Google: No results found for "If you have a stash of masks, we'll be knocking on your door." The query without quotes also doesn’t show any relevant hits on the first two pages.
Also: the Facebook story is from Sunday. It’s not very likely that it is a reaction to a press conference on Monday, is it?
You and all the other Trump supporters should stop making stuff up and/or learn to link to sources at least after being asked repeatedly to provide them.
I feel already damaged listening to Trump for over one hour. Watch the update yourself and you will hear it 1:1. I do not want to go thru that torture again! All his "update" could be compressed in one short paragraph.
Maybe one day I will propose a Trump compression algorithm as his vocabulary is very limited and he keeps repeating the same nonsense a million times hoping on inducing some hypnotonic effect in his low-IQ fans...
Low-IQ is not a choice. Mocking people for having a lower IQ is the same as mocking someone born without an arm or a leg or any other sort of genetic or birth defect that one has no control over. Those who suffer from mental retardation have low IQ. Should they not be spoken to in a way they can understand? Trump recognizes that everyone in the country has vastly different levels of intelligence, and speaks in a way that everyone can understand. I'm not sure why that's a point of criticism other than someone who thinks their natural intelligence somehow makes them better than others.
You clearly understand I was not referring to people with medical conditions. He doesn't say anything meaningful and definitely does not do it so that people with disabilities can get him. If that was his strategy, he would speak slowly, and not go in circles and confuse everybody, and force his people to publish clarifications after all the confusion he brings us with his TV appearances!
It's California. We get wildfires. I had medical N95 masks at home as well. Gave them to the hospital when they appealed for them.
It makes sense. If it weren't for Facebook not having this reserve we would just be 720k short. It's not like the companies selling these would just hold inventory, especially since if you store them too long the elastic and the seal becomes weak across a large enough sample.
Why was Facebook stashing so many masks? Anyway, if they didn't donate them, the Goverment said they are gonna confiscate them, and this was already clear.
It doesn't explain the vast amount of masks and gloves. They were stashing. I want to see a document showing exactly when they've purchased them. I won't be surprised if it was in 2020. These masks have expiry, so, why would one company stash so many - their staff is nowhere close!
“To help, Facebook donated our emergency reserve of 720,000 masks that we had bought in case the wildfires continued,” Zuckerberg said in a post, adding that the company is also working on “sourcing a lot more to donate.”
It says in the article they were purchased in case of continued wildfires.
Do you have a source for the government confiscating emergency supplies? My understanding was that that was only in cases of hoarding and profiteering in response to this crisis.
Characterizing preparedness as 'hording' is a socially toxic behavior which will discourage future preparedness.
It's not like they had plans to sell them for price gouging purposes nor did they purchase them immediately ahead of a crisis and create/contribute to a shortage or anything anti-social like that.
For durable emergency supplies like masks. all of us should, if we're able, be maintaining a supply outside of emergency times to help buffer demand shocks at times of need.
We're not talking 70K masks, we're talking 720K! These masks have an expiration date. I want them to publish their purchase documents! I won't be surprised if they bought them back in February like possibly many other corporations and that's why we ended up with no masks.
Man, this really is a case of no good deed goes unpunished, isn't it. That the response to a donation of their emergency reserves comes with "clearly they were up to no good" isn't exactly encouraging further cooperation.
The government also said that “everyone who wants to get tested can get tested”. And with all the specificity we have come to expect and love, he-who-shall-not-be-named also said “lots and lots, very much many” masks had been acquired.
Yet according to https://www.vox.com/2020/3/23/21191003/coronavirus-trump-def..., the federal government has not made a single order for masks, ventilators, or any other material. So I’d be surprised if they directly went for requisitions, especially from non-producers such as Facebook. I’d actually be surprised if they even knew Facebook had masks.
Which is enough for 14 days for ~50,000 people at 1/day. It seems like huge overkill when stated as a single number, but two weeks is a reasonable amount to plan for, especially for reserves at a time when the supply chain is stressed.
I wish our hospitals' administration had as much foresight. I think this crisis is making it clear that management in health care is vastly overpaid.
If you're wearing an n95 mask for particulate pollution there isn't a particular reason why you can't reuse it.
When I heard the numbers, I figured they purchased extra so they could also supply them to the surrounding community so as to avoid drama about facebook employees having masks while few others did.
Wore mine for 2 weeks during the fires when they were in short supply. It was definitely worse for wear at the end. And mine didn't have a valve on it. If it did, it might have lasted longer.
I used to mow 1/2 acre of Bermuda grass at least once a week from May - October on a riding mower. Would take 2 1/2 hours. I used the n95's you get at Home Depot and would reuse them for many weeks and probably could have continued to reuse them until I couldn't breath through them or the straps broke. They're for stopping particulates so as long as they're not clogged they still work. If the particulates are infectious virus particles then reuse becomes more problematic but they still filter particles.
Self reply to all others: try doing something that actually tests the limits a bit for health reasons. you can tell in a welding/woodshop when N95s and P100s go bad, they get physically harder to breath through after about 6-8 hours. If they don't they're not sealed well enough. they do keep working longer (probably), but they get quite a bit worse.
Doesn't really apply to the situation being discussed. You can absolutely wear it for two weeks during the fires. It will work just fine even well sealed. Not sufficient particulate matter in the air to be significant blocker.
The filtration doesn't run out when working with particulates, it actually gets better. The reason you have to replace them is they get too good at filtering and it restricts natural breath (or they get damaged).
In this situation, you assume the mask catches particles containing coronavirus. The mask becomes a biohazard pretty quickly. They could probably be safely disinfected and reused.
It truly is insane how quickly the severity of the crisis ramped up. Monday co-workers on slack were messaging how the flu was more of a worry, after Wednesday it was mandatory work from home. And it truly feels like medical authorities were as caught off guard as the rest of us. Who was on guard duty? Was no one monitoring the situation? No one thought to increase production of PPE or RNA tests?
Being as apolitical as possible, the fault is 100% Trump's. Our pandemic response team was gutted in Spring 2018. One of my favorite science journalists, Ed Yong, wrote this shortly after; there's a lot of contextual history before he starts spitting fire at the president's egotistic idiocy.
> Yet even the U.S. is disturbingly vulnerable—and in some respects is becoming quickly more so. It depends on a just-in-time medical economy, in which stockpiles are limited and even key items are made to order. https://www.theatlantic.com/magazine/archive/2018/07/when-th...
^ this is our current system. The people that would have been responsible for activating production had been fired. The CDC bungled the first tests. The FDA prevented anybody but the CDC from performing tests until just recently. The FDA tried to stop the Seattle Flu Study from back testing their samples to find evidence of infections; the scientists defied the FDA and found early evidence that would not have been found earlier.
Here's Trump responding to a reporter asking about the risks of firing the pandemic response team, back in 2018:
He later denied any knowledge of doing this. And instead of hiring back the people, he called the virus a Democrat hoax. Only later did he even pay attention to it, but there are debates about whether the VP he said was in charge, or his son-in-law is actually in charge. Nobody knows what is going on, every press conference is filled with basic inaccuracies, and he ignores the science. https://arstechnica.com/tech-policy/2020/03/dr-fauci-explain...
It's rotten from the top. We have robbed our government from essential functions, not to really save any money, but because we have an executive that doesn't know what he is doing and is too narcissistic to let anybody stick around that might reveal his inferiority complex.
Politicians that know better keep silent for fear of angering this president.
This is not a partisan statement, this is a statement of the fundamental distinction of having a bad leader. No corporation would survive like this. For the federal government, which is several orders of magnitude more complex than any corporation, we are absolutely devastated by having such terrible executive leadership.
People need to start speaking up and realizing that we must drop the partisanship in order for our country to remain a leader in science and economic power.
It took climate scientistS more than a decade to realize that being apolitical meant that the science would be politicized by monied interests; anybody who is interested in truth and science should realize that we must now mobilize against a political force with so large a lust for power that it will acknowledge no external authority, no truth, no empirical reality. These are strange times.
I think you’re being downvoted because of that very first sentence (no matter how much I hate the guy, laying the blame 100% on his frail shoulders seems a bit hyperbolic).
But I don’t see what’s downvotable (if not agreeable) about the rest of what was said
In defense of my first statement: There's really nobody else to blame that I can see. Perhaps incompetence in the FDA and CDC management, but those are his people, not the rank and file. This is all had management and ignoring expertise, and there is only one person to blame for that.
Other countries with more developed healthcare systems and more competent leadership are staving this off quickly, which will let them return to full economic activity much more quickly with proper covid surveillance and tracking.
Here in the US, others have stepped up in the absence of the usual leadership that is provided by federal monitoring agencies. It's like we were attacked by invading ground forces, but the president had fired all the generals down to the lieutenants. We have other private individuals stepping up to our defense, but the normal defense infrastructure has been gutted.
"Quick left amid a bitter U.S. trade dispute with China when she learned her federally funded post, officially known as resident adviser to the U.S. Field Epidemiology Training Program in China, would be discontinued as of September, the sources said. The U.S. CDC said it first learned of a “cluster of 27 cases of pneumonia” of unexplained origin in Wuhan, China, on Dec. 31."
The US had a pandemic response team, who's job it would have been to be on guard duty. They were "let go" in 2018 to reduce wasteful government spending.
My other comment on this was flagged, which had far more links. I'm not 100% sure why it was flagged other than the voting revealed it to be very controversial.
Hospitals only get paid for actually treating people. Many of them have asked for financing for disaster preparation, but nobody was willing to pay for it.
And it makes you wonder how exactly healthcare $$$ is flowing through the supply chain. It obviously isn't tied up in equipment inventory or logistics management. Time to shake the healthcare-costs tree and see what falls out!
I believe the healthcare system is so bloated because of a lack of competition. It made news when Trump pushed for legislation that would force hospitals to tell you how much they cost. Think about that. Setting aside all the arguments that it shouldn't be left up to the free market at all, in what world can a marketplace be healthy without something so basic as price disclosure?
Good point, I know that healthcare price disclosure is legally required in Australia. I wonder how the systems compare.
If you trace through the hospital's costs, it seems like a bulk of healthcare money ends up in the pockets of medical device companies. In my opinion, it doesn't seem like competition is behaving naturally at that level either. It seems like these companies are using the healthcare flustercluck as a proxy for anti-competitive behavior.
>I wish our hospitals' administration had as much foresight. I think this crisis is making it clear that management in health care is vastly overpaid.
Facebook has just a tad bit more money to prepare for these remote possibilities compared with your average hospital. Plus hospitals have to justify every cost in relation to how many lives it will save. Is prepping for a once in a century pandemic going to save more lives than having an extra doctor on staff for every shift? Almost everyone would have answered no to that questions up until a few weeks or months ago.
This isn’t a remote possibility. The California wildfires were real. People were wearing N95 masks last year due to the wildfires. There was even a famous article about a couple who had their engagement pictures taken wearing N95 masks due to the california wildfires, which you could see in the background of the photos. And since global warming is actually a real thing, we could project more wildfires for this year.
It isn’t a “remote” possibility that facebook employees end up needing respirators since it isn’t a “remote” possibility that there will be wildfires again in California this year. That is what is expected to happen.
Although it’s hard to tell what will be the impact of the global shut-downs reducing greenhouse gases on global temperatures this summer (if that will even have any impact so soon).
I would still say that having stockpiles of PPE is good management. My sister is a nurse and she had been complaining about having to find gloves last year, long before there even was a crisis. Some of these hospitals really do skimp on equipment. Just In Time and LEAN practices are cool, but you need to keep a stock of backups enough to last a month or two in the event of a shortage where every other hospital is also trying to produce the same equipment. Some might say it’s easy to say this in hindsight, but I’ve been hearing about these practices long before this crisis. Right now everything on the news about these shortages just echoes what many healthcare professionals already knew and were concerned about. There are systemic management issues in the medical industry. Hopefully a bill comes from this.
As an Australian the only reason I had masks was because of the fires as well. I think it is still not a part of our culture like in other countries to wear them.
I love the fact that rich people doesn't hesitate on helping ang sharing what they have during the pandemic. If I am rich I will probably help as well. Let us continue on praying for the world and people healing.
For a comparison of scale, consider the (rare) healthcare worker [who does not work just for money (and therefore does not actually need the day's or month's wage) who still goes into work to help the sick during this time] to _the Facebook_ who has built its wealth via very questionable means and is now donating supplies it otherwise did not need.
Forgive my pessimism here, but I'm not impressed. Good that they did it, but countless individuals of minimal means regularly give everything they can to help their fellows without credit or reward.
When someone does something good, I don't think it should be an impulse to point out that others have done better. Donating supplies is useful. Facebook should be lauded for that.
In isolation of actions, sure. But in the scope of Facebook's normal actions...?
Are we so easily distracted by the sparkly costless action that they now take that we forget the several known (and who knows how many unknown) deceptive and harmful actions they have intentionally taken against us in pursuit of money?
I'm not trashing them for doing something good. But just as I don't bow to the guy on the street that puts his candy wrapper in the rubbish bin instead of throwing it on the ground, I don't admire FB for giving out something they already possessed and were not having a planned use of.
Some guy in accounting, "I forgot we bought all these masks last year, someone tell our leader". Timing seems a little odd with the media clearly talking about the shortage of masks for weeks and this comes out today.
A note for those critical about donations not coming sooner:
It is important to understand hospitals and doctors could not legally use industrial N95 masks. No hospital could accept them without exposing themselves to massive litigation. I know this sounds stupid from outside the US. Sadly, this is part of our reality.
The key that unlocked donations was President Trump. Upon learning of this restriction he quickly put into place a release of liability for medical use of industrial N95 masks. This will be in force until at least 2024.
Because of this companies, contractors, suppliers and individuals came forward to donate masks. Apple donated a couple million units. I believe this might easily unlock tens of millions of masks as companies evaluate their inventories and continue to donate.
Commentary:
It is important to realize that the US healthcare system does not have an insurance problem. Politicians would have you think this is the case. It is not. The root cause of our high cost of healthcare, among other things, has to do with the underlying and hidden costs of doing business. This issue of masks is a simple example.
Hospitals, medical professionals and medical suppliers live in fear of greedy attorneys going after them for anything from masks to more complex equipment. This leads to major losses and costs and even legislation. And all of it increases the costs of doing business.
After this virus runs its course we would be well served to review a number of things, tort reform being a good idea. The other would be term limits for the House and Senate, I think it is beyond obvious these institutions have gone putrid to the very core.
It might also be rather strange to those outside the US to learn that in this wonderful country doctors and nurses cannot legally provide their services outside of the State where they are licensed. A doctor or nurse licensed in California cannot see patients in, say, Maine. In other words, we are not a country, we are a group of fenced-off kingdoms with some of the most ridiculous rules one could possibly imagine.
Our doctors can travel to Africa and practice medicine, yet they can't go to another State and do the same. How ridiculous is this?
That's just another element of our system that has to change. There's more, a lot more. The onerous and massively expensive drug or medical device approval process is another example.
Insurance is the last item in a very long list of issues we must address in order to bring sanity to our healthcare system.
When I think about the reasons the cost of US healthcare is so high, over-legislation is definitely up there, but so is the arms race between insurance and healthcare providers. It seems to me that the hight cost just is a symptom, and that we should focus our efforts on deregulation so that we drive prices down to competitive levels.
> The key that unlocked donations was President Trump. Upon learning of this restriction he quickly put into place a release of liability for medical use of industrial N95 masks.
President Trump did nothing except sign the law when it came to his desk. The provision was in the “Second Coronavirus Package” that originated in the US House of Representatives. It was written by Democratic lawmakers and sponsored by Nita Lowey, a New York Democrat.
It’s also unclear what type of masks Facebook had in stock. They might have been of the medical variety for all we know. And even if not, there would not have been liability anyway: it was manufactures that were previously liable when selling the wrong type of mask to health care workers. But in Facebook donating masks, no manufacturer is part of the transaction.
I’ll not go through the rest of your half-truths, except to note that if you believe any MD can see patients in “Africa” without going through some sort of accreditation you’re wrong.
Why are people so butt hurt with Trump? I get it, the guy inspires projectile vomiting every time he opens his mouth. I clean vomit off my floor every day after we watch the WH Coronavirus briefing. I get it.
And yet, the guy is doing the right things. And, yes, he signed the bill DESPITE 40 Republicans voting against it. Get it? HE GOT IT DONE BECAUSE IT WAS IMPORTANT, DESPITE HIS OWN PARTY VOTING AGAINST IT! He did the right thing. Without his signature the supply of industrial masks would not have been released for use.
So, c'mon. Relax a bit. We are on this boat together. The guy is doing a good job with this. Tough card. There are not magical solutions. There are no perfect solutions.
Superman isn't going to come flying and save us all.
How about a little FUCKING unity?
I did not vote for the guy and yet I can wipe my mouth from the vomit he induces every time he is on TV speaking like a 5 year old and recognize that either by talent, luck or divine intervention he seems to be able to steer this ship in the right direction.
Get off that high horse and become part of the solution. What did I do? I put on hold my self funded startup after investing $250K of my own money to pivot and work on development of technology we believe will be critical as COVID-19 subsides.
So, yeah, and sorry to put it this way. Stop it! Find something you can contribute. And, yes, if you have to help Trump, fucking help him. I have even reached in to the WH to offer help with manufacturing capabilities.
United we float this ship. Divided we sink it.
I hope to hell Democrats could get off their high horses and get with the program! Enough is enough!
As an independent what they have been doing has me so angry there is no way I will vote for a Democrat for a long time. I did not vote for Trump last time but I sure as hell will vote for him this time. And this is because of the petty dick-head Democrat politicians and people who just can't let go and do nothing but cause discord and division.
And, BTW, if Democrats want to win in November they better figure out a way to nominate Andrew Cuomo, only dumb-fucks would vote for Biden. Cuomo could do it. I would even consider voting for him, even as angry as I am about what Democrats have put our country through for almost four years. Trump isn't ideal, but he is doing a good job.
> I’ll not go through the rest of your half-truths, except to note that if you believe any MD can see patients in “Africa” without going through some sort of accreditation you’re wrong.
Well, my wife a doctor with international credentials. We are multicultural and have lived in other countries. We also have multiple doctors in the family who practice in various states in the US as well as Europe and South America. She also has friends who work with Médecins Sans Frontières. So, no, I know what I am talking about. And, yes, the problems with our healthcare system have almost nothing to do with insurance.
I mean, ANYONE who understands business also understands the very proposal that insurance is the problem is ridiculous. Insurance responds to costs and probability of expenditures. If you don't think so, go get a Ferrari insured and ask them why it costs so much. Drive down costs and insurance ceases to be a problem. Our healthcare system has layers of costs that are not being addressed and cannot be addressed by insurance.
To drive the other point home even further, here are the requirements for doctors withing to join Médecins Sans Frontières:
A doctor from California can join Médecins Sans Frontières and go practice all over the world and yet, that same doctor, is not allowed to practice medicine in other states within the US. There are few exceptions, but that's the general rule. This i...
Yeah, I’ve had enough. As a classical liberal sitting near the political middle I’ve been watching the political left devote four years to doing absolutely nothing but try to reverse an election. We are trying to destroy ourselves from the inside. And now Dems try to stuff piles of unrelated stuff into an emergency bill, taking advantage of several Republicans being sick with the virus? Really? I would be just as incensed if it were the other way around. These people are playing with lives. The American Left has gone insane.
As for Biden...I’d like to see anyone defend him as a real choice. The only thing we can say is he is less worse than Bernie, who would destroy this nation.
Dems don’t have a serious candidate. Get governor Cuomo to run. That would be a serious candidate.
Aside from that taking quotes out of context is a cheap shot.
President Trump signed the law and made it happen despite the fact that a good number of Republicans were against it. That's the point. He is making the right decisions.
As for your comment regarding accreditation for doctors operating outside the US, you are wrong. As a simple example, I refer you to the requirements for working anywhere Doctors Without Borders/Médecins Sans Frontières opearates:
My wife is a doctor with international credentials. We have friends and family members in various areas in the US, Europe and South America who are doctors covering a range of disciplines in various domains. And we lived in more than one country. Through them and life experience I know these medical systems, their drivers, advantages, disadvantages and issues very well. I am not pulling these statements out of a vacuum chamber.
With regards to US doctors not being able to practice across state lines. It's real, messy and complicated:
And, yes, it is ridiculous. Either we are a country or a bunch clans. I can't think of any other nation where a doctor is limited to practicing medicine in a single province. To say this is crazy is an understatement. Doctors take time and tons of money to produce, they are a scarce resource...and we limit them to operating within a single state? Someone tell me why this makes sense.
On the topic of fixing the system with insurance. Someone please explain how the cost of insurance can be lowered without lowering the underlying costs said insurance covers first. This is a very fundamental principle of business. If you want to reduce the cost of a downstream element in the chain you have to first address costs upstream. Cause and effect. You can't reverse that reality. Impossible.
Or, to put it in different terms, if the cost of operating a business is $10MM per year and revenue is $1MM per year that business is not sustainable. You can't lower insurance costs artificially. The cost of insurance is an effect, not a cause.
> And even if not, there would not have been liability anyway: it was manufactures that were previously liable when selling the wrong type of mask to health care workers. But in Facebook donating masks, no manufacturer is part of the transaction.
Just noticed this. It's wrong.
Hospitals could not accept donations of industrial masks, or, more accurately, they could not use them. This would expose them to potentially serious legal liability. Simple example: Someone dies. Lawyers discover medical team member were using using industrial masks they accepted from donations. They sue the hospital, every doctor, nurse and practitioner in the hospital and perhaps even whoever donated the masks.
How do I know this?
Well, as I mentioned elsewhere, my wife is a doctor and we have many doctors, nurses and other medical practitioners in our circle. In addition to this, we tried to donate many thousands of N95 masks from our own manufacturing operation's inventory to our local hospitals. They were refused, citing, very specifically "we cannot legally use industrial masks".
Once Trump went against Republicans in the House and Senate and signed the law releasing liability until 2024 we got a call from the hospitals we had contacted asking if the masks were still available. That's when we handed them over.
This, sadly, is how our legal system works. This is reality.
BTW, I do believe it was the White House who asked for the industrial mask exception to be included in the legislation. I don't have the time to go track down this assertion, so take it for what it is.
> It is important to realize that the US healthcare system does not have an insurance problem. Politicians would have you think this is the case.
As an outsider from New Zealand, I completely believe your insurance system is a huge problem, and that belief is founded on the problems I see (not what your politicians say, I don’t know anything about them).
One major issue is linking insurance to your job. Lose your job, lose your insurance.
Our socialised healthcare has it’s issues, but I have personally seen it work again and again for my friends, acquaintances, and family.
Disclaimer: I choose to also pay for private insurance, which costs me $40 per month for a middle aged guy, to get improved private health cover. I’m not against insurance, but the US system appears completely broken to me, and the insurance structure appears to be part of that.
The issue you bring up is absolutely on point. This idea of healthcare being linked to your employer is stupid and wrong. You are right.
However, this isn't really the top problem on the list. It definitely is one of the last items, if not the last.
Allow me to make a simple, yet imperfect, parallel.
If you buy a Toyota your auto insurance will cost X.
If, on the other hand, you buy a Ferrari, it will cost many times more than X.
Why?
Because a Ferrari costs more to repair and the probability of accidents might be statistically higher given the extra power, etc.
Insurance costs are a result of statistical analysis of the underlying probability distribution of costs to the insurance company based on a range of factors. These would include known and unknown costs, personal history, regional factors, legislation and more.
One cannot magically reduce the cost of insurance and obtain better results on the other end. You cannot force insurance to cover the potential costs of a Ferrari to only cost as much as it does for a Toyota. You can only do that if you remove coverage. For example, you are not covered if the car is stolen, damage or if you are driving above the speed limit and you are required to install a monitoring device in the car. In other words, make the potential cost surface as equivalent as that of a Toyota.
This is why the US does not have an insurance problem and our healthcare system will never be fixed through insurance. This "Medicare for All" nonsense is exactly that. It's like forcing Ferrari insurance down to Toyota level. In other words, it turns a blind eye to the underlying structural issues in the system, fixes nothing and pretends it is a solution.
Lower insurance costs in the US is a theoretically simple task that, in practice, is difficult due to our politics. We have to reduce costs. And these costs are related to the regulatory burden, the financial reality of lawsuits and the cost of medical education, to name three factors.
When you are rolled into an operating room in the US and are surrounded by, say, ten professionals, their collective school loan debt is likely in the two to three million dollar range. They each spend tens of thousands of dollars a year in insurance to protect from lawsuits. Each of the pieces of equipment in that room, from the masks to the ventilators, endoscopes, scalpels, table and more are the result of having spent from millions to billions of dollars in regulatory licensing and testing. Each of the companies making these products must maintain teams of attorneys, entire floors full of them in some cases, to protect against lawsuits. They must also pay for insurance for the same reason. The hospital in which this operating room exists is also the subject of pretty intense regulations that start with the planning and construction of the building and the rooms. The permits alone to build a hospital can cost a hundred million dollars and take ten years to obtain. Once built, the hospital is subject to yet another layer of cost-increasing regulations (the current example of not being able to use industrial N95 masks is relevant here) and must carry insurance to protect itself an its entire staff from lawsuits (which could cost billions of dollars).
That is a super simplified view in to the innards of the US healthcare system. None of these costs and problems are magically fixed by changing insurance, no matter what we do. We can take it away from employers. Sure. So what? How does it change any of the above? We can make it this crazy "Medicare for All". So what? How does it change the realities I disclosed above?
No, insurance isn't our problem. Sure, it could be better. Yet it is pointless to even talk about making insurance changes when the underlying cost structure is massively broken.
I hope this clarifies things for you. I understand it isn't easy to understand the inner workings of something like this from afar. I only understand the way things are in other countrie...
It seems many companies, prudently, had stocks of masks for their employees. Mastercard donated 25k masks and Goldman Sachs 20k[1].
My question is why the US government didn't have a bigger stockpile of them? We treat national security products with such deference, but yet defense against pandemics has been an afterthought.
Here are two looks inside the Strategic National Stockpile from NPR, the first from 2016.
The first story reports the loss of 50,000 state and local health officials.
The second from Mar 2020, reported that the SNS 'currently holds about 30 million simple surgical masks and 12 million of the more protective N95 masks....' Compare those numbers to what's needed.
Off topic: could HN make a rule that any questions that could be easily answered from reading the article will result in a day ban? There are way too many people here who didn't read this article ("why did they have so many masks?") and half the comments could be removed if they had!
I fail to see how stating the country of origin is racist. I've seen some people refer to it as "Kung Flu", which is clearly and obviously racist. The argument that associating a virus to it's country of origin is wrong makes no sense to me at all
I also don't see wrong stating the origin of something - French wine, Spanish wine, Chinese virus. I am Bulgarian and on the national TV, everybody calls it "the Chinese virus". There no acts against the many Chinese living in Bulgaria. Even doctors use it - Lyme disease, Marseilles fever, West Nile virus, etc. So, it's a matter of mentality, not how you call the virus. It is the same low-IQ crowd, which discriminate Americns from Chinese ancestry due to some name!
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[ 3.8 ms ] story [ 153 ms ] threadAlso: the Facebook story is from Sunday. It’s not very likely that it is a reaction to a press conference on Monday, is it?
You and all the other Trump supporters should stop making stuff up and/or learn to link to sources at least after being asked repeatedly to provide them.
Maybe one day I will propose a Trump compression algorithm as his vocabulary is very limited and he keeps repeating the same nonsense a million times hoping on inducing some hypnotonic effect in his low-IQ fans...
He is scum.
https://youtu.be/YdpxrgXldsY?t=4186
It makes sense. If it weren't for Facebook not having this reserve we would just be 720k short. It's not like the companies selling these would just hold inventory, especially since if you store them too long the elastic and the seal becomes weak across a large enough sample.
https://www.bloomberg.com/news/articles/2020-03-23/zuckerber...
Do you have a source for the government confiscating emergency supplies? My understanding was that that was only in cases of hoarding and profiteering in response to this crisis.
It's not like they had plans to sell them for price gouging purposes nor did they purchase them immediately ahead of a crisis and create/contribute to a shortage or anything anti-social like that.
For durable emergency supplies like masks. all of us should, if we're able, be maintaining a supply outside of emergency times to help buffer demand shocks at times of need.
There are going to be lawsuits going on for a decade because of the government ordering things that they are not allowed to do.
But "Qualified" immunity is an adjunct concept.
https://en.wikipedia.org/wiki/Executive_Order_6102
https://en.wikipedia.org/wiki/United_States_Railroad_Adminis...
https://en.wikipedia.org/wiki/Amtrak
https://en.wikipedia.org/wiki/Conrail
https://en.wikipedia.org/wiki/Emancipation_Proclamation
Yet according to https://www.vox.com/2020/3/23/21191003/coronavirus-trump-def..., the federal government has not made a single order for masks, ventilators, or any other material. So I’d be surprised if they directly went for requisitions, especially from non-producers such as Facebook. I’d actually be surprised if they even knew Facebook had masks.
So: have a link for “the government said”?
Sadly there weren't enough for everyone, even before this hoarding craze began.
“To help, Facebook donated our emergency reserve of 720,000 masks that we had bought in case the wildfires continued,”
I wish our hospitals' administration had as much foresight. I think this crisis is making it clear that management in health care is vastly overpaid.
When I heard the numbers, I figured they purchased extra so they could also supply them to the surrounding community so as to avoid drama about facebook employees having masks while few others did.
(I cannot remember my sources, sorry.)
In this situation, you assume the mask catches particles containing coronavirus. The mask becomes a biohazard pretty quickly. They could probably be safely disinfected and reused.
> Yet even the U.S. is disturbingly vulnerable—and in some respects is becoming quickly more so. It depends on a just-in-time medical economy, in which stockpiles are limited and even key items are made to order. https://www.theatlantic.com/magazine/archive/2018/07/when-th...
^ this is our current system. The people that would have been responsible for activating production had been fired. The CDC bungled the first tests. The FDA prevented anybody but the CDC from performing tests until just recently. The FDA tried to stop the Seattle Flu Study from back testing their samples to find evidence of infections; the scientists defied the FDA and found early evidence that would not have been found earlier.
Here's Trump responding to a reporter asking about the risks of firing the pandemic response team, back in 2018:
https://twitter.com/public_citizen/status/123992026897964646...
He later denied any knowledge of doing this. And instead of hiring back the people, he called the virus a Democrat hoax. Only later did he even pay attention to it, but there are debates about whether the VP he said was in charge, or his son-in-law is actually in charge. Nobody knows what is going on, every press conference is filled with basic inaccuracies, and he ignores the science. https://arstechnica.com/tech-policy/2020/03/dr-fauci-explain...
It's rotten from the top. We have robbed our government from essential functions, not to really save any money, but because we have an executive that doesn't know what he is doing and is too narcissistic to let anybody stick around that might reveal his inferiority complex.
Politicians that know better keep silent for fear of angering this president.
This is not a partisan statement, this is a statement of the fundamental distinction of having a bad leader. No corporation would survive like this. For the federal government, which is several orders of magnitude more complex than any corporation, we are absolutely devastated by having such terrible executive leadership.
People need to start speaking up and realizing that we must drop the partisanship in order for our country to remain a leader in science and economic power.
It took climate scientistS more than a decade to realize that being apolitical meant that the science would be politicized by monied interests; anybody who is interested in truth and science should realize that we must now mobilize against a political force with so large a lust for power that it will acknowledge no external authority, no truth, no empirical reality. These are strange times.
But I don’t see what’s downvotable (if not agreeable) about the rest of what was said
Other countries with more developed healthcare systems and more competent leadership are staving this off quickly, which will let them return to full economic activity much more quickly with proper covid surveillance and tracking.
Here in the US, others have stepped up in the absence of the usual leadership that is provided by federal monitoring agencies. It's like we were attacked by invading ground forces, but the president had fired all the generals down to the lieutenants. We have other private individuals stepping up to our defense, but the normal defense infrastructure has been gutted.
https://apnews.com/ce014d94b64e98b7203b873e56f80e9a
"Quick left amid a bitter U.S. trade dispute with China when she learned her federally funded post, officially known as resident adviser to the U.S. Field Epidemiology Training Program in China, would be discontinued as of September, the sources said. The U.S. CDC said it first learned of a “cluster of 27 cases of pneumonia” of unexplained origin in Wuhan, China, on Dec. 31."
https://www.reuters.com/article/us-health-coronavirus-china-...
Same old 3-card Monte. 'Look over here!'
https://www.politico.com/news/2020/03/25/trump-coronavirus-n...
My other comment on this was flagged, which had far more links. I'm not 100% sure why it was flagged other than the voting revealed it to be very controversial.
If you trace through the hospital's costs, it seems like a bulk of healthcare money ends up in the pockets of medical device companies. In my opinion, it doesn't seem like competition is behaving naturally at that level either. It seems like these companies are using the healthcare flustercluck as a proxy for anti-competitive behavior.
Facebook has just a tad bit more money to prepare for these remote possibilities compared with your average hospital. Plus hospitals have to justify every cost in relation to how many lives it will save. Is prepping for a once in a century pandemic going to save more lives than having an extra doctor on staff for every shift? Almost everyone would have answered no to that questions up until a few weeks or months ago.
It isn’t a “remote” possibility that facebook employees end up needing respirators since it isn’t a “remote” possibility that there will be wildfires again in California this year. That is what is expected to happen.
Although it’s hard to tell what will be the impact of the global shut-downs reducing greenhouse gases on global temperatures this summer (if that will even have any impact so soon).
I would still say that having stockpiles of PPE is good management. My sister is a nurse and she had been complaining about having to find gloves last year, long before there even was a crisis. Some of these hospitals really do skimp on equipment. Just In Time and LEAN practices are cool, but you need to keep a stock of backups enough to last a month or two in the event of a shortage where every other hospital is also trying to produce the same equipment. Some might say it’s easy to say this in hindsight, but I’ve been hearing about these practices long before this crisis. Right now everything on the news about these shortages just echoes what many healthcare professionals already knew and were concerned about. There are systemic management issues in the medical industry. Hopefully a bill comes from this.
Ontario just found 55m yesterday. Finding stuff you don't use often in warehouses is difficult.
Forgive my pessimism here, but I'm not impressed. Good that they did it, but countless individuals of minimal means regularly give everything they can to help their fellows without credit or reward.
Are we so easily distracted by the sparkly costless action that they now take that we forget the several known (and who knows how many unknown) deceptive and harmful actions they have intentionally taken against us in pursuit of money?
I'm not trashing them for doing something good. But just as I don't bow to the guy on the street that puts his candy wrapper in the rubbish bin instead of throwing it on the ground, I don't admire FB for giving out something they already possessed and were not having a planned use of.
It is important to understand hospitals and doctors could not legally use industrial N95 masks. No hospital could accept them without exposing themselves to massive litigation. I know this sounds stupid from outside the US. Sadly, this is part of our reality.
The key that unlocked donations was President Trump. Upon learning of this restriction he quickly put into place a release of liability for medical use of industrial N95 masks. This will be in force until at least 2024.
Because of this companies, contractors, suppliers and individuals came forward to donate masks. Apple donated a couple million units. I believe this might easily unlock tens of millions of masks as companies evaluate their inventories and continue to donate.
Commentary:
It is important to realize that the US healthcare system does not have an insurance problem. Politicians would have you think this is the case. It is not. The root cause of our high cost of healthcare, among other things, has to do with the underlying and hidden costs of doing business. This issue of masks is a simple example.
Hospitals, medical professionals and medical suppliers live in fear of greedy attorneys going after them for anything from masks to more complex equipment. This leads to major losses and costs and even legislation. And all of it increases the costs of doing business.
After this virus runs its course we would be well served to review a number of things, tort reform being a good idea. The other would be term limits for the House and Senate, I think it is beyond obvious these institutions have gone putrid to the very core.
It might also be rather strange to those outside the US to learn that in this wonderful country doctors and nurses cannot legally provide their services outside of the State where they are licensed. A doctor or nurse licensed in California cannot see patients in, say, Maine. In other words, we are not a country, we are a group of fenced-off kingdoms with some of the most ridiculous rules one could possibly imagine.
Our doctors can travel to Africa and practice medicine, yet they can't go to another State and do the same. How ridiculous is this?
That's just another element of our system that has to change. There's more, a lot more. The onerous and massively expensive drug or medical device approval process is another example.
Insurance is the last item in a very long list of issues we must address in order to bring sanity to our healthcare system.
Rather than repeat things here, please read the comment I just posted here:
https://news.ycombinator.com/item?id=22671872
President Trump did nothing except sign the law when it came to his desk. The provision was in the “Second Coronavirus Package” that originated in the US House of Representatives. It was written by Democratic lawmakers and sponsored by Nita Lowey, a New York Democrat.
Here’s the law in question: https://www.congress.gov/bill/116th-congress/house-bill/6201...
This Link should take you directly to the relevant section about industrial masks: https://www.congress.gov/bill/116th-congress/house-bill/6201...
Here’s the vote in the House: http://clerk.house.gov/evs/2020/roll102.xml All 40 “Nays” were Republican.
Here’s the Senate vote: https://www.senate.gov/legislative/LIS/roll_call_lists/roll_... all votes against were, once again, Republicans.
It’s also unclear what type of masks Facebook had in stock. They might have been of the medical variety for all we know. And even if not, there would not have been liability anyway: it was manufactures that were previously liable when selling the wrong type of mask to health care workers. But in Facebook donating masks, no manufacturer is part of the transaction.
I’ll not go through the rest of your half-truths, except to note that if you believe any MD can see patients in “Africa” without going through some sort of accreditation you’re wrong.
And yet, the guy is doing the right things. And, yes, he signed the bill DESPITE 40 Republicans voting against it. Get it? HE GOT IT DONE BECAUSE IT WAS IMPORTANT, DESPITE HIS OWN PARTY VOTING AGAINST IT! He did the right thing. Without his signature the supply of industrial masks would not have been released for use.
So, c'mon. Relax a bit. We are on this boat together. The guy is doing a good job with this. Tough card. There are not magical solutions. There are no perfect solutions. Superman isn't going to come flying and save us all.
How about a little FUCKING unity?
I did not vote for the guy and yet I can wipe my mouth from the vomit he induces every time he is on TV speaking like a 5 year old and recognize that either by talent, luck or divine intervention he seems to be able to steer this ship in the right direction.
Get off that high horse and become part of the solution. What did I do? I put on hold my self funded startup after investing $250K of my own money to pivot and work on development of technology we believe will be critical as COVID-19 subsides.
So, yeah, and sorry to put it this way. Stop it! Find something you can contribute. And, yes, if you have to help Trump, fucking help him. I have even reached in to the WH to offer help with manufacturing capabilities.
United we float this ship. Divided we sink it.
I hope to hell Democrats could get off their high horses and get with the program! Enough is enough!
As an independent what they have been doing has me so angry there is no way I will vote for a Democrat for a long time. I did not vote for Trump last time but I sure as hell will vote for him this time. And this is because of the petty dick-head Democrat politicians and people who just can't let go and do nothing but cause discord and division.
And, BTW, if Democrats want to win in November they better figure out a way to nominate Andrew Cuomo, only dumb-fucks would vote for Biden. Cuomo could do it. I would even consider voting for him, even as angry as I am about what Democrats have put our country through for almost four years. Trump isn't ideal, but he is doing a good job.
> I’ll not go through the rest of your half-truths, except to note that if you believe any MD can see patients in “Africa” without going through some sort of accreditation you’re wrong.
Well, my wife a doctor with international credentials. We are multicultural and have lived in other countries. We also have multiple doctors in the family who practice in various states in the US as well as Europe and South America. She also has friends who work with Médecins Sans Frontières. So, no, I know what I am talking about. And, yes, the problems with our healthcare system have almost nothing to do with insurance.
I mean, ANYONE who understands business also understands the very proposal that insurance is the problem is ridiculous. Insurance responds to costs and probability of expenditures. If you don't think so, go get a Ferrari insured and ask them why it costs so much. Drive down costs and insurance ceases to be a problem. Our healthcare system has layers of costs that are not being addressed and cannot be addressed by insurance.
To drive the other point home even further, here are the requirements for doctors withing to join Médecins Sans Frontières:
https://www.doctorswithoutborders.org/careers/work-field/gen...
A doctor from California can join Médecins Sans Frontières and go practice all over the world and yet, that same doctor, is not allowed to practice medicine in other states within the US. There are few exceptions, but that's the general rule. This i...
> only dumb-fucks would vote for Biden
>> Relax a bit.
> HE GOT IT DONE
Notice something?
As for Biden...I’d like to see anyone defend him as a real choice. The only thing we can say is he is less worse than Bernie, who would destroy this nation.
Dems don’t have a serious candidate. Get governor Cuomo to run. That would be a serious candidate.
Aside from that taking quotes out of context is a cheap shot.
As for your comment regarding accreditation for doctors operating outside the US, you are wrong. As a simple example, I refer you to the requirements for working anywhere Doctors Without Borders/Médecins Sans Frontières opearates:
https://www.doctorswithoutborders.org/careers/work-field/gen...
My wife is a doctor with international credentials. We have friends and family members in various areas in the US, Europe and South America who are doctors covering a range of disciplines in various domains. And we lived in more than one country. Through them and life experience I know these medical systems, their drivers, advantages, disadvantages and issues very well. I am not pulling these statements out of a vacuum chamber.
With regards to US doctors not being able to practice across state lines. It's real, messy and complicated:
https://www.ortholive.com/blog/practicing-medicine-across-st...
And, yes, it is ridiculous. Either we are a country or a bunch clans. I can't think of any other nation where a doctor is limited to practicing medicine in a single province. To say this is crazy is an understatement. Doctors take time and tons of money to produce, they are a scarce resource...and we limit them to operating within a single state? Someone tell me why this makes sense.
On the topic of fixing the system with insurance. Someone please explain how the cost of insurance can be lowered without lowering the underlying costs said insurance covers first. This is a very fundamental principle of business. If you want to reduce the cost of a downstream element in the chain you have to first address costs upstream. Cause and effect. You can't reverse that reality. Impossible.
Or, to put it in different terms, if the cost of operating a business is $10MM per year and revenue is $1MM per year that business is not sustainable. You can't lower insurance costs artificially. The cost of insurance is an effect, not a cause.
Just noticed this. It's wrong.
Hospitals could not accept donations of industrial masks, or, more accurately, they could not use them. This would expose them to potentially serious legal liability. Simple example: Someone dies. Lawyers discover medical team member were using using industrial masks they accepted from donations. They sue the hospital, every doctor, nurse and practitioner in the hospital and perhaps even whoever donated the masks.
How do I know this?
Well, as I mentioned elsewhere, my wife is a doctor and we have many doctors, nurses and other medical practitioners in our circle. In addition to this, we tried to donate many thousands of N95 masks from our own manufacturing operation's inventory to our local hospitals. They were refused, citing, very specifically "we cannot legally use industrial masks".
Once Trump went against Republicans in the House and Senate and signed the law releasing liability until 2024 we got a call from the hospitals we had contacted asking if the masks were still available. That's when we handed them over.
This, sadly, is how our legal system works. This is reality.
BTW, I do believe it was the White House who asked for the industrial mask exception to be included in the legislation. I don't have the time to go track down this assertion, so take it for what it is.
As an outsider from New Zealand, I completely believe your insurance system is a huge problem, and that belief is founded on the problems I see (not what your politicians say, I don’t know anything about them).
One major issue is linking insurance to your job. Lose your job, lose your insurance.
Our socialised healthcare has it’s issues, but I have personally seen it work again and again for my friends, acquaintances, and family.
Disclaimer: I choose to also pay for private insurance, which costs me $40 per month for a middle aged guy, to get improved private health cover. I’m not against insurance, but the US system appears completely broken to me, and the insurance structure appears to be part of that.
However, this isn't really the top problem on the list. It definitely is one of the last items, if not the last.
Allow me to make a simple, yet imperfect, parallel.
If you buy a Toyota your auto insurance will cost X.
If, on the other hand, you buy a Ferrari, it will cost many times more than X.
Why?
Because a Ferrari costs more to repair and the probability of accidents might be statistically higher given the extra power, etc.
Insurance costs are a result of statistical analysis of the underlying probability distribution of costs to the insurance company based on a range of factors. These would include known and unknown costs, personal history, regional factors, legislation and more.
One cannot magically reduce the cost of insurance and obtain better results on the other end. You cannot force insurance to cover the potential costs of a Ferrari to only cost as much as it does for a Toyota. You can only do that if you remove coverage. For example, you are not covered if the car is stolen, damage or if you are driving above the speed limit and you are required to install a monitoring device in the car. In other words, make the potential cost surface as equivalent as that of a Toyota.
This is why the US does not have an insurance problem and our healthcare system will never be fixed through insurance. This "Medicare for All" nonsense is exactly that. It's like forcing Ferrari insurance down to Toyota level. In other words, it turns a blind eye to the underlying structural issues in the system, fixes nothing and pretends it is a solution.
Lower insurance costs in the US is a theoretically simple task that, in practice, is difficult due to our politics. We have to reduce costs. And these costs are related to the regulatory burden, the financial reality of lawsuits and the cost of medical education, to name three factors.
When you are rolled into an operating room in the US and are surrounded by, say, ten professionals, their collective school loan debt is likely in the two to three million dollar range. They each spend tens of thousands of dollars a year in insurance to protect from lawsuits. Each of the pieces of equipment in that room, from the masks to the ventilators, endoscopes, scalpels, table and more are the result of having spent from millions to billions of dollars in regulatory licensing and testing. Each of the companies making these products must maintain teams of attorneys, entire floors full of them in some cases, to protect against lawsuits. They must also pay for insurance for the same reason. The hospital in which this operating room exists is also the subject of pretty intense regulations that start with the planning and construction of the building and the rooms. The permits alone to build a hospital can cost a hundred million dollars and take ten years to obtain. Once built, the hospital is subject to yet another layer of cost-increasing regulations (the current example of not being able to use industrial N95 masks is relevant here) and must carry insurance to protect itself an its entire staff from lawsuits (which could cost billions of dollars).
That is a super simplified view in to the innards of the US healthcare system. None of these costs and problems are magically fixed by changing insurance, no matter what we do. We can take it away from employers. Sure. So what? How does it change any of the above? We can make it this crazy "Medicare for All". So what? How does it change the realities I disclosed above?
No, insurance isn't our problem. Sure, it could be better. Yet it is pointless to even talk about making insurance changes when the underlying cost structure is massively broken.
I hope this clarifies things for you. I understand it isn't easy to understand the inner workings of something like this from afar. I only understand the way things are in other countrie...
My question is why the US government didn't have a bigger stockpile of them? We treat national security products with such deference, but yet defense against pandemics has been an afterthought.
[1]https://www.wsj.com/articles/financial-institutions-share-st...
https://www.washingtonpost.com/investigations/face-masks-in-...
The first story reports the loss of 50,000 state and local health officials.
The second from Mar 2020, reported that the SNS 'currently holds about 30 million simple surgical masks and 12 million of the more protective N95 masks....' Compare those numbers to what's needed.
https://www.npr.org/sections/health-shots/2016/06/27/4830698...
https://www.npr.org/sections/health-shots/2020/03/14/8141218...
It made it harder for hospitals to buy the N95 masks and other equipment from China.
So to the Americans that voted in Trump to wage his disastrous trade war against China, then this is partially your fault too.
[I am not sure about all the capitalisation - we aren't speaking German (yet).]