4 ms·

This will be downvoted but- in the US, on a national level, "poor management" is a deliberate choice. The chaos that stems from absence of leadership suits the

This will be downvoted but- in the US, on a national level, "poor management" is a deliberate choice. The chaos that stems from absence of leadership suits the Chaos Monkey President. Like all grifter/carnival barkers, he despises his customers (marks), whose only option in the absence of information, support, structure, is YOLO, and who will therefore ultimately suffer the most, while continuing to turn to him for his cynical false messaging and identification of an Other to blame for any misfortune. Those who are not under his spell are beaten into apathy by the sheer unrelenting awfulness and the absence of an alternative national strategy other than "vote in November." Even states/regions (like mine, NY) where there is less insulation for incompetent or malignant leadership than at the national level and that are finally proceeding rationally and relatively transparently nevertheless failed to act quickly enough at the start, and continue to be presented with grotesque and criminal obstacles by the national government. It is an appalling state of insanity that we are in, that's for sure.

cabaalis 6y ago
The US health system is not well positioned for command-and-control from a centralized source. This has various advantages and disadvantages, but is a severe hindrance in a pandemic. There wasn't even a unified diagnosis code for COVID until April 1, and that required a herculean effort and a shirking of normal coding update processes. There were various guidances for coding, but identifying diagnosis in structured data for fast analysis was a difficult ask. (I know this to be true, I've done it across the health records of millions of patients.) I'm sure some fault lies in the administration, but my belief is that our health system is systemically unable to properly deal with widespread pandemic, especially from a newly discovered illness. That's one of those trade-offs that have to be considered when looking at how health care in the US should be handled in the future.
- Retric 6y ago
  As long as the US has free movement of people across state borders, it needs a nationwide response to infections disease. Historically, the US had the ability to coordinate a nationwide response to pandemics. Starting in 1947 the National Malaria Eradication Program was one very successful example of this process which succeeded in eradicating malaria in the United States by 1951. https://en.wikipedia.org/wiki/National_Malaria_Eradication_Program https://en.wikipedia.org/wiki/National_Malaria_Eradication_P... Similar efforts for widespread vaccinations etc have also worked just fine. This pandemic is exactly what the CDC was designed to handle, it’s simply been horrifically mishandled. PS: The blame goes beyond this administration, but great leadership early on could have made a massive difference.
- nradov 6y ago
  Are you referring to ICD-10 code U07.01? I thought the US had to wait for the WHO to add the code, so I'm not clear on how our health system was worse than other countries in that respect. https://www.who.int/classifications/icd/icd10updates/en/ https://www.who.int/classifications/icd/icd10updates/en/
  - cabaalis 6y ago
    Yes, U07.1. I was not aware of the WHO aspect (only that it had to be accelerated.) Prior to April 1 there were several CDC guidances for covid that unfortunately were complicated by existing code re-use.
- jonahbenton 6y ago
  Thanks for reply. No disagreement about the US health system from a command and control perspective. There actually isn't even a US health system, in the sense of other countries having a (public) health system. The US has a ton of private health systems, plus some large public ones for the elderly, poor, and veterans who are unable to buy into a private system. It is a mess. Issues with this mishmash of public and private systems aside, the primary failing I would argue is political- as a coordinated response to a pandemic involves education, housing, supply chain- lots of systems that have nothing directly to do with health. I would be curious if points you raise from a health system perspective were to some extent covered in the pandemic playbook that had been created and was handed over to the new political leadership following the election- then abandoned by them, as is well documented. If they were, it points even more strongly to political failure, as an aggressive political approach, building on prior planning work, could have greased so many administrative wheels- instead of, as is clearly happening now, simply and shamelessly lining the pockets of political allies. Cheers.
roman_greco 6y ago
Comments like this make me worry (& weary) about the state of modern political discourse
- yummypaint 6y ago
  This isnt a modern issue, people have been debating how to talk about and respond to criminality in national leadership for a long time. https://www.haaretz.com/us-news/.premium-america-s-fear-of-incivility-appeased-nazism-we-can-t-go-there-again-1.6220593 https://www.haaretz.com/us-news/.premium-america-s-fear-of-i...
  - roman_greco 6y ago
    > These acts, in turn, have sparked calls for administration opponents to be more civil. > Intrepid Internet sleuths have discovered similar resistance and calls for civility during the Nazi > American Christian religious leaders urging Jews to "appeal to the German sense of justice and German national conscience" rather than "baiting Hitler and trying to fight back," and Jews would be better served if they showed "good-will" towards the Nazis rather than "hate." I don't necessarily agree with the idea(s)/opinion(s) presented in the article, or the comparisons, but I do appreciate discourse that attempts to put forward an idea/opinion tactfully & thoughtfully. I think everyone is better served to understand/hear/read/listen to other points of view. That being said, if your article had opened with lines such as: > Chaos Monkey President > Like all grifter/carnival barkers I don't know that it would have gotten the point across as well as it did. However, given how upvoted the comment I replied to appears to be, perhaps I am in the minority.
- jonahbenton 6y ago
  Happy to engage and exchange and learn more. HN is not really the best platform for this (opportunity for a startup! :). Cheers.
rconti 6y ago
No disagreement on your points; we have a "leader" who has precisely 0 desire to lead, and 100% desire to seen as a leader, to inflate his ego. To do so requires fawning attention, deflecting blame, and avoiding hard decisions. However, even in states that are taking strong stances, they're all at least slightly different, and I still have a sense that they're all sort of biding time until some "adults" come along and provide leadership from the top, because that's how it's always worked in the past.
quietthrow 6y ago
I upvoted you. Objectively speaking, we are at a juncture in time where People need to think and act from the perspective of allegiance to economic opportunity rather than arbitrary geographies (called nations). This kind of thinking leads to non violent approach of forming groups of people on a given geography rather than a violent approach that is bred by nations and patriotism. It’s time to consider moving out of US may be. Smaller countries are better managed. They are poised to act fast and the higher degree of homogeneity (in thinking) helps with policies, laws etc. making the govt actually able to do things for its citizens rather than form factions along party lines and paralyze the system. The chaos monkey is just a symptom not the root problem. And so long as the root problem remains unaddressed there will be more monkeys and I would say worse than this one. He has set the bar for what presidents can do which mean other politicians with see it as it’s ok to use tactics like his over time this becomes the norm and only to be one broken by even worse monkeys in their efforts to “stray from the normal”. As a result the normal just keeps degrading. In the end we get the govt and politicians we deserve. The system that has morphed in the US for its citizens is quite worse. The masses are so busy they are merely citizens Trying to meet ends with their busy lives and can’t perform active citizenry which is critical for democracy. Between school,children and work there is very little personal time let alone be an active citizen. The youth is somewhat detached from the reality of the corrosive system of govt working from them because they mostly don’t feel the direct consequences of an inept govt system as their needs are somewhat less than middle aged masses. The older folk are just pissed at what they see and become one issue voters. So the people who actually have the time to vote are voting for very specific issues. This breeds politicians that cater to these voters and what you get is a political body that caters to and operates on extreme positions of left and right rather a more centrist or moderate approach. All in all there are too many structural issues from years of “corrosion“. As with most changes in history the catalyst for big change is usually natural disasters and wars. Technology advances to play a role too. Covid is one of those power shifting natural disasters. The shift will be gradual an not a sudden as spectacular as a building being demolished. The citizens are like frogs being boiled alive. Most don’t realize what’s happening right under given the slow degradation with small flares here and there thst grab their attention but not big enough to muster any energy to drive change.
- 6y ago

cabaalis 6y ago

The US health system is not well positioned for command-and-control from a centralized source. This has various advantages and disadvantages, but is a severe hindrance in a pandemic. There wasn't even a unified diagnosis code for COVID until April 1, and that required a herculean effort and a shirking of normal coding update processes. There were various guidances for coding, but identifying diagnosis in structured data for fast analysis was a difficult ask. (I know this to be true, I've done it across the health records of millions of patients.) I'm sure some fault lies in the administration, but my belief is that our health system is systemically unable to properly deal with widespread pandemic, especially from a newly discovered illness. That's one of those trade-offs that have to be considered when looking at how health care in the US should be handled in the future.

Retric 6y ago
As long as the US has free movement of people across state borders, it needs a nationwide response to infections disease. Historically, the US had the ability to coordinate a nationwide response to pandemics. Starting in 1947 the National Malaria Eradication Program was one very successful example of this process which succeeded in eradicating malaria in the United States by 1951. https://en.wikipedia.org/wiki/National_Malaria_Eradication_Program https://en.wikipedia.org/wiki/National_Malaria_Eradication_P... Similar efforts for widespread vaccinations etc have also worked just fine. This pandemic is exactly what the CDC was designed to handle, it’s simply been horrifically mishandled. PS: The blame goes beyond this administration, but great leadership early on could have made a massive difference.
nradov 6y ago
Are you referring to ICD-10 code U07.01? I thought the US had to wait for the WHO to add the code, so I'm not clear on how our health system was worse than other countries in that respect. https://www.who.int/classifications/icd/icd10updates/en/ https://www.who.int/classifications/icd/icd10updates/en/
- cabaalis 6y ago
  Yes, U07.1. I was not aware of the WHO aspect (only that it had to be accelerated.) Prior to April 1 there were several CDC guidances for covid that unfortunately were complicated by existing code re-use.
jonahbenton 6y ago
Thanks for reply. No disagreement about the US health system from a command and control perspective. There actually isn't even a US health system, in the sense of other countries having a (public) health system. The US has a ton of private health systems, plus some large public ones for the elderly, poor, and veterans who are unable to buy into a private system. It is a mess. Issues with this mishmash of public and private systems aside, the primary failing I would argue is political- as a coordinated response to a pandemic involves education, housing, supply chain- lots of systems that have nothing directly to do with health. I would be curious if points you raise from a health system perspective were to some extent covered in the pandemic playbook that had been created and was handed over to the new political leadership following the election- then abandoned by them, as is well documented. If they were, it points even more strongly to political failure, as an aggressive political approach, building on prior planning work, could have greased so many administrative wheels- instead of, as is clearly happening now, simply and shamelessly lining the pockets of political allies. Cheers.

roman_greco 6y ago

Comments like this make me worry (& weary) about the state of modern political discourse

yummypaint 6y ago
This isnt a modern issue, people have been debating how to talk about and respond to criminality in national leadership for a long time. https://www.haaretz.com/us-news/.premium-america-s-fear-of-incivility-appeased-nazism-we-can-t-go-there-again-1.6220593 https://www.haaretz.com/us-news/.premium-america-s-fear-of-i...
- roman_greco 6y ago
  > These acts, in turn, have sparked calls for administration opponents to be more civil. > Intrepid Internet sleuths have discovered similar resistance and calls for civility during the Nazi > American Christian religious leaders urging Jews to "appeal to the German sense of justice and German national conscience" rather than "baiting Hitler and trying to fight back," and Jews would be better served if they showed "good-will" towards the Nazis rather than "hate." I don't necessarily agree with the idea(s)/opinion(s) presented in the article, or the comparisons, but I do appreciate discourse that attempts to put forward an idea/opinion tactfully & thoughtfully. I think everyone is better served to understand/hear/read/listen to other points of view. That being said, if your article had opened with lines such as: > Chaos Monkey President > Like all grifter/carnival barkers I don't know that it would have gotten the point across as well as it did. However, given how upvoted the comment I replied to appears to be, perhaps I am in the minority.
jonahbenton 6y ago
Happy to engage and exchange and learn more. HN is not really the best platform for this (opportunity for a startup! :). Cheers.

rconti 6y ago

No disagreement on your points; we have a "leader" who has precisely 0 desire to lead, and 100% desire to seen as a leader, to inflate his ego. To do so requires fawning attention, deflecting blame, and avoiding hard decisions. However, even in states that are taking strong stances, they're all at least slightly different, and I still have a sense that they're all sort of biding time until some "adults" come along and provide leadership from the top, because that's how it's always worked in the past.

quietthrow 6y ago

I upvoted you. Objectively speaking, we are at a juncture in time where People need to think and act from the perspective of allegiance to economic opportunity rather than arbitrary geographies (called nations). This kind of thinking leads to non violent approach of forming groups of people on a given geography rather than a violent approach that is bred by nations and patriotism. It’s time to consider moving out of US may be. Smaller countries are better managed. They are poised to act fast and the higher degree of homogeneity (in thinking) helps with policies, laws etc. making the govt actually able to do things for its citizens rather than form factions along party lines and paralyze the system. The chaos monkey is just a symptom not the root problem. And so long as the root problem remains unaddressed there will be more monkeys and I would say worse than this one. He has set the bar for what presidents can do which mean other politicians with see it as it’s ok to use tactics like his over time this becomes the norm and only to be one broken by even worse monkeys in their efforts to “stray from the normal”. As a result the normal just keeps degrading. In the end we get the govt and politicians we deserve. The system that has morphed in the US for its citizens is quite worse. The masses are so busy they are merely citizens Trying to meet ends with their busy lives and can’t perform active citizenry which is critical for democracy. Between school,children and work there is very little personal time let alone be an active citizen. The youth is somewhat detached from the reality of the corrosive system of govt working from them because they mostly don’t feel the direct consequences of an inept govt system as their needs are somewhat less than middle aged masses. The older folk are just pissed at what they see and become one issue voters. So the people who actually have the time to vote are voting for very specific issues. This breeds politicians that cater to these voters and what you get is a political body that caters to and operates on extreme positions of left and right rather a more centrist or moderate approach. All in all there are too many structural issues from years of “corrosion“. As with most changes in history the catalyst for big change is usually natural disasters and wars. Technology advances to play a role too. Covid is one of those power shifting natural disasters. The shift will be gradual an not a sudden as spectacular as a building being demolished. The citizens are like frogs being boiled alive. Most don’t realize what’s happening right under given the slow degradation with small flares here and there thst grab their attention but not big enough to muster any energy to drive change.

6y ago