Tuesday, March 31, 2020

Healthcare

I always figured that Americans would receive gov't-sponsored healthcare at the nexus of national security and law enforcement. That is, when the gov't hits a point where it needs the DNA and/or biometric data of the citizenry as a means of protecting its borders or policing internal relations, then the citizenry will get "free" healthcare in the form of regular preventive checkups. When the gov't needs the citizenry to yield its medical data, only then will the gov't be incentivized to provide those necessary medical checkups. Yeah, people screaming for free healthcare is in and of itself not enough to move the gov't to do something it doesn't particularly want to do. The only way it happens is when the gov't itself needs to get it done. And when the technology matures enough to allow these developments to happen.

Well, that's where we are now, right? The gov't needs the citizenry to be tested to accurately account for the spread of Covid-19. And here's the deal with those tests: they're not likely to be particularly accurate at first. And by only testing those with symptoms, you actually don't learn much about how the virus has penetrated the population. So you need everyone (yeah, all 320 million of 'em) to get tested multiple times; say, every 4 weeks for at least 24 weeks, right? Then you'll be able to confidently map out which areas are at risk and which areas no longer need to be worried about (again: there is a point where spreading the virus becomes the strategy). And what does it mean to be "recovered" from Covid-19? Only further testing will tell. So ongoing testing for everyone is the first step to any kind of solution and hopefully the first step to preventing the next virus outbreak (*).

Indeed, Covid-19 has shown us the level of healthcare all Americans should be receiving: regular checkups. Once a year, you get your fluids checked, receive any necessary vaccines or inoculations and your bio-metric data is cataloged. This is not an open-ended system where your kidney transplant is automatically paid for but a basic preventive examination where everyone gets checked out to determine how dangerous they are to each other. This type of preventive checkup system would save an awful lot of lives and improve those saved lives, too. (And would produce a need for expanded labor in Healthcare related fields and a subsequent need for expanded education in Healthcare)

Gov't sponsored healthcare in the American political landscape has, I think, basically always been a Hail Mary of the self-pitying Left, that wants to blame politicians for perfectly natural events and then pat themselves on the back for 'speaking truth to power', when their very definitions of 'power' are distorted and dangerous. Ted Kennedy for decades in the Senate was the master of giving impassioned speeches only when he knew he was going to lose 96-2, making a big show of his attempts to stop injustice, when really what he was doing was distancing himself from his own inability to get votes or make a worthwhile argument to his fellow senators. And that to me was what the healthcare was in the hands of liberal pols: not a plea to consider a new method of satisfying the healthcare needs of Americans but a white flag in the form of empty angry rhetoric. Medicare for All would not have protected us from this or necessarily even projected this occurrence. Medicare for All isn't a real plan, it just sounds like something people would agree with and politicians are just looking for agreement.

But shit's different now. For the first time in our existence, the gov't needs us to have healthcare more than the citizens even want it for themselves. (And that's when action happens: when it gets forced on the people) This virus is going to create an immense amount of changes in our system over the next 2-3 years: the banks are going to need to completely redefine basic terms just to pay their taxes this year, the states have a whole new sense of what is and isn't in the federal domain and the courts are going to be litigating the last three weeks for the next five years. Our lives as workers, students, parents, tenants, taxpayers, etc., are going to be dislocated and/or restructured. And that's just domestically! Internationally, it's all going to change. All of it. It kinda has to: trade and transportation and tourism protocols are going to be completely redesigned, which means suddenly the standards of countries we don't live in will matter a great deal to us. This virus has awakened things in us that we didn't know were there.

Will the gov't be providing these regular free checkups to the citizens? Eventually, I reckon, but probably not in the next month, which is when we need them. But afterwards, plans like this may sink in and take hold. Seriously: just regular checkups would save a lot of lives and teach the living to live better. The expanded economic potential of a happy healthy populace is incalculable, how can we afford not to develop a comprehensive health care plan?

A fascinating element of this: this isn't about race or guns or the environment or industry or region--holy fucking balls, it isn't even about money! It is literally only about public health. The level of the gov't's interest in the public health is now clearly laid bare. There is no need for politics: Medicare for All would not have prevented our current situation and the Republican version of...well, nothing at all....is simply not a productive response for the good of the land.

So the citizens need medical checkups and the gov't needs us to have them. Now you've got something for politicians to work with. And they have the mandate now to be creative (what every politician dreams of!). Rather than shooting for the moon, build it up from the bottom, collect the data, make sure the shit works and go from there. Annual checkups, that's all we need and its a great place to start. But gov't-sponsored healthcare will only exist when it is in the government's favor to provide it and the derived data is indispensable and we may have hit that time.


And that brings me to my real point: data. Data is what the political economy wants from us and it is what we have to offer. I'll be further outlining my thoughts on this subject in a series of blog posts that I have only begun to work on (though I have been contemplating for several years).

Changes are coming and the sooner we awaken ourselves to that fundamental fact, then the sooner we can position ourselves to fight for the good stuff and eliminate the wasteful practices of the past. The virus is not going to kill us off (at least, I'm pretty sure it won't) but for the survivors it will be a new world. And we should strive to make it better than the old one (**).



(*) Oh yeah, there's no reason to think this is the last one. There will be more, the earth will keep coming up with new ways to kill us off/make us stronger, that's just what it does.

(**) Don't get me wrong: I've been a big fan of the old world. But it hasn't been nearly as good as it should've been.

Thursday, March 26, 2020

Covid-19 (the virus)

Okay, I think I'm ready to write about Covid-19. Most of what I'm about to write is what I thought a week and a half ago but I feared writing at the time because it felt too optimistic in the face of impending tragedy. But since we're on the very precipice of that coming tragedy, I feel a little more secure about writing, a little less like I'm tempting fate. I think fate is already here now and I can speak to it eye to eye.

I think the ugliness in America is about to take off. The next two weeks will likely suck real bad. NYC, Atlanta and Denver are looking like war zones and San Francisco and Los Angeles (and why not Philadelphia and DC, too?) are getting there, too. So far the quarantine has been fun and games (our toilet paper obsession indicates we're a nation of Al Bundys, which is not heartwarming facing into a storm), but as the virus spreads we'll see more outages in food production, energy distribution and probably even basic utilities across entire zip codes. As long as the grocery stores and gas stations hold out and as long as there's internet, I feel like Americans can bunker down like no one else; but those amenities will be tested along the way and how we react will be telling. But so far nothing has deviated my original thoughts, so I'll try to recapture them.

So not quite two weeks ago (Friday, March 13) when it became apparent that quarantining was the only way to go it seemed to me we'd be on a 6-week plan, something like this: in two weeks we'd have a lot more testing done and we'd be able to replace models with data, we'd be terrified to learn that testing will (likely) show that the virus is waaaaaaay more wide spread than we anticipated and this would lead to another two weeks of quarantine. After two more weeks, the bodies would start piling up and the virus would spread a little wider and quarantine would feel even more like a necessity. After two more weeks, the deaths would taper off, the science would be better, the healthcare would become steadily more active and productive and the end of quarantining would at least be in sight.

And though many will die in that six week span, many others will be taking better care of themselves and their surroundings, they'll be eating healthier, cleaning more thoroughly, driving less, generally treasuring their happiness in a way most Americans just don't, and they'll likely emerge with a stronger sense of sense of purpose, a newly articulated desire for social interaction and a whole new appreciation of work. I don't say that as a cock-eyed optimist, I really do believe that is the likely outcome. The death rates of the virus are scary to those initially exposed to the virus, but pushing off exposure--the name of the game--will keep death rates from spiraling into Walking Dead territory (which I think is an entirely unlikely scenario). And I wouldn't be surprised to see a baby boom in the next 9-12 months, so overall death rates may well find replacement (in a species-level sense). 

What's happening is that the virus is coming for us and we will all get it. Oh yeah, that's worth remembering: we're not avoiding this, it's going to get each and every one of us. But the hope is that by pushing off that initial contact, we each give ourselves a vastly greater chance of surviving the virus because in the coming future a) we'll have a better sense of how to handle it, b) the virus itself will be weaker and less dangerous and c) the healthcare structures around us will be able to assist us rather than being overwhelmed by other virus-infected masses. At that point circulating among others will be quite a bit less dangerous, though big events will probably be rare at first.

The problem with the 6-week plan is in six weeks this will still be the same plan. Letting everybody get back to normal won't seem like a good idea if the virus re-emerges and the numbers start ticking higher again. So I would expect the quarantine to continue at least 12 weeks and in that time testing should've spread enough to target the proper locales to quarantine and which ones can ease up restrictions on movement and/or interaction. The places where the virus has spread worst should be the first places to come back from it, as more residents recover from infection, life can edge back toward normal.

None of this is really over until either a vaccine is found or the overall penetration of the virus is so deep that quarantining no longer matters. Of the former, the thought is 12-18 months; of the latter only massive amounts of testing will tell, so I'd say at least 12-18 months. So dig in, America, social distancing is is gonna be with us for a while. And destined to be one of the great days in American history is the day spreading the virus becomes the correct line of action (that's probably a few years down the road--but that day will come whether we realize it or not).

Again, I'd say 12 weeks at the absolute earliest on getting back to the new normal. I put that day at June 5, 2020. If things are as bad as they are today on June 5, then we can stop being scared because fear will just be a waste of precious time. But I do not anticipate that events will be as dire as today and that seems like a reasonable time for the powers-that-be to have formed some kind of plan for getting people back to work (or paying them to remain at home).

Can the NBA start playing again by June 5? Can we start getting summer action movies by June 5? Will museums and theaters and public parks get back to being full again by June 5? I dunno. I kinda doubt it but by June 5 we'll have a much better sense of where to go and how to get there. Until then we just gotta hope that grocery stores and gas stations can keep it going. (I think they will in America and I think they will around the globe, too;

The world will be stronger when this has passed, that is the good thing to look forward to. Viruses occur because nature is constantly testing us (re: trying to kill us) and each obstacle that does not kill us makes us stronger (one thought, for example, is that Covid-19 has shown tendencies of strengthening the arterial walls around the heart, which may be a brace for heart disease). The earth is trying to make us stronger and it will succeed (eventually) but first it will make us wait in solitude.

That the virus will pass and when it does humankind will in the long run be better off....is this too optimistic? No. Strengthening through endurance is the way of things, this has happened numerous times before (and will happen again). Stay smart, stay strong, stay alive, that's all one can do in the face of nature's tests.

Covid-19 (the politics)

I get my news through a steady diet email newsletters from a variety of industries, sources, and political persuasions. I stay in touch with developments while keeping hype to a minimum and the wide variety of viewpoints keeps me from getting too paranoid in any particular direction. I don't get on Twitter (though I'm pondering a way to craft a useful Twitter life) and I'm too boring a person for Facebook or Instagram. I look at Reddit throughout the day and that's where my political-ness comes from. During this period of quarantine I have seen no diminution in the sheer amount of political stories (er, that is, teenagers being snarky for on-line plaudits, not even because they believe their own snark) and I guess I'm not surprised: politics is a popular parlor game among the sophisticated but bored populace.

But the gov't has never been less crucial to me than this week. I've seen enough of Trump that I don't understand why anybody bothers to watch him.  What could a normal citizen possibly learn from watching this guy? He clearly doesn't get how the virus works--and why would he? Why would it matter if he did? Are you waiting for the president to cure a coronavirus? He doesn't do stuff like that, so why exactly does the population even need him to pretend like he does? Indeed, this is a States' problem more than a Federal one and each State will show different ways to react and recover that will be invaluable going forward while the Federal gov't isn't likely to do much of anything relating to the virus itself that is useful at all.

Even the quarantine didn't derive from the gov't but from the citizenry. The corporations, the banks, the insurance companies, the markets, the masses....we embraced social distancing as a means of fending off this virus and the gov't was forced to come along--even though Trump clearly doesn't like this or want any part of this. The gov't is downright hostile to the plan--so why are we looking to the gov't in this time when it is looking only to us?

It was the NBA that let the cat out of the bag: public interaction is way too much of a liability to afford to have a game. When you have 20,000 people in an arena, it is easy to assume that 2% of those people (400) have the virus and that two hours of sitting crampacked together will surely spread the disease to at least another 2% of anyone with 10 feet of the person (which might be up to 30-40 people); now if anyone dies of this virus--anyone anywhere in the world dies of this--now the NBA is potentially liable to anyone that has ever heard of the NBA. Yes, many of those cases would be frivolous but they would still cost the NBA an enormous amount just to make them go away or many cases would be cheaper for the NBA to pay off rather than litigate, which can be brutally expensive and at least implies a level of culpability, which opens the league to further claims. If the virus progresses as the spreadsheets suggest and the death rates maintain to expected levels, then the NBA becomes financially liable to potentially hundreds of thousands of claims just for a regular old Kings-Nuggets game on a Tuesday night.

Likewise with South-by-Southwest (SXSW): I suspect that at the last minute insurance underwriters came through and said something like, 'yeah, normally we charge a thousand for this but this year it's going to be a million because the rate of spread of this virus is too much to handle.' When liability balloons like that, then calling the whole thing off--cancelling out on the thousands of people and vendors that looked forward to the event every year--is much easier and cheaper than going through with the event.

Well, the logic behind the science that dictates that putting too many people together will spread the virus too quickly, applies to non-basketball games and music festivals, too. Indeed, it applies to anyone and everyone. The NBA showed us that, then the gov't jumped in to look busy.

We think of cold blooded capitalists that just want their money no matter who is injured but when the potential liability of injury is exponential then cancelling the show and foregoing the profits is a wildly cheaper move.

That's where the quarantine came from: insurance companies realizing that, in a legal liability sense, it is too dangerous (potentially too expensive) for people to be around each other. It didn't come from the gov't. The gov't was reacting to what society itself and the markets had already instinctively grasped: that 'flattening the curve' was the only hope to avoid a throttling of our health care infrastructure.

'Flattening the curve' undoubtedly came from insurance companies, not from the gov't. The gov't doesn't have a good eye for gloomy futures, politicians love to keep things rosy no matter how dire the situation truly is. But insurance companies are basically nothing but pessimism machines. And flattening the curve is the only thing that makes sense to them. Again, the gov't is reacting to the markets, not the other way around.

The gov't wasn't completely absent but are the CDC and the Federal Reserve really "gov't"? (Ehh, that's a hobby horse I'll give a ride to some other time) The gov't's initial response came in the form of the CDC sending out tests in early February to track down the spread of the virus within USA's borders. The tests were faulty, thus we lost two weeks of figuring out what was going on. Is that Trump's' fault? No. Hell, I'm not even blaming the CDC--this shit's hard, man! No one knew this virus existed three months ago, putting together a test, mass producing it, implementing it, getting the results back and then analyzing said results is a long process. And it is much easier to do it wrong (as we've seen) than it is to do it right. That's not a function of gov't, that's just how life works. Expecting the gov't to immediately and completely solve all problems (or even diagnose them) is an unrealistic expectation and though it may be fun to barb your political enemies, it does you no service as a citizen or a human being to fill your brain with unrealistic expectations.

The other early gov't action was the Federal Reserve spontaneously lowering interest rates near zero on March 3. That was about week before the virus started spooking Americans but it had already begun to hit the markets. As far back as January I saw choppy waters ahead for the stock market but I figured this was just another one of those viruses we've been getting steadily for the last 20 years (H1N1, swine flu, Mers, bird flu, SARS, West Nile, Zika, Ebola, just to name a few) and that this one would fade like the others, making an impact but ultimately moving on. When the Fed did that rate cut in the middle of the day, that caught me off guard (kinda scared me, truth be told), because that was the first indication that the powers that be knew this was going to be huge. That was the first moment that Covid-19 struck me as a coming onslaught, not merely another one of these influenzas that occasionally spooks us.

The effect of the Fed actions and Congress's subsequent economic overhauls will only become apparent over time. For now, these moves are so large as to be pretty much imaginary. Congress's newly passed $2 trillion bill is really just a giant placeholder for what will eventually be negotiated. Economically speaking it's easy to see where this is going: for now the credit card companies will pay all the bills and the insurance companies will end up with all the liability and they'll have to sit down with the gov't to whack it all out. Until then, I don't really understand why the markets would bother to go up or down: I know cash flow is a concern but in my lifetime I doubt there has ever been less cash flow in the American economy than this week (or the coming weeks) and it feels like getting by on even the shakiest credit is probably gonna work for most people.

I expect the economy to bounce back quickly. Why? Because there has been no physical deterioration of industrial production or of our supply lines. This is not like a war or a hurricane or an earthquake. What this is, economically speaking, is a labor stoppage: the physical infrastructure is just fine except that the workers are not working right now. Once they get back to work, I expect the economy to come back hard and fast. This period will be a gap down in the macro-economy, which is a godawful struggle while its happening but should be a boon to new and future growth once it has been absorbed.

When the workers get back to work, the economy will be strong again--indeed, I don't see why it wouldn't. Not everything will be the same, not everyone will emerge unscathed, it will be a while before things get back to "normal" (yeah, with quotation marks). But the larger economy has suffered only a shock to the system, nothing suggestive of overall material decline, a coma (as Larry Summers suggested). When people do get back to "normal" I think they'll get back to it hard. Workers will suddenly have a new appreciation for work and consumers will have a new appreciation for the products and services they need.

Remember the CDC was the first to act and the Federal Reserve came next (two quasi-gov't institutions, I would add). The gov't is not well-equipped to get ahead of problems: the White House steadily downplayed this as long as they could--and fought being dragged into a quarantine--and Congress only acts when it is absolutely forced to. You can blame the particular personalities in office at the moment or you can recognize that that is simply how gov't works: slowly and only when forced to act. It was SXSW and the NBA and the NCAA that made the fateful decisions that showed the public the light....not the gov't. Long live the people!

It is the citizenry, the markets, the corporations, the PEOPLE that made the move to save lives and they will bring back a new way of life when the time is right. The people have done it and the people will do more. Fuck the gov't, they're a bunch of fucking clowns. In short, Trump was forced into this. I am convinced he never wanted any of this and still doesn't. So crediting Trump or blaming Trump is just a waste of your time. Perhaps pillorying politicians is an amusement to you, in which case, well, Trump is a pretty obvious target. But in my home state of Kentucky we have a governor that's on TV every night and pummeling my inbox with spam every day and he sure wants to look like he's in charge and he is kindly, he is the anti-Trump...and I got no use for him either. What is that dude gonna tell me that's gonna make my life better?

Politicians don't create vaccines and until they do, who gives a fuck what they have to say? They are functionaries, they are fungible commodities, they are not sexy or knowledgeable or important and pretending as if they are (or are supposed to be) is a just a poor use of your conception of gov't. This nation is people, the gov't is just the gov't.