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I'm in favor of building things. But we build in response to demand. Once people need more of something (e.g. PPE), production ramps up. That effect has been i

I'm in favor of building things. But we build in response to demand. Once people need more of something (e.g. PPE), production ramps up. That effect has been in place and has worked quite well for thousands of years. It doesn't require any policy or government, or even a new social movement, it's just an emergent property of humans being free. You might argue that we could be smarter, and that we should build excess PPE before the demand hits just in case. This is reasonable to an extent, but probably to less of an extent than you think. The problem is that there are dozens of possible scenarios we should prepare for, and we can't know ahead of time which one is going to strike next. We have to prepare for them all: nuclear bunkers, asteroid deflection, global warming mitigation, sea walls, military capacity, etc, etc. Giving the competition among possible future disasters, it is often wiser to KEEP YOUR POWDER DRY (in capitals, because that is my main point) so you can respond to any of them after they eventuate, not before. This requires that we have the capacity to ramp up production quickly. That's not always a given, so I'm in favor of governmental action to ensure we have "stragetic capacity" to ramp up anything we might desperately need. But I'm not in favor of just building lots of things that we might need.

kitotik 7y ago
There has been a huge demand for cheaper and more widely available healthcare for a long time.
- TbobbyZ 7y ago
  Cheaper healthcare cannot be achieved because of the amount of regulation that is in the healthcare system.
  - karatestomp 6y ago
    The amount? Do all the other OECD states have a smaller "amount" of regulation on their healthcare systems?
    - TbobbyZ 6y ago
      Of course there is not a shared level regulation among all the states. But generally speaking, the healthcare industry is a highly regulated system, which means higher costs.
      - lotsofpulp 6y ago
        It also has something to do with healthcare being an incredibly difficult product to provide requiring extremely smart people to deliver extremely hard to device solutions, which also result in much of the regulation. Obviously, it’s possible there is too much regulation and resources are not allocated properly, but on its face, I would expect something as complicated and risky as operating on people’s brains and chemotherapy and transplants to be expensive.
        kitotik 6y ago
        You are discounting the millions of people who can not afford to call someone and get a prescription for a zpack. It’s not all brain surgery and organ replacement.
        lotsofpulp 6y ago
        I agree, but calling someone to get a zpack is not a good example as it's been under regulated if anything: https://www.cdc.gov/media/releases/2016/p0503-unnecessary-prescriptions.html https://www.cdc.gov/media/releases/2016/p0503-unnecessary-pr... https://www.medscape.com/viewarticle/820736 https://www.medscape.com/viewarticle/820736 https://www.cidrap.umn.edu/asp/overuse-overprescribing-of-antibiotics https://www.cidrap.umn.edu/asp/overuse-overprescribing-of-an...
        kitotik 6y ago
        Agreed, antibiotics was a terrible example. “Minor, common health issues” is probably a better choice of words.
        6y ago
BurningFrog 7y ago
If you get rid of price gouging laws, private stockpiling and ramped up production both become worth doing.
sanj 7y ago
I've spent the last month setting up a company to build PPEs, so I hope to bring an interesting perspective here. Most importantly: production ramps slowly because of the implications of structural organization. 1. From what I can tell, our supply chains are carefully tuned for efficient output of known, predictable, quantities 2. If you want to suddenly double, triple, or 10x production, it isn't easy: the reconfiguration necessary is hard. Building new injection molds is hard, the surrounding transport chains are hard. 3. In light of those two facts, our existing manufacturing infrastructure is wholly unequipped to change or to help. This is exactly where a strategic, savvy reserve would make a huge difference. You can see this in the flurry of press releases from three weeks ago which have largely turned into nothing. Bupkis. By contrast, my small, scrappy, and deeply dedicated team of volunteers has designed, prototyped, iterated, refined, and is now shipping emergency PPE in quantity. Go visit https://maskson.org https://maskson.org We're ramping up to 2000 masks shipped a day. That's going to take $100k/day in capital: http://gofundme.com/f/maskson http://gofundme.com/f/maskson
- oconnor663 7y ago
  I think power grids have a kind of similar problem, super oversimplifying here because this isn't my area: Baseload power plants (e.g. coal) are large and comparatively efficient, but they need to be kept running continuously, and they take a long time to restart. Other types of plants (e.g. natural gas) can start and stop more quickly to meet surges in demand, but they aren't as efficient overall. In order to keep the second type of plant available, but not constantly running, there's a whole separate contracts market for short-notice capacity. What could such a market look like for e.g. hospital equipment capacity contracts? Food growing capacity?
  - RubenvanE 6y ago
    Your analogy with the energy market is quite good, the only thing I would address is that coal plants aren’t more energy efficient than gas plants (roughly 40% and 50%, respectively). The reason coal plants provide the base load is that the raw material, coal, is cheaper than gas. However, with falling oil and gas prices this might change in the ‘near’ future. The reason the US military (among others) buys so much equipment even during relatively peaceful periods is to keep alive the ability to produce massive amounts of tanks etc. whenever they really _do_ need them. So just not outsourcing these kind of essential goods to foreign nations might be already a great leap in the right direction.
XorNot 7y ago
The government, and the US, and in fact most countries, are actually really really big places. 300 million people is a lot of people - much larger then anyone can imagine as actual, real human beings. The government stockpiling and coordinating emergency measures is exactly what a government is for. The US maintains the largest military on the planet for exactly this stated purpose - just in case. Why is the idea of allocating capacity to preventing non-military disasters seem like such an impossibility? 300 million people is a lot of experts, studies, research and development and logistics, which can run simultaneously to plan for multiple disaster scenarios and review those plans continuously.
pmarca 7y ago
Anyone who builds a new product is creating supply ahead of demand.
- sanj 6y ago
  Drop me a line, help me get these PPEs in clinician hands.

kitotik 7y ago

There has been a huge demand for cheaper and more widely available healthcare for a long time.

TbobbyZ 7y ago
Cheaper healthcare cannot be achieved because of the amount of regulation that is in the healthcare system.
- karatestomp 6y ago
  The amount? Do all the other OECD states have a smaller "amount" of regulation on their healthcare systems?
  - TbobbyZ 6y ago
    Of course there is not a shared level regulation among all the states. But generally speaking, the healthcare industry is a highly regulated system, which means higher costs.
    - lotsofpulp 6y ago
      It also has something to do with healthcare being an incredibly difficult product to provide requiring extremely smart people to deliver extremely hard to device solutions, which also result in much of the regulation. Obviously, it’s possible there is too much regulation and resources are not allocated properly, but on its face, I would expect something as complicated and risky as operating on people’s brains and chemotherapy and transplants to be expensive.
      - kitotik 6y ago
        You are discounting the millions of people who can not afford to call someone and get a prescription for a zpack. It’s not all brain surgery and organ replacement.
        lotsofpulp 6y ago
        I agree, but calling someone to get a zpack is not a good example as it's been under regulated if anything: https://www.cdc.gov/media/releases/2016/p0503-unnecessary-prescriptions.html https://www.cdc.gov/media/releases/2016/p0503-unnecessary-pr... https://www.medscape.com/viewarticle/820736 https://www.medscape.com/viewarticle/820736 https://www.cidrap.umn.edu/asp/overuse-overprescribing-of-antibiotics https://www.cidrap.umn.edu/asp/overuse-overprescribing-of-an...
        kitotik 6y ago
        Agreed, antibiotics was a terrible example. “Minor, common health issues” is probably a better choice of words.
        6y ago

BurningFrog 7y ago

If you get rid of price gouging laws, private stockpiling and ramped up production both become worth doing.

sanj 7y ago

I've spent the last month setting up a company to build PPEs, so I hope to bring an interesting perspective here. Most importantly: production ramps slowly because of the implications of structural organization. 1. From what I can tell, our supply chains are carefully tuned for efficient output of known, predictable, quantities 2. If you want to suddenly double, triple, or 10x production, it isn't easy: the reconfiguration necessary is hard. Building new injection molds is hard, the surrounding transport chains are hard. 3. In light of those two facts, our existing manufacturing infrastructure is wholly unequipped to change or to help. This is exactly where a strategic, savvy reserve would make a huge difference. You can see this in the flurry of press releases from three weeks ago which have largely turned into nothing. Bupkis. By contrast, my small, scrappy, and deeply dedicated team of volunteers has designed, prototyped, iterated, refined, and is now shipping emergency PPE in quantity. Go visit https://maskson.org https://maskson.org We're ramping up to 2000 masks shipped a day. That's going to take $100k/day in capital: http://gofundme.com/f/maskson http://gofundme.com/f/maskson

oconnor663 7y ago
I think power grids have a kind of similar problem, super oversimplifying here because this isn't my area: Baseload power plants (e.g. coal) are large and comparatively efficient, but they need to be kept running continuously, and they take a long time to restart. Other types of plants (e.g. natural gas) can start and stop more quickly to meet surges in demand, but they aren't as efficient overall. In order to keep the second type of plant available, but not constantly running, there's a whole separate contracts market for short-notice capacity. What could such a market look like for e.g. hospital equipment capacity contracts? Food growing capacity?
- RubenvanE 6y ago
  Your analogy with the energy market is quite good, the only thing I would address is that coal plants aren’t more energy efficient than gas plants (roughly 40% and 50%, respectively). The reason coal plants provide the base load is that the raw material, coal, is cheaper than gas. However, with falling oil and gas prices this might change in the ‘near’ future. The reason the US military (among others) buys so much equipment even during relatively peaceful periods is to keep alive the ability to produce massive amounts of tanks etc. whenever they really _do_ need them. So just not outsourcing these kind of essential goods to foreign nations might be already a great leap in the right direction.

XorNot 7y ago

The government, and the US, and in fact most countries, are actually really really big places. 300 million people is a lot of people - much larger then anyone can imagine as actual, real human beings. The government stockpiling and coordinating emergency measures is exactly what a government is for. The US maintains the largest military on the planet for exactly this stated purpose - just in case. Why is the idea of allocating capacity to preventing non-military disasters seem like such an impossibility? 300 million people is a lot of experts, studies, research and development and logistics, which can run simultaneously to plan for multiple disaster scenarios and review those plans continuously.

pmarca 7y ago

Anyone who builds a new product is creating supply ahead of demand.

sanj 6y ago
Drop me a line, help me get these PPEs in clinician hands.