situation it looks like a bunch of meatheads whose answer to everything is brawn and military superiority.
  - throwaway32120 7y ago
    And like most things in America, the military costs much more than other countries and does much less for its citizens. A good example is what happened when Yemen fell apart: China used its military to evacuate Chinese citizens[1], India used its military to evacuate its citizens[2], and the US told its citizens that they were on their own[3]. The American embassy even told Americans trapped in Yemen that they should seek out the help of India in order to get out of the country[4]. It's hard to escape the notion that for decades America has suffered under a political class that's been a mix of incompetent, self-serving, and uncaring. [1] https://www.bbc.com/news/world-middle-east-32173811 https://www.bbc.com/news/world-middle-east-32173811 [2] https://en.wikipedia.org/wiki/Operation_Raahat https://en.wikipedia.org/wiki/Operation_Raahat [3] https://foreignpolicy.com/2015/04/21/washington-to-americans-stuck-in-yemen-youre-on-your-own-evacuation/ https://foreignpolicy.com/2015/04/21/washington-to-americans... [4] https://www.washingtonpost.com/news/worldviews/wp/2015/04/08/india-leads-rescue-of-foreign-nationals-including-americans-trapped-in-yemen/ https://www.washingtonpost.com/news/worldviews/wp/2015/04/08...
    - Gibbon1 7y ago
      I've read that same thing about the 2004 Boxing Day Tsunami. Other countries worked hard to help their citizens and get them out. The US just abandoned theirs.
  - mistermann 7y ago
    > When I look at the whole situation it looks like a bunch of meatheads whose answer to everything is brawn and military superiority. I'm not overly familiar with how the US medical system works at a detail level, but is it illegal for individual hospitals, clinics, dental offices, etc to independently stockpile critical supplies?
    - vajrabum 7y ago
      No, but hospitals are mostly for profit in the US so they don't. They run lean so as to make the best return on investment. That's also why we have as few hospital beds as we do. Most US hospitals used to be non-profit. When they were converted to for profit institutions there was a concerted decades long effort to reduce hospital stays and the beds that requires. Completely understandable given the need to make as much money as possible.
      - danans 7y ago
        This points to an obvious bit of legislation that we need in the US: require hospitals to keep minimum stockpiles of pandemic response supplies, just like banks have minimum financial reserve requirements.
        ethbro 7y ago
        Given that there's an accute shortage of hospitals serving rural areas, regulation of that nature better be accompanied by federal funding for that work. I wouldn't be surprised to see some serious DHS money redirected to hospitals, after this is all over. They could certainly put it to better use than police departments.
        mistermann 7y ago
        Alternatively, you could assign maintaining the mask inventory to admin staff. I know they often don't have advanced degrees, but I can't imagine they'd do a worse job of it. Actually, they'd probably take the job a lot more seriously than the "experts" who are in charge currently. Assigning such tasks to a central body seems like an extremely fragile design, and as evidence for this assertion, I offer the current state of reality. I find it a rather convincing argument, but then I'm probably quite biased.
  - danans 7y ago
    The dust hasn't settled on this yet, but it appears that countries that are in a siege military footing (S. Korea, Israel, Cuba, Taiwan) have done better in controlling this situation because they have strong universal health systems and institutions coupled with mentality of constant preparation for a military siege. The culture of real preparedness is present throughout those countries' institutions, military or not. This was discussed by Max Brooks on Fresh Air yesterday: https://www.npr.org/2020/03/24/820601571/all-of-this-panic-could-have-been-prevented-author-max-brooks-on-covid-19 https://www.npr.org/2020/03/24/820601571/all-of-this-panic-c... What Brooks doesn't discuss is the extent to which those countries have varying degrees of authoritarianism or the tendency for citizens to voluntarily comply with public orders. In the US however, our military stockpiling is geared toward propping up defense industries. This has value to a point, but only when its objectives are actually defense preparedness, but not when the objectives are profit maximization. The military is no substitute for having properly resourced and coordinated national institutions to deal with huge public health issues.
    - magicsmoke 7y ago
      The difference with those four countries is that they expect fighting a war on their own soil to be a future possibility. When's the last time Americans actually saw what war on their doorstep looks like? The civil war? America's real defense is the Pacific and Atlantic. The US military is a raiding force that's free to attack anywhere in the world without fear of retaliation because they know the American continent is geographically unassailable.
      - danans 7y ago
        > they know the American continent is geographically unassailable. And COVID19 is turning that assumption on its head. The only question that remains is whether the US can buttress what's left of its public health institutions to keep it at bay, and prepare for the next wave that comes, whether of this pandemic or the next one.
        ethbro 7y ago
quietthrow 7y ago
Consumerism is how they define rich here. The idea thst you have access to more good and services (to buy) than your grandparents did is how this is the best country in the world. It’s a none sense argument and this crisis has just totally exposed it. We have a bunch of old career politicians running decrepit institutions chief of whom comes up with worse ideas every week than he did the prior week. This weeks special: use religious symbolism of Easter to inspire the masses to support his idea of resurrecting the economy. The sad irony here is that the people who help elect this clown and his posse are likely the ones that will be impacted most by this crises. In a weird way it’s fitting - as they say you deserve the politicians you get. And in this case you is the subset of all voters whose votes mattered (swing states) and their electoral vote resulted the people we have today.
- exclusiv 7y ago
  > In a weird way it’s fitting - as they say you deserve the politicians you get. Or, you get the politicians you were served by one of the two major parties. Almost all of whom are bought by special interests.
dominotw 7y ago
> private institutions have been optimized to extract profits Where are the private institutions trying to extract profit from selling facemasks. I cannot find one at any price.
- amiga_500 7y ago
  The private company outsourced production last year to extract more profit.
- lopmotr 7y ago
  They're not allowed to operate. In a more free market, masks would be available but at a higher price. Here's a shop that was required to stop selling masks because its price was too high: https://www.macombdaily.com/news/local/warren-company-accused-of-price-gouging-in-sale-of-masks/article_cb596962-6a31-11ea-b6b6-3b1e9521cb82.html https://www.macombdaily.com/news/local/warren-company-accuse...
rejschaap 7y ago
They could change it to "richest countries", because the US isn't the only rich country that screwed up. Look at Austria and Switzerland and their reliance on importing masks from other countries. Or at the Netherlands, which can actually produce large quantities of masks for domestic use but didn't because the government was too busy downplaying the epidemic.
- jeffdavis 7y ago
  Yeah. I feel like the U.S. is always in the spotlight for criticism, but there are an awful lot of mistakes to go around. People just don't handle crises well.
- Daishiman 7y ago
  Those countries have implemented emergency legislation that makes up for employee pay and institutes a bunch of emergency measures that will make the countries come out the crisis rapidly and more robustly.
  - Gibbon1 7y ago
    I think the odds are about 2 to 3 that the wealthy and connected in the US use the pandemic as an excuse to use free money to wholesale loot everyone else.
amiga_500 7y ago
Agreed. Per capita they are not the richest, whatever their figures say. Much of usd health spending is just numbers on paper, they don't have the resources.
Robotbeat 7y ago
I don't think it is a disservice, and it's not just a "few" or "many" who are relatively well off. The US has one of the highest median incomes in the world, and no one with higher is even a tenth as populous. It's perfectly fair to call us the richest country. That we don't have institutions to match is a shame all the more because of our richness. We had/have the resources. We foolishly didn't use them.
- jellicle 7y ago
  The USA is something like 6th in median income adjusted for PPP. If you adjust for how many hours worked to get those wages, it would fall a lot more - 20th? Lower? If you adjusted for public services available it would be lower than that. Not the worst, but definitely not the richest, not for most people. It's an astonishingly poor showing considering how much money is available to the USA overall.

danans 7y ago

I've been thinking along the same lines, that our lack of public preparedness for this is reflected in concentration of returns to capital at the top of the wealth distribution. But that said, there are things the US stockpiles: corn, petroleum, and weapons.

quietthrow 7y ago
We over index on preparedness for war. Bill gates has a great ted talk on this who basically called this corona virus situation a few years ago. https://www.ted.com/talks/bill_gates_the_next_outbreak_we_re_not_ready?language=en https://www.ted.com/talks/bill_gates_the_next_outbreak_we_re... When I look at the whole situation it looks like a bunch of meatheads whose answer to everything is brawn and military superiority.
- throwaway32120 7y ago
  And like most things in America, the military costs much more than other countries and does much less for its citizens. A good example is what happened when Yemen fell apart: China used its military to evacuate Chinese citizens[1], India used its military to evacuate its citizens[2], and the US told its citizens that they were on their own[3]. The American embassy even told Americans trapped in Yemen that they should seek out the help of India in order to get out of the country[4]. It's hard to escape the notion that for decades America has suffered under a political class that's been a mix of incompetent, self-serving, and uncaring. [1] https://www.bbc.com/news/world-middle-east-32173811 https://www.bbc.com/news/world-middle-east-32173811 [2] https://en.wikipedia.org/wiki/Operation_Raahat https://en.wikipedia.org/wiki/Operation_Raahat [3] https://foreignpolicy.com/2015/04/21/washington-to-americans-stuck-in-yemen-youre-on-your-own-evacuation/ https://foreignpolicy.com/2015/04/21/washington-to-americans... [4] https://www.washingtonpost.com/news/worldviews/wp/2015/04/08/india-leads-rescue-of-foreign-nationals-including-americans-trapped-in-yemen/ https://www.washingtonpost.com/news/worldviews/wp/2015/04/08...
  - Gibbon1 7y ago
    I've read that same thing about the 2004 Boxing Day Tsunami. Other countries worked hard to help their citizens and get them out. The US just abandoned theirs.
- mistermann 7y ago
  > When I look at the whole situation it looks like a bunch of meatheads whose answer to everything is brawn and military superiority. I'm not overly familiar with how the US medical system works at a detail level, but is it illegal for individual hospitals, clinics, dental offices, etc to independently stockpile critical supplies?
  - vajrabum 7y ago
    No, but hospitals are mostly for profit in the US so they don't. They run lean so as to make the best return on investment. That's also why we have as few hospital beds as we do. Most US hospitals used to be non-profit. When they were converted to for profit institutions there was a concerted decades long effort to reduce hospital stays and the beds that requires. Completely understandable given the need to make as much money as possible.
    - danans 7y ago
      This points to an obvious bit of legislation that we need in the US: require hospitals to keep minimum stockpiles of pandemic response supplies, just like banks have minimum financial reserve requirements.
      - ethbro 7y ago
        Given that there's an accute shortage of hospitals serving rural areas, regulation of that nature better be accompanied by federal funding for that work. I wouldn't be surprised to see some serious DHS money redirected to hospitals, after this is all over. They could certainly put it to better use than police departments.
        mistermann 7y ago
        Alternatively, you could assign maintaining the mask inventory to admin staff. I know they often don't have advanced degrees, but I can't imagine they'd do a worse job of it. Actually, they'd probably take the job a lot more seriously than the "experts" who are in charge currently. Assigning such tasks to a central body seems like an extremely fragile design, and as evidence for this assertion, I offer the current state of reality. I find it a rather convincing argument, but then I'm probably quite biased.
- danans 7y ago
  The dust hasn't settled on this yet, but it appears that countries that are in a siege military footing (S. Korea, Israel, Cuba, Taiwan) have done better in controlling this situation because they have strong universal health systems and institutions coupled with mentality of constant preparation for a military siege. The culture of real preparedness is present throughout those countries' institutions, military or not. This was discussed by Max Brooks on Fresh Air yesterday: https://www.npr.org/2020/03/24/820601571/all-of-this-panic-could-have-been-prevented-author-max-brooks-on-covid-19 https://www.npr.org/2020/03/24/820601571/all-of-this-panic-c... What Brooks doesn't discuss is the extent to which those countries have varying degrees of authoritarianism or the tendency for citizens to voluntarily comply with public orders. In the US however, our military stockpiling is geared toward propping up defense industries. This has value to a point, but only when its objectives are actually defense preparedness, but not when the objectives are profit maximization. The military is no substitute for having properly resourced and coordinated national institutions to deal with huge public health issues.
  - magicsmoke 7y ago
    The difference with those four countries is that they expect fighting a war on their own soil to be a future possibility. When's the last time Americans actually saw what war on their doorstep looks like? The civil war? America's real defense is the Pacific and Atlantic. The US military is a raiding force that's free to attack anywhere in the world without fear of retaliation because they know the American continent is geographically unassailable.
    - danans 7y ago
      > they know the American continent is geographically unassailable. And COVID19 is turning that assumption on its head. The only question that remains is whether the US can buttress what's left of its public health institutions to keep it at bay, and prepare for the next wave that comes, whether of this pandemic or the next one.
      - ethbro 7y ago

quietthrow 7y ago

Consumerism is how they define rich here. The idea thst you have access to more good and services (to buy) than your grandparents did is how this is the best country in the world. It’s a none sense argument and this crisis has just totally exposed it. We have a bunch of old career politicians running decrepit institutions chief of whom comes up with worse ideas every week than he did the prior week. This weeks special: use religious symbolism of Easter to inspire the masses to support his idea of resurrecting the economy. The sad irony here is that the people who help elect this clown and his posse are likely the ones that will be impacted most by this crises. In a weird way it’s fitting - as they say you deserve the politicians you get. And in this case you is the subset of all voters whose votes mattered (swing states) and their electoral vote resulted the people we have today.

exclusiv 7y ago
> In a weird way it’s fitting - as they say you deserve the politicians you get. Or, you get the politicians you were served by one of the two major parties. Almost all of whom are bought by special interests.

dominotw 7y ago

> private institutions have been optimized to extract profits Where are the private institutions trying to extract profit from selling facemasks. I cannot find one at any price.

amiga_500 7y ago
The private company outsourced production last year to extract more profit.
lopmotr 7y ago
They're not allowed to operate. In a more free market, masks would be available but at a higher price. Here's a shop that was required to stop selling masks because its price was too high: https://www.macombdaily.com/news/local/warren-company-accused-of-price-gouging-in-sale-of-masks/article_cb596962-6a31-11ea-b6b6-3b1e9521cb82.html https://www.macombdaily.com/news/local/warren-company-accuse...

rejschaap 7y ago

They could change it to "richest countries", because the US isn't the only rich country that screwed up. Look at Austria and Switzerland and their reliance on importing masks from other countries. Or at the Netherlands, which can actually produce large quantities of masks for domestic use but didn't because the government was too busy downplaying the epidemic.

jeffdavis 7y ago
Yeah. I feel like the U.S. is always in the spotlight for criticism, but there are an awful lot of mistakes to go around. People just don't handle crises well.
Daishiman 7y ago
Those countries have implemented emergency legislation that makes up for employee pay and institutes a bunch of emergency measures that will make the countries come out the crisis rapidly and more robustly.
- Gibbon1 7y ago
  I think the odds are about 2 to 3 that the wealthy and connected in the US use the pandemic as an excuse to use free money to wholesale loot everyone else.

amiga_500 7y ago

Agreed. Per capita they are not the richest, whatever their figures say. Much of usd health spending is just numbers on paper, they don't have the resources.

Robotbeat 7y ago

I don't think it is a disservice, and it's not just a "few" or "many" who are relatively well off. The US has one of the highest median incomes in the world, and no one with higher is even a tenth as populous. It's perfectly fair to call us the richest country. That we don't have institutions to match is a shame all the more because of our richness. We had/have the resources. We foolishly didn't use them.

jellicle 7y ago
The USA is something like 6th in median income adjusted for PPP. If you adjust for how many hours worked to get those wages, it would fall a lot more - 20th? Lower? If you adjusted for public services available it would be lower than that. Not the worst, but definitely not the richest, not for most people. It's an astonishingly poor showing considering how much money is available to the USA overall.