The View from Right Field

We Need More Capacity in the Medical System. And It’s Going to Cost Money.

It is clear we need more capacity in the medical system.  More rooms; more ICU units; more equipment.  On hand and ready to use.  If you cut things too close, you may not have enough in an emergency or a pandemic.  

But if we want more capacity, it is going to cost money, and somebody is going to have to pay for it.  We don’t have to argue about that now.  Other things are more important at this point.  But we are going to have to discuss it in the future; when this is over.  Because more won’t be free.

Social Distancing – And Thanking Those Who Are Doing the Jobs That Let the Rest of Us Do It

We are being told to social distance.  Not just to stay away from sick people but to decrease the number of all people we come into contact with.  Society as a whole needs to increase its social distance.  And the reasons make sense, as can be seen in this article: “Why outbreaks like coronavirus spread exponentially, and how to ‘flatten the curve.’”  If we decrease the average number of social contacts we have, we slow down the spread of coronavirus. 

Which means that everybody who can increase their social distancing should do so.  Events and get-togethers that are not critical should not happen.

But there are things that are essential.  Food stores, doctors’ offices, drug stores.  They need to be open, and we need people to work in them.  And we need to thank the people who are doing the jobs that need to be done – while the rest of us increase our social distancing so the average social distance increases, and we all get through this together.

Blogging Through the Coronavirus

I probably won’t be blogging as much in the next few weeks, though with social distancing, etc., I may have more time.  Also, in whatever comments I make on current events, I will limit my criticisms to ones that are potentially useful, as opposed to ripping on people for being stupid or dumb or whatever (though there is a lot of that going on at all levels).

In looking at information on the coronavirus, one thought might be to limit what you look at to smart, thoughtful people.  That may cut down on your fear and will save you a lot of time.  Two people I would suggest following on Twitter.  First, and perhaps most important, because this guy knows what he is talking about: Scott Gottlieb, MD, director of the FDA from 2017 to 2019 (@ScottGottliebMD).  Second, Megan McArdle (@asymmetricinfo).
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UPDATE (3/15/20 11:05 am): Corrected the link to Megan McArdle.  Once again, it's @asymmetricinfo.

Coronavirus. Europe Travel Ban. What Kind of a Country Do We Want to Be?

On Wednesday evening, I tweeted my thoughts about President Trump’s address to the nation on the coronavirus situation.  What I’d like to do here is look at his address, and the ban on travel from Europe (technically, the Schengen zone), from a different point of view.

The Economist publishes an annual installment of “The World If” articles.  The articles are about things that could happen in the future (or might have happened in the past), some good, some bad, and what might be (or have been) the consequences.  Alternate history articles, in a manner of speaking.  One of the articles in 2017 was about the risk that the United States, and other countries, face from a prolonged loss of electricity.  It’s low risk, but if it happens … wow.  Here are some excerpts from the article:

“On March 13th 1989 a surge of energy from the sun, from a ‘coronal mass ejection’, had a startling impact on Canada.  Within 92 seconds, the resulting geomagnetic storm took down Quebec’s electricity grid for nine hours.  It could have been worse.  On July 23rd 2012 particles from a much larger solar ejection blew across the orbital path of Earth, missing it by days.  Had it hit America, the resulting geomagnetic storm would have destroyed perhaps a quarter of high-voltage transformers ….

Among the Reasons You Can’t Trust China's Reports on Coronavirus

While on our trip to Egypt, I saw an article in The Egyptian Gazette last Thursday on the coronavirus efforts in Wuhan, China.  The article reported that inspectors were going door-to-door in Wuhan, trying to identify every infected person.  Wang Zhonglin, the new Communist Party secretary in Wuhan, was quoted as saying, “If a single new case [of coronavirus] is found (after Wednesday), the district leaders will be held responsible.”  Which means, of course, that no new cases will be reported because the district leaders know what will happen to them if one is.

It reminds me of this story:

Illinois Is Starting on the Next “Great Experiment”

On January 16, 1920, the Eighteenth Amendment came into effect, launching Prohibition across the country.  It was called, by some, the “Great Experiment.”  Needless to say, it did not work out as expected and, within fourteen years, it was repealed.

On Wednesday, Illinois began its own “Great Experiment,” though this one involves legalization, not prohibition, and it involves marijuana, not alcohol.  The question is how this new “Great Experiment” is going to turn out.

#MedicareForAll – How It Will Really Work

While New Zealand has been in the news for other reasons lately, a hearing before the health select committee of the New Zealand Parliament last week should be of interest to those who think “Medicare for All,” or some other form of government-run single-payer health plan, is the answer to our problems with health care.

At the hearing, women with advanced breast cancer asked for pressure to be brought on Pharmac, the government-run drug-buying agency, to fully fund two additional drugs for breast cancer, Kadcyla and Palbociclib (also known as Ibrance).

The pleas of the women were very moving.  One of the women said that Ibrance was a “game-changer” in other countries for conditions like hers.  She asked why women in New Zealand had to travel to Malaysia or move to England or Australia to get access to cheaper life-extending drugs.  Another woman said that she was alive only because she had paid for the drug herself.  “This would … be impossible if I had to rely on Pharmac.” 

Obamacare’s Elusive 60th Vote

Democrats complained a lot about the way Republicans passed the tax bill.  Megan McArdle explained¹:

“Last week, as you may have noticed, Republicans passed a tax bill.  As you may also have noticed, Democrats were aghast.  Passing a bill like that on straight party lines!  Using a parliamentary maneuver to push through something that could never have survived a filibuster!  How could Republicans be so brazen, so immoral, so fiscally irresponsible?

Those of us who remembered saying many of the same things during the passage of Obamacare had to beg them to stop.  I mean, we could have been seriously hurt, laughing that hard.”

In addition to the things Ms. McArdle mentioned, there were complaints about how Senators Bob Corker and Mario Rubio agreed to vote for the bill at the last minute.  Democrats complained Senator Corker had abandoned his concerns about the deficit, and Senator Rubio was bought off by a last-minute change to the family tax credit.  Of course, in making those complaints, the Democrats forgot about the Cornhusker Kickback and the Louisiana Purchase that got Senators Ben Nelson (of Nebraska) and Mary Landrieu (of Louisiana) to vote for Obamacare.

What Goes Around Comes Around: The Obamacare Version.

Donald Trump couldn’t get Congress to do what he wanted on Obamacare, so he has issued an executive order to try to accomplish much the same thing.  Hmmm.  I wonder where he got the idea to do that?

Medicare for All (Or At Least More): Will It Mean Political Campaigns Based on More Knee Replacements?

Democratic Representative John Conyers, Jr., from Michigan has introduced a bill that would allow anybody, of any age, to buy into Medicare.  The theory is “everyone loves Medicare,” so why not let people buy into it if they want to.  Last year Hillary Clinton proposed letting people over 55 buy into Medicare.

Megan McArdle explained the problems with this idea.  Among others, there was this:

“If we followed Clinton’s plan, and lowered the Medicare eligibility age, one effect would be to take some pressure off Obamacare’s exchanges, by moving the sicker and older patients out of the pool.  But that cost has to go somewhere, and where it’s likely to end up is in hospitals, as their patient load shifts dramatically toward lower-reimbursed Medicare patients.