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> It seems to resonate a bit here, when Marc speaks of things like regulatory capture. I heard a few years back that a US health insurance startup had to provid

> It seems to resonate a bit here, when Marc speaks of things like regulatory capture. I heard a few years back that a US health insurance startup had to provide on the order of 6000 pages of documentation to be approved. No wonder that there hadn't been another provider for twenty years or so. It seems like some things are hard to build mostly because some people want it that way. Sure, but is this actually a high order blocker? I'd argue that it's not even a first order effect. The problem here is not that we don't have enough insurance capacity; the problem is that we don't have enough ventilators. And it turns out, actually building those things to spec is hard. Intellectual property and regulatory capture are bad things to be reduced, IMO, but they're only part of our current equation. The moneyed classes of America don't like redundancy and they don't like long term investments. Since they hold such a huge chunk of wealth compared to the rest of America, their preferences (which I might note, Marc represents professionally) make these decisions long before patent troll lawsuits or building inspectors can rain on any parade. > Point being, why not write simpler laws and regulations and leave it to the courts to interpret what adheres to the spirit of it? With the barriers of entry gone, I think we'd see a renewed vitality to many ossified sectors. Litigation is the most costly way to settle these things. Your idea would require even more startup capital per small business to overcome the legal obstacles you seemed eager to abolish.

oxymoron 6y ago
We’re not necessarily talking about litigation here. Like another commenter pointed out, other legal system allows you to ask the courts for decisions without an opposing party.
thu2111 6y ago
We're actually not running out of ventilators anywhere. Existing installed base is sufficient and moreover, it turned out the federal government had a large stockpile anyway, which rather invalidates the central thesis of the article re: lack of preparedness. The claim about ventilators was one of the first dodgy claims I noticed but really the entire first part of the article is a pack of lies. Andreessen says: "We see this today with the things we urgently need but don’t have. We don’t have enough coronavirus tests, or test materials — including, amazingly, cotton swabs and common reagents" This isn't amazing. The amount of testing being performed has scaled exponentially over the space of just a few months, from a standing start. In fact there's a lot of evidence that the supposedly exponential growth of the virus was really due to an exponential growth in testing, when positives are viewed as a proportion of overall tests done. It's not an indictment of "the West" that materials run out after such a vast acceleration - if anything I'm amazed it didn't happen earlier! "We don’t have enough ventilators, negative pressure rooms, and ICU beds" All three are in plentiful supply. Even in localised hotspots like New York problems are limited to a handful of hospitals. I've been reading about the near deserted state of most hospitals for over a week now. I don't understand where Marc is getting his information from if he isn't aware of this. "We also don’t have therapies or a vaccine — despite, again, years of advance warning about bat-borne coronaviruses" Vaccines can't be created for a virus that doesn't exist yet regardless of how many vague warnings there are, so this isn't remarkable: it's inevitable. As for therapies, that's what ventilators and CPAP are. "then we may not have the manufacturing factories required to scale their production" Given the data appearing in a flood of new papers, showing that the virus is not dangerous enough to warrant current policy, no unusual rates of manufacturing scale-up will be required. "it took scientists 5 years to get regulatory testing approval for the new Ebola vaccine after that scourge’s 2014 outbreak, at the cost of many lives" I'm actually on Marc's side on this one, in that I suspect current FDA approval processes are overkill. But this claim is also nonsense. FDA allows fast-track approval bypass for cases where someone is going to die without treatment anyway, and Ebola disappeared after 2014 - according to CDC the next time it was spotted was Zaire in 2018 with a grand total of 8 cases. That's not even close to "many lives". "A government that collects money from all its citizens and businesses each year has never built a system to distribute money to us when it’s needed most." Tax credits, quantitative easing, loan subsidies. The government has many ways to distribute money to people. "At least therapies and vaccines are hard! Making masks and transferring money are not hard" In fact making medical masks is hard. It requires special materials and machines, the supply of which can't be rapidly scaled up. https://www.businessinsider.com/why-factories-cant-keep-up-demand-for-face-masks-coronavirus-2020-4?r=US&IR=T https://www.businessinsider.com/why-factories-cant-keep-up-d... Headline is literally "Factories are scrambling to make 20 times more face masks a day to keep up with demand amid coronavirus outbreak, but the masks are surprisingly difficult and expensive to make" As for money, transferring money is easy. Figuring out the right amounts and the right people to send it to, without creating an explosion of fraud and waste - that's not so easy.
- simonspurr 6y ago
  Please could you link some of the papers you mention on the scale of the coronavirus problem? I'm not doubting they exist, I'd just be interested to have a read.
  - thu2111 6y ago
    This page has many links to such papers: https://swprs.org/a-swiss-doctor-on-covid-19/ https://swprs.org/a-swiss-doctor-on-covid-19/
    - KirinDave 6y ago
      "A swiss doctor on COVID-19," huh? Well since it's written by a doctor we should give it the benefit of the doubt and read the page and the links. But I confess, upon doing so I find that this is a page full of good (and in some cases, familiar) resources presented in a way that reminds me of a well-produced climate science denial websites. That's an incendiary claim, so please let me provide an example. Here's point 4 on the overview: > The age and risk profile of deaths thus essentially corresponds to normal mortality. Up to 60% of all Covid19-related deaths have occurred in particularly vulnerable nursing homes. "Nursing homes" is highlighted and links to an article talking about mortality in nursing homes and long term care facilities. It is both cautious about its claims (pointing out data is not very good yet) an doesn't make the point that nursing homes are in fact the fatality concentration point. It's not clear how we'd draw a larger conclusion from this. Another example, next point: > Many media reports of young and healthy people dying from Covid19 have proven to be false upon closer inspection. Many of these people either (did not)[1] die from Covid19 or they in fact had (serious preconditions)[2] (such as undiagnosed leukaemia). Firstly, I'm not sure anyone has disputed that young people are much less likely to die of the virus. But there are two links in this point, one to a Daily Mail article about how a coroner is waiting for a toxicology report before ruling the cause of death is COVID-19. This is probably the right call, but an infant testing positive for COVID-19 appears to have died over respiratory distress. It's difficult to just shrug and go, "Oh well that's SIDS not the virus even though the nature of the death is identical." Really, these points read like someone with an agenda trying to make a lot of cites for legitimacy. But there isn't a lot of evidence of a larger pattern here, just a lot of data which is then presented in a leading way to facilitate a narrative. Another example of this: > The often shown exponential curves of “corona cases” are (misleading)[3], since the number of tests also increases exponentially. In most countries, the ratio of positive tests to total tests either remains constant between (5% to 25%)[4] or increases rather slowly. This is another really misleading bullet point. Looking at [4], we see indeed that the over-time ratio of tests has remained at an average of 25% positive by country (this is of course averaged, hotspots see totally different numbers). But the author has previously pointed out that testing administration has risen exponentially, so this is a constant proportion of an exponential population. If we decline to extrapolate from this, the author cannot make their point. But if we do, we see an exponential growth in COVID-19 cases. I see more examples but I won't further belabor the point. This resource is written by someone with an agenda they want to execute on. It doesn't appear to be someone honestly engaging in inquiry and arriving at a data-driven conclusion. [0]: https://ltccovid.org/2020/04/12/mortality-associated-with-covid-19-outbreaks-in-care-homes-early-international-evidence/ https://ltccovid.org/2020/04/12/mortality-associated-with-co... [1]: https://www.dailymail.co.uk/news/article-8193487/Coroner-refuses-rule-COVID-19-cause-death-six-week-old-Connecticut-baby.html https://www.dailymail.co.uk/news/article-8193487/Coroner-ref... [2]: https://sports.yahoo.com/spanish-football-coach-francisco-garcia-163153573.html https://sports.yahoo.com/spanish-football-coach-francisco-ga... [3]: https://multipolar-magazin.de/artikel/coronavirus-irrefuhrung-fallzahlen https://multipolar-magazin.de/artikel/coronavirus-irrefuhrun... [4]: https://web.archive.org/web/20200415203945/https://mobile.twitter.com/FScholkmann/status/1249645557431361538 https://web.archive.org/web/20200415203945/https://mobile.tw...
malandrew 6y ago
> The moneyed classes of America don't like redundancy and they don't like long term investments. This class denigrating language does nothing to elevate the discussion and it is absolutely false (in the sense that it is only a "truth" within your worldview and the worldview of others who share it), and it is false in the sense that it doesn't accurately describe the behaviors of individuals in the "moneyed class". The "moneyed classes" as you call it if anything have more redundancy and longer term investments that most other classes. It is incredibly rare for anyone in the "moneyed classes" to not have a balanced portfolio of investments that add in fiscal redundancy in case one investment goes bad. The portfolios are also balanced insofar as balancing short term and long term growth depending on their investment horizon. The problems you've identified have far more to do with a coordination problem than the vices of individuals. The "moneyed class" is not one coordinated hive mind mass that all conspire with one another to avoid redundancy and eschew long term investments. The "moneyed class" like the "unmoneyed class" are all individual actors each acting in their own self interest and trying to figure out an optimal solution given limited imperfect information and handicapped by many cognitive biases. Any system that is going to solve the issue of redundancy and long term investments needs to acknowledge the reality of limited imperfective information and cognitive biases and the impact these have on human reasoning and the subsequent actions of individuals.

oxymoron 6y ago

We’re not necessarily talking about litigation here. Like another commenter pointed out, other legal system allows you to ask the courts for decisions without an opposing party.

thu2111 6y ago

We're actually not running out of ventilators anywhere. Existing installed base is sufficient and moreover, it turned out the federal government had a large stockpile anyway, which rather invalidates the central thesis of the article re: lack of preparedness. The claim about ventilators was one of the first dodgy claims I noticed but really the entire first part of the article is a pack of lies. Andreessen says: "We see this today with the things we urgently need but don’t have. We don’t have enough coronavirus tests, or test materials — including, amazingly, cotton swabs and common reagents" This isn't amazing. The amount of testing being performed has scaled exponentially over the space of just a few months, from a standing start. In fact there's a lot of evidence that the supposedly exponential growth of the virus was really due to an exponential growth in testing, when positives are viewed as a proportion of overall tests done. It's not an indictment of "the West" that materials run out after such a vast acceleration - if anything I'm amazed it didn't happen earlier! "We don’t have enough ventilators, negative pressure rooms, and ICU beds" All three are in plentiful supply. Even in localised hotspots like New York problems are limited to a handful of hospitals. I've been reading about the near deserted state of most hospitals for over a week now. I don't understand where Marc is getting his information from if he isn't aware of this. "We also don’t have therapies or a vaccine — despite, again, years of advance warning about bat-borne coronaviruses" Vaccines can't be created for a virus that doesn't exist yet regardless of how many vague warnings there are, so this isn't remarkable: it's inevitable. As for therapies, that's what ventilators and CPAP are. "then we may not have the manufacturing factories required to scale their production" Given the data appearing in a flood of new papers, showing that the virus is not dangerous enough to warrant current policy, no unusual rates of manufacturing scale-up will be required. "it took scientists 5 years to get regulatory testing approval for the new Ebola vaccine after that scourge’s 2014 outbreak, at the cost of many lives" I'm actually on Marc's side on this one, in that I suspect current FDA approval processes are overkill. But this claim is also nonsense. FDA allows fast-track approval bypass for cases where someone is going to die without treatment anyway, and Ebola disappeared after 2014 - according to CDC the next time it was spotted was Zaire in 2018 with a grand total of 8 cases. That's not even close to "many lives". "A government that collects money from all its citizens and businesses each year has never built a system to distribute money to us when it’s needed most." Tax credits, quantitative easing, loan subsidies. The government has many ways to distribute money to people. "At least therapies and vaccines are hard! Making masks and transferring money are not hard" In fact making medical masks is hard. It requires special materials and machines, the supply of which can't be rapidly scaled up. https://www.businessinsider.com/why-factories-cant-keep-up-demand-for-face-masks-coronavirus-2020-4?r=US&IR=T https://www.businessinsider.com/why-factories-cant-keep-up-d... Headline is literally "Factories are scrambling to make 20 times more face masks a day to keep up with demand amid coronavirus outbreak, but the masks are surprisingly difficult and expensive to make" As for money, transferring money is easy. Figuring out the right amounts and the right people to send it to, without creating an explosion of fraud and waste - that's not so easy.

simonspurr 6y ago
Please could you link some of the papers you mention on the scale of the coronavirus problem? I'm not doubting they exist, I'd just be interested to have a read.
- thu2111 6y ago
  This page has many links to such papers: https://swprs.org/a-swiss-doctor-on-covid-19/ https://swprs.org/a-swiss-doctor-on-covid-19/
  - KirinDave 6y ago
    "A swiss doctor on COVID-19," huh? Well since it's written by a doctor we should give it the benefit of the doubt and read the page and the links. But I confess, upon doing so I find that this is a page full of good (and in some cases, familiar) resources presented in a way that reminds me of a well-produced climate science denial websites. That's an incendiary claim, so please let me provide an example. Here's point 4 on the overview: > The age and risk profile of deaths thus essentially corresponds to normal mortality. Up to 60% of all Covid19-related deaths have occurred in particularly vulnerable nursing homes. "Nursing homes" is highlighted and links to an article talking about mortality in nursing homes and long term care facilities. It is both cautious about its claims (pointing out data is not very good yet) an doesn't make the point that nursing homes are in fact the fatality concentration point. It's not clear how we'd draw a larger conclusion from this. Another example, next point: > Many media reports of young and healthy people dying from Covid19 have proven to be false upon closer inspection. Many of these people either (did not)[1] die from Covid19 or they in fact had (serious preconditions)[2] (such as undiagnosed leukaemia). Firstly, I'm not sure anyone has disputed that young people are much less likely to die of the virus. But there are two links in this point, one to a Daily Mail article about how a coroner is waiting for a toxicology report before ruling the cause of death is COVID-19. This is probably the right call, but an infant testing positive for COVID-19 appears to have died over respiratory distress. It's difficult to just shrug and go, "Oh well that's SIDS not the virus even though the nature of the death is identical." Really, these points read like someone with an agenda trying to make a lot of cites for legitimacy. But there isn't a lot of evidence of a larger pattern here, just a lot of data which is then presented in a leading way to facilitate a narrative. Another example of this: > The often shown exponential curves of “corona cases” are (misleading)[3], since the number of tests also increases exponentially. In most countries, the ratio of positive tests to total tests either remains constant between (5% to 25%)[4] or increases rather slowly. This is another really misleading bullet point. Looking at [4], we see indeed that the over-time ratio of tests has remained at an average of 25% positive by country (this is of course averaged, hotspots see totally different numbers). But the author has previously pointed out that testing administration has risen exponentially, so this is a constant proportion of an exponential population. If we decline to extrapolate from this, the author cannot make their point. But if we do, we see an exponential growth in COVID-19 cases. I see more examples but I won't further belabor the point. This resource is written by someone with an agenda they want to execute on. It doesn't appear to be someone honestly engaging in inquiry and arriving at a data-driven conclusion. [0]: https://ltccovid.org/2020/04/12/mortality-associated-with-covid-19-outbreaks-in-care-homes-early-international-evidence/ https://ltccovid.org/2020/04/12/mortality-associated-with-co... [1]: https://www.dailymail.co.uk/news/article-8193487/Coroner-refuses-rule-COVID-19-cause-death-six-week-old-Connecticut-baby.html https://www.dailymail.co.uk/news/article-8193487/Coroner-ref... [2]: https://sports.yahoo.com/spanish-football-coach-francisco-garcia-163153573.html https://sports.yahoo.com/spanish-football-coach-francisco-ga... [3]: https://multipolar-magazin.de/artikel/coronavirus-irrefuhrung-fallzahlen https://multipolar-magazin.de/artikel/coronavirus-irrefuhrun... [4]: https://web.archive.org/web/20200415203945/https://mobile.twitter.com/FScholkmann/status/1249645557431361538 https://web.archive.org/web/20200415203945/https://mobile.tw...

malandrew 6y ago

> The moneyed classes of America don't like redundancy and they don't like long term investments. This class denigrating language does nothing to elevate the discussion and it is absolutely false (in the sense that it is only a "truth" within your worldview and the worldview of others who share it), and it is false in the sense that it doesn't accurately describe the behaviors of individuals in the "moneyed class". The "moneyed classes" as you call it if anything have more redundancy and longer term investments that most other classes. It is incredibly rare for anyone in the "moneyed classes" to not have a balanced portfolio of investments that add in fiscal redundancy in case one investment goes bad. The portfolios are also balanced insofar as balancing short term and long term growth depending on their investment horizon. The problems you've identified have far more to do with a coordination problem than the vices of individuals. The "moneyed class" is not one coordinated hive mind mass that all conspire with one another to avoid redundancy and eschew long term investments. The "moneyed class" like the "unmoneyed class" are all individual actors each acting in their own self interest and trying to figure out an optimal solution given limited imperfect information and handicapped by many cognitive biases. Any system that is going to solve the issue of redundancy and long term investments needs to acknowledge the reality of limited imperfective information and cognitive biases and the impact these have on human reasoning and the subsequent actions of individuals.