Set a price high enough that this becomes clearly a good thing: what about $25k/person, spent directly on vaccines for others? I've been thinking about the whole "public vaccination" virtue signaling that politicians have been doing. The most ethical path would be to be immunized publicly as a politician at the same time as your risk group rather than before, ideally as the last person in your risk group so you have skin in the game. Whoever is overseeing the vaccine program should go last, for skin in the game.
Now if they had integrity, the ones that dismissed, downplayed, ignored, refused to wear masks, etc. should have skipped their dose and given it to someone else.
>immunized publicly as a politician at the same time as your risk group
That would be nice except Congress is fairly old, average age is 57.6 in the House and 62.9 in the Senate. Not sure there are enough available doses for this to occur.
Put yourselves in their shoes: they see a blunt affirmation about a medical treatment, without any source, nor any clear term that can be easily searchable in pubmed.
Since I do not doubt that you only mention a treatment you're read about in a serious peer-reviewed medecine journal, or have first-hand experience with, I completely understand how hard it must be for you to be downvoted.
Maybe take the occasion to enlighten us even more next time.
Do you have some more information about this treatment? I haven’t heard about it, but that might be because I’m not in the market for $150k medical treatments :)
He might be talking about the monoclonal antibody treatment that Trump, Rudy, Chris Christie, and some others have received. They gave the president 8 grams of the stuff. His was the Regeron formulation, I'm not totally sure how much that costs. Bamlanivimab, from Eli Lily, apparently runs about $1200 a vial[0] (with a vial being 700mg), so if Trump had gotten that it would have only been in the neighborhood of $20k.
And, of course, antibodies aren't made from stem cells, so I don't actually know what the poster is on about here.
I wouldn't even charge for the privilege. As long as health care workers and nursing homes stay at the absolute head of the line, nothing else really matters until we hit herd immunity.
Publicize how desperate the rich are to get the vaccine and that 60% willingness to get vaccinated will go up (which is a large part of what the article said). I think charging money to skip, just causes a whole raft of other problems.
Let the elites think they are pulling strings and just give it to them.
Given the gigantic cost of lockdowns to the economy - billions a day - the government has likely already thrown an lot of money at vaccine production and distribution. If more money could be usefully spent, it would have been.
Therefore, if an 80-year-old is 300x more likely to die than 37-year-old Martin Shkreli, moving a dose from the former and to the latter is inefficient.
I disagree. Various populations are at greater risk. Unhoused people, for example, should get the vaccine before me. So should anyone who has to work on site somewhere. Parents and care givers who care for children, etc etc.
I work in tech, I work from home and can have stuff delivered. Put me at the end of the line.
> In the first tier, 100 of the wealthiest Americans each donate $100 million to be first in line for a vaccine
For $100 mil you can buy a small biotech lab and create your own mRNA vaccine. They are not that complicated compared to classical vaccines, and the testing was basically done already by Pfizer/Moderna.
And for much less, surely there will be ways to "source" doses. It's ridiculous to think that many rich people will pay $100 mil for a dose.
It would be intereseting to see the content organization targeting antivaxers switch from "the vaccine is dangerous, no famous people would take it" to "the vaccine is too expensive, they want to let us die !", probably via a short segway through "the vaccine is dangerous but the rich people are only pretending to take it so that they can kill you."
Sounds good to me, let them be the guinea pigs. The ultra-rich and influential seem to be a renewable resource so it’s not like society will run out, if there are risks not found by tests thus far it won’t be swept under the rug, and they are not so numerous that they will make a serious impact on the supply chain.
Initial results [0] on Moderna’s are on 95 participants in a trial with 30k [1] due to run to 10/22. I’ll be happy to monitor results and ADE rates before taking the plunge although I’m really excited about the promise of mRNA.
The $100M/vaccine price is stupid, but I would easily pay $1000 to get the vaccine early and raise money for factories. With just 20M doses it would mean $10B income for Moderna.
Second, are manufacturers interested in filling that 6 billion gap? They can already afford to build the infrastructure and make more vaccines, but it doesn’t do any good if there is nobody to buy them and no way to get them to patients.
Yeah, but it's much cheaper to re-open your factory without vaccinating your workers and just threaten to fire anyone who has health concerns. That's how most places have been operating so far.
The prices suggested in this article are too high, even for the super rich. They have other forms of influence. They might have a golf buddy who knows the CEO of a pharma company who can get a few doses off the line for friends.
But, offering the middle/upper income class a $1000 chance to jump ahead could generate just as much money with a much larger population getting protection.
You’re right, in the current system political connections matter, not money. People don’t like capitalism, but basically politicians get the good stuff, and provide nothing in return to the companies.
The article assumes the vaccine can only be sourced from the US Gov. This brings up some interesting questions about access direct from the manufacturers.
When will the manufacturers backorder obligations be filled so they sell the vaccine on the open market? Do they have any contractual requirements to sell through government determined channels?
I was wondering as well. One manufacturer wants to use one charge for his employees (to ensure production), but this is sidetracking the official process.
"ModernaTX, Inc. will supply Moderna COVID‑19 Vaccine either directly or through authorized distributor(s), to emergency response stakeholders as directed by the U.S. government, including the Centers for Disease Control and Prevention (CDC) and/or other designee, for use consistent with the terms and conditions of this EUA;"
So they don't have permission to market it at all really.
Thank you for this!
It appears that it is a condition of the Emergency Use Authorization. That would not preclude Moderna going through the full approval process and marketing the product.
Or we could just raise taxes on anyone who has enough money to pay $100 million for a dose and then give all the vaccines to the people who need them most.
“Liberals can view it as a wealth tax”. Not really, a tax is something that the government levies on everyone subject to some tax code. What is suggested is not a tax because it’s entirely optional - you’re not paying a tax you’re buying a vaccine.
I don't think it's a crazy idea, but the numbers here seem a bit hopeful. I don't think you're gonna get 100 people to pay $100 million for an earlier spot in the line. Or 1000 people to pay $10 million. Particularly because people with that amount of money to throw around (if you can pay $10 million for one vaccine, you are very very wealthy) know that they can most likely pull strings to get ahead in the line anyway. So at most, they are probably paying to jump ahead by just two or three months from where they will be anyway. (If you are young, healthy and rich, you probably don't care enough to pay these prices. If you are old and rich, you probably are gonna be not-too-far-back in the line anyway).
~$25,000, sure. That's pocket change for some people. But this article is talking about payments of $10 to $100 million. And in any case, I'm not convinced that 400,000 people would pay $25k.
I thought this was satire after reading the headline.
But no, this is someone suggesting celebrities and billionaires should be the first people we protect.
In a healthy functioning society, we'd protect the most vulnerable first -- elderly, front line workers, grocery store workers, etc. And we'd find the funding to make that happen either by taxing the ultra wealthy or just printing money because it's a pandemic and they are relatively rare events and the cost to vaccinate everyone is relatively fixed.
We have plenty of elderly celebrities who could still be at the front of the line cheering on the vaccine.
The approach the author suggests seems like government with extra steps to me.
It's a scarcity problem. We have a finite amount of doses and more importantly, ways to transport and give those doses. Many (but not all) of those problems can be solved by putting more money into the system.
One way we handle scarcity in capitalism is by charging for things. Would you be willing to let a rich guy pay $10 million for the vaccine.. if it meant a 1000 teachers could get it for free next week?
It is basically a tax on the rich except it's opt in.
Philanthropy is someone wealthy paying for 1000 teachers to get the vaccine and not getting anything in return. Philanthropy may or may not have covenants attached and the philanthropist will have different levels of control: "You must give these vaccines first to the teachers of my local elementary school" or "these must go to teachers in low income areas", etc.
That the rich person receives the vaccine for their money, ie a material consideration, makes this not philanthrophy by definition - it's a sale. Or, put another way, me buying an overpriced handmade christmas ornament from Etsy isn't philanthropy either, even if I'm choosing to really overpay.
Also, philanthropy often gives you stuff. The WWF gives me a nice stuffed animal and thank you card, for instance. And plenty of wealthy donors mysteriously get their kids into colleges.
If you donate to the WWF, you can't demand they give you a stuffed animal and sue them if they fail to. Yes, you can respond to a gift with a gift - that doesn't make it a sale.
Taxes are taking wealth for government functions, whether it's against an individual, a company, etc. When you buy a pack of cigarettes (in the US) you're being taxed - the same goes for gasoline. Overcharging for the vaccine intentionally and using that to give out free vaccine doses is by definition a tax, in the same way that any consumption tax is a tax.
> But no, this is someone suggesting celebrities and billionaires should be the first people we protect.
I don't think that's what it's saying though. It's saying by allocating ~500k vaccines (or as few as ~100k), we can raise $50 billion dollars, and show people that other "influential" people see the vaccine not only as safe, but as something that should be sought after. In the grand scheme of things, that represents a very small portion of the total supply, and hence I'd argue the upside ($50B + more people getting the vaccine) would be worth it.
By charging $500,000 per dose? You think there are 100k people who would pay that?
Also, if this was a cause the billionaires believed in, they could just give $500,000 to vaccination efforts and also give up their spot in line. Nothing stopping them from just being charitable without expecting anything in exchange.
Everyone has their idea of what a "healthy, functioning society" is. To me, a society fighting this optimally would maximize QALYs. That means some really elderly people will be permitted to die while high connectivity young uns would be vaccinated.
Of course, the naïve view is that there is one known "healthy, functioning society" and that others are optimizing for greed or some other vice.
I'm not quite in the top 400k of wealth in the country, but I'm decently close, and I can say it's hard to picture paying 25k to skip the line. Nevermind that a lot of the wealthiest folks (older folks) are already at the front of the line due to their advanced age.
What this article doesn’t seem to realize is that they don’t have a seat at the table. If you haven’t been invited then you don’t count.
Look at how Stanford Medicine allocated its allocation of the vaccine. It allocated it to administrators first then apologized when it was exposed. What is left unsaid is that they never gave up their power to decide who gets the vaccine.
Have you heard of anyone giving up their place in line for the vaccine?
Let someone pay 20,000x the price of a good or service if they want to. This is a good thing, not a bad thing. This drives early returns on investment, leading to cheaper and widely distributed drugs in the future.
Doesn't it take money to increase the supply of a good? A manufacturer making bank on a product is going to reinvest that into his supply chain, increasing the overall supply... a good thing for everyone, which eventually, depresses prices and makes said goods commodity and affordable for everyone.
The existing purchase guarantees completely swamp any extra demand from private bidders.
Say you got a million (or 10 million) people to pay extra (it'd be lot of people at that point); the manufacturing demand wouldn't go up any, and they would probably just delay delivery of some other doses for a week (or a month).
I think this includes a number of questionable assumptions.
1) The money would go to the manufacturer.
2) The supply limiting factor can be addressed in a reasonable timeline
3) The demand will exist at the time when supply is increased.
4) The price is a limiting factor.
As far as I know, lead times for this drug manufacturing equipment is usually >1 yr and the demand will not be there when it arrives. All of the vaccines currently cost $2-20.
ditto this. if some rich people are willing to pay 20,000x, then that roughly means (20,000 - 1) more vaccine for others (per rich person willing to pay, that is.)
The other option is paying with tax-money...
btw, another view: why fix it to 20,000x? why not auction?
Jesus, when did economists get so single minded? The benefits of a vaccine are almost exclusively from the network effects. It is almost purely externality. Since when are markets capable of efficiently allocating externalities? Likelihood to spread the virus does not correlate with personal incentive to get vaccinated.
There might be a market scheme for allocating the virus that does align with society's incentives, but I would bet dollars to pennies that that solution is basically just democratically elected government.
Given the number of people I know personally who have already gotten the vaccine, it seems to me that they aren't being terribly stingy with handing it out to people.
I would expect the even moderately wealthy to be able to cut in line and acquire it whether or not they admit to it publicly.
This is just not a serious idea. Firstly, if you do decide you want to suggest diverting the vaccine from people at high risk to people at low risk in order to raise revenue then the least you can do is run the numbers on how many more of those high risk people will die.
Secondly "this isn't political! It's either a free-market solution or a tax". No. It's not a free-market solution, it's the governemnt setting an arbitrary price for a product they have a legal monopoly on, it's also not a tax since it's entirely optional for people to pay it.
Thirdly, the comparison to Delaney is massively off - Delaney's plan would save nearly $100Bn compared to the current solution of selling the vaccine and congress being forced to hand out $2000 stimulus checks. Becuase the checks weren't really about getting people to take the vaccine, it was about providing the stimulus checks that are already going to happen, but tying them to something.
Finally, if you're rich enough to give $100k for a vaccine you're probably rich enough to find a way of getting it somewhere else, so really what we're saying is that you're asking them to make a massive donation for something that they don't need fron you.
I'm curious how much people would be willing to pay for this vaccine if they had to. As someone who is not in an at-risk category and who don't work on the front line, I don't think I'd be willing to pay very much.
Use the vaccine to protect the people who are actually in danger. If a billionaire gets covid they can get the super special sci-fi insta-cure that every other person in power gets.
The solution to a public health communications issue is not 'get influencers on board' it's to amplify the science communicators who are already doing it, and public policy.
This article is morally wrong, but the rich is going to get it before the rest of us anyway. I say give it to them, you can't change the fact they will get it first, at least let them beta test it. After most people get it, the risks disappear.
The author seems to be overstating the actual value of the vaccine. The fair market value is probably somewhere around $10k right now. Any more than that, and you're rich enough to just hop a private jet to New Zealand and hang out with other millionaires right now. The people who would actually pay for this are the 9%; those with just enough means to drop a serious sum, but not enough to abstract away reality the way the 1% can.
I have no problem, let them pay more and subsidize for the rest of the people. At least for covid, the risk is low enough to not matter. I would happily be the last line to get one.
Besides I'm not sure supply constraint would be a big problem, i think there are quite lot of people that understand the actual risk of getting seriously sick from covid and wouldn't be that eager to get a vaccine.
If we lived in a free market-driven world, there would be no question about this. The vaccine would be allocated and priced just like any other scarce resource should be allocated and priced: by demand and supply.
After all, it's the strategy that allowed us to feed and shelter a planet of 8 billion.
But in reality the vaccine distribution is made through policy and politics. Because this strategy worked so well back in March, with the PPE. If this doesn't prove that we live under socialism, I don't know what will.
So check if you have a friend in high places, if you are one of the chosen ones. Because in socialism resources are allocated through the good old power networks. Relations, bureaucracy and so on. Who you know becomes more important than what you know, who you do more important than what you do. It's a brave new world and I hope your dossier is perfect.
But don't worry: you'll easily buy a dose on the black market.
91 comments
[ 3.3 ms ] story [ 158 ms ] threadYou mean a tax?
>Money paid to the government other than for transaction-specific goods and services.
https://en.wiktionary.org/wiki/tax
That's not virtue signaling, or not ONLY virtue signaling - they get priority due to continuity of government laws. See https://www.rollcall.com/2020/12/13/white-house-congress-jud...
Now if they had integrity, the ones that dismissed, downplayed, ignored, refused to wear masks, etc. should have skipped their dose and given it to someone else.
>immunized publicly as a politician at the same time as your risk group
That would be nice except Congress is fairly old, average age is 57.6 in the House and 62.9 in the Senate. Not sure there are enough available doses for this to occur.
Since I do not doubt that you only mention a treatment you're read about in a serious peer-reviewed medecine journal, or have first-hand experience with, I completely understand how hard it must be for you to be downvoted.
Maybe take the occasion to enlighten us even more next time.
https://investor.regeneron.com/news-releases/news-release-de...
This doesn’t contain stem cells but was tested on fetal tissue:
https://www.verywellhealth.com/regeneron-antibody-cocktail-s...
And, of course, antibodies aren't made from stem cells, so I don't actually know what the poster is on about here.
[0] https://www.globaldata.com/eli-lillys-covid-19-mab-bamlanivi...
Publicize how desperate the rich are to get the vaccine and that 60% willingness to get vaccinated will go up (which is a large part of what the article said). I think charging money to skip, just causes a whole raft of other problems. Let the elites think they are pulling strings and just give it to them.
Why?
>Let the elites think they are pulling strings and just give it to them.
But why not give it to them, but also try to extract money from them at the same time?
Therefore, if an 80-year-old is 300x more likely to die than 37-year-old Martin Shkreli, moving a dose from the former and to the latter is inefficient.
I work in tech, I work from home and can have stuff delivered. Put me at the end of the line.
For $100 mil you can buy a small biotech lab and create your own mRNA vaccine. They are not that complicated compared to classical vaccines, and the testing was basically done already by Pfizer/Moderna.
And for much less, surely there will be ways to "source" doses. It's ridiculous to think that many rich people will pay $100 mil for a dose.
https://wight.consulting/2020/05/19/marketing-and-stolen-pot...
Initial results [0] on Moderna’s are on 95 participants in a trial with 30k [1] due to run to 10/22. I’ll be happy to monitor results and ADE rates before taking the plunge although I’m really excited about the promise of mRNA.
0. https://www.nih.gov/news-events/news-releases/promising-inte...
1. https://clinicaltrials.gov/ct2/show/NCT04470427
Second, are manufacturers interested in filling that 6 billion gap? They can already afford to build the infrastructure and make more vaccines, but it doesn’t do any good if there is nobody to buy them and no way to get them to patients.
Open auction, with price going as high as it wants, right down to zero.
Special categories (e.g. multiple co-morbidities, medical workers) cut to the front, and pay market rate.
Let businesses foot much of the bill. If I need to pay $1000 to reopen my factory, it might be a good investment. Free market will allocate resources.
For extra credit: https://www.tpr.org/business/2020-12-17/tyson-foods-fires-7-...
But, offering the middle/upper income class a $1000 chance to jump ahead could generate just as much money with a much larger population getting protection.
When will the manufacturers backorder obligations be filled so they sell the vaccine on the open market? Do they have any contractual requirements to sell through government determined channels?
https://www.fda.gov/media/144636/download
"ModernaTX, Inc. will supply Moderna COVID‑19 Vaccine either directly or through authorized distributor(s), to emergency response stakeholders as directed by the U.S. government, including the Centers for Disease Control and Prevention (CDC) and/or other designee, for use consistent with the terms and conditions of this EUA;"
So they don't have permission to market it at all really.
https://investors.modernatx.com/news-releases/news-release-d...
But no, this is someone suggesting celebrities and billionaires should be the first people we protect.
In a healthy functioning society, we'd protect the most vulnerable first -- elderly, front line workers, grocery store workers, etc. And we'd find the funding to make that happen either by taxing the ultra wealthy or just printing money because it's a pandemic and they are relatively rare events and the cost to vaccinate everyone is relatively fixed.
We have plenty of elderly celebrities who could still be at the front of the line cheering on the vaccine.
The approach the author suggests seems like government with extra steps to me.
Well, in your idea of a healthy functioning society.
EDIT: the above sounds probably too harsh. But the real question is:
Why is that bad?
Take also into account that vaccinating celebs is just counting beans in the whole process.
One way we handle scarcity in capitalism is by charging for things. Would you be willing to let a rich guy pay $10 million for the vaccine.. if it meant a 1000 teachers could get it for free next week?
It is basically a tax on the rich except it's opt in.
That the rich person receives the vaccine for their money, ie a material consideration, makes this not philanthrophy by definition - it's a sale. Or, put another way, me buying an overpriced handmade christmas ornament from Etsy isn't philanthropy either, even if I'm choosing to really overpay.
Also, philanthropy often gives you stuff. The WWF gives me a nice stuffed animal and thank you card, for instance. And plenty of wealthy donors mysteriously get their kids into colleges.
Taxes are taking wealth for government functions, whether it's against an individual, a company, etc. When you buy a pack of cigarettes (in the US) you're being taxed - the same goes for gasoline. Overcharging for the vaccine intentionally and using that to give out free vaccine doses is by definition a tax, in the same way that any consumption tax is a tax.
I don't think that's what it's saying though. It's saying by allocating ~500k vaccines (or as few as ~100k), we can raise $50 billion dollars, and show people that other "influential" people see the vaccine not only as safe, but as something that should be sought after. In the grand scheme of things, that represents a very small portion of the total supply, and hence I'd argue the upside ($50B + more people getting the vaccine) would be worth it.
Also, if this was a cause the billionaires believed in, they could just give $500,000 to vaccination efforts and also give up their spot in line. Nothing stopping them from just being charitable without expecting anything in exchange.
Of course, the naïve view is that there is one known "healthy, functioning society" and that others are optimizing for greed or some other vice.
Look at how Stanford Medicine allocated its allocation of the vaccine. It allocated it to administrators first then apologized when it was exposed. What is left unsaid is that they never gave up their power to decide who gets the vaccine.
Have you heard of anyone giving up their place in line for the vaccine?
Say you got a million (or 10 million) people to pay extra (it'd be lot of people at that point); the manufacturing demand wouldn't go up any, and they would probably just delay delivery of some other doses for a week (or a month).
1) The money would go to the manufacturer.
2) The supply limiting factor can be addressed in a reasonable timeline
3) The demand will exist at the time when supply is increased.
4) The price is a limiting factor.
As far as I know, lead times for this drug manufacturing equipment is usually >1 yr and the demand will not be there when it arrives. All of the vaccines currently cost $2-20.
The other option is paying with tax-money...
btw, another view: why fix it to 20,000x? why not auction?
There might be a market scheme for allocating the virus that does align with society's incentives, but I would bet dollars to pennies that that solution is basically just democratically elected government.
I would expect the even moderately wealthy to be able to cut in line and acquire it whether or not they admit to it publicly.
Secondly "this isn't political! It's either a free-market solution or a tax". No. It's not a free-market solution, it's the governemnt setting an arbitrary price for a product they have a legal monopoly on, it's also not a tax since it's entirely optional for people to pay it.
Thirdly, the comparison to Delaney is massively off - Delaney's plan would save nearly $100Bn compared to the current solution of selling the vaccine and congress being forced to hand out $2000 stimulus checks. Becuase the checks weren't really about getting people to take the vaccine, it was about providing the stimulus checks that are already going to happen, but tying them to something.
Finally, if you're rich enough to give $100k for a vaccine you're probably rich enough to find a way of getting it somewhere else, so really what we're saying is that you're asking them to make a massive donation for something that they don't need fron you.
Use the vaccine to protect the people who are actually in danger. If a billionaire gets covid they can get the super special sci-fi insta-cure that every other person in power gets.
The solution to a public health communications issue is not 'get influencers on board' it's to amplify the science communicators who are already doing it, and public policy.
Besides I'm not sure supply constraint would be a big problem, i think there are quite lot of people that understand the actual risk of getting seriously sick from covid and wouldn't be that eager to get a vaccine.
After all, it's the strategy that allowed us to feed and shelter a planet of 8 billion.
But in reality the vaccine distribution is made through policy and politics. Because this strategy worked so well back in March, with the PPE. If this doesn't prove that we live under socialism, I don't know what will.
So check if you have a friend in high places, if you are one of the chosen ones. Because in socialism resources are allocated through the good old power networks. Relations, bureaucracy and so on. Who you know becomes more important than what you know, who you do more important than what you do. It's a brave new world and I hope your dossier is perfect.
But don't worry: you'll easily buy a dose on the black market.