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by worik·6y ago·view on hn ↗
I completely disagree.

If the government had done it in house they could have succeeded.

The problem here was the profit motive. Cheep ventilators endanger profits.

It is a side effect of free markets (I like free markets) that big firms get bigger, get more market power, kill off competition then price gouge. Health is a bad bad place to have free markets as the incentives are almost all wrong (exceptions: E.g. running clinics as a service for state run health systems turns out to work well here in Aotearoa - but even that is under pressure from consolidation)

Nationalise the whole ball of wax. Use waiting lists not wealth to ration access. FFS the richest country in the world is heading to a health catastrophe. What a bunch of idiots!

2 comments
> If the government had done it in house they could have succeeded.

Ok, so how do we get the government to do it in house, and stick to it long enough so that the stockpile is there when the next disease crisis happens, which might not be for another 10 years? That's five Congressional elections and at least two changes of Presidential administration.

Party politics is a separate shit show. It should be an elected council with no single representation. That would allow smaller, manageable policy changes rather than burn the entire universe every few years.
> Party politics is a separate shit show. It should be an elected council with no single representation.

Ok, so your plan for solving the ventilator issue is to change the entire system of government. Good luck with that.

Government is not congress, or a president. It is civil servants beavering away.
> Government is not congress, or a president. It is civil servants beavering away.

The civil servants work on what Congress and the President set as priorities. They cannot execute plans that span multiple Congresses and Presidential administrations unless every single Congress and Administration over that time period agrees to support the plan.

They flew to the moon.

They built a horrifying arsenal.

I really do not see why they cannot build a health system. They have done so here.

> They flew to the moon.

Yes, because three successive Presidential administrations and six successive Congresses supported it.

More precisely, two successive administrations and about four successive Congresses supported it. The third administration began to back off, as did the fifth Congress; then the sixth Congress, along with the administration, stopped supporting it--and the moon missions stopped. Despite the fact that a large number of civil servants were making cogent arguments for why they should continue.

> They built a horrifying arsenal.

Yes, because every President and every Congress since 1945 has supported it.

Healthcare is a much larger proportion of the economy than NASA ever was. And if you're trying to put up the US military as an exemplar of US government efficiency and competence, no thank you.
There's no "free market" in healthcare; it's one of the most heavily regulated sectors in the economy. It's a known side-effect of regulation that big and politically-connected firms are advantaged over smaller and leaner ones, market power tends to increase in lockstep with the regulatory burden, and a lot of price gouging becomes feasible that wouldn't occur in a more contestable environment.
Not only is health care regulated, it isn't even a market in the correct sense, because the people actually getting the health care services--patients--don't even know how much the services themselves cost. Which means that nobody is in a position to judge whether the services are worth what they cost. This isn't a market at all, it's a recipe for disaster. Which of course is exactly what we have.