Month: September 2024

$6 Billion of Taxpayer Money Wasted in 2021 for Bogus Hospital “Facility” Fees Where No Hospital Facility Was Used

The complexity, opaqueness, arbitrariness, and conflicts of interest of government healthcare, as exemplified by Medicare, make it rife for several kinds of inefficiency and fraud. The passages quoted below, document one kind.

(p. B4) Hospitals are adding billions of dollars in facility fees to medical bills for routine care in outpatient centers they own. Once an annoyance, the fees are now pervasive, and in some places they are becoming nearly impossible to avoid, data compiled for The Wall Street Journal show. The fees are spreading as hospitals press on with acquisitions, snapping up medical groups and tacking on the additional charges.

The fees raise prices by hundreds of dollars for widely used and standard medical care, including colonoscopies, mammograms and heart screening.

The added cost isn’t justified, physicians and economists say. Medicare advisers said last year the federal insurer likely overpaid for a sample of services by about $6 billion because of the fees in 2021.

. . .

The fees show up on patients’ bills after hospitals snap up clinics and doctors. Hospitals can designate the newly acquired clinics as an extension of their operations, forcing patients to pay the fees to cover costs for the entire hospital.

Fees have grown more pervasive as hospitals have gone on an acquisition tear in recent years, chasing after patients who have more options to get medical care somewhere else. Many hospital systems now get at least half their revenue from patients who aren’t admitted. By one estimate, more than half of doctors work for hospitals.

For the full story see:

Melanie Evans. “Patients Rack Up Hidden Hospital Fees.” The Wall Street Journal (Tuesday, March 26, 2024): B4.

(Note: ellipsis added.)

(Note: the online version of the story has the date March 25, 2024, and has the title “Hospitals Are Adding Billions in ‘Facility’ Fees for Routine Care.”)

Federal Government Creates Perverse Incentives for Medical Insurers to Harvest Diagnoses for Untreated Maladies in the So-Called Medical “Advantage” Program

Notice that the federal government has set up the incentives of the Medicare Advantage program so that insurers will receive benefits, but no costs, for diagnosing patients with certain conditions, that the patients have not asked them to treat. The nurse home visits aimed at harvesting diagnoses do not benefit patients, but instead waste patients’ time and taxpayers’ money. Is UnitedHealth Group the most despicable organization for shamelessly exploiting the perverse incentives, or is the federal government the most despicable organization for creating the perverse incentives?

(p. A3) Millions of times each year, insurers send nurses into the homes of Medicare recipients to look them over, run tests and ask dozens of questions.

The nurses aren’t there to treat anyone. They are gathering new diagnoses that entitle private Medicare Advantage insurers to collect extra money from the federal government.

A Wall Street Journal investigation of insurer home visits found the companies pushed nurses to run screening tests and add unusual diagnoses, turning the roughly hourlong stops in patients’ homes into an extra $1,818 per visit, on average, from 2019 to 2021. Those payments added up to about $15 billion during that period, according (p. A9) to a Journal analysis of Medicare data.

Nurse practitioner Shelley Manke, who used to work for the HouseCalls unit of UnitedHealth Group, was part of that small army making home visits. She made a half-dozen or so visits a day, she said in a recent interview.

Part of her routine, she said, was to warm up the big toes of her patients and use a portable testing device to measure how well blood was flowing to their extremities. The insurers were checking for cases of peripheral artery disease, a narrowing of blood vessels. Each new case entitled them to collect an extra $2,500 or so a year at that time.

But Manke didn’t trust the device. She had tried it on herself and had gotten an array of results. When she and other nurses raised concerns with managers, she said, they were told the company believed that data supported the tests and that they needed to keep using the device.

“It made me cringe,” said Manke, who stopped working for HouseCalls in 2022. “I didn’t think the diagnosis should come from us, period, because I didn’t feel we had an adequate test.”

. . .

Last month, the Journal reported that insurers received nearly $50 billion in payments from 2019 to 2021 due to diagnoses they added themselves for conditions that no doctor or hospital treated. Many of the insurer-driven diagnoses were outright wrong or highly questionable, the Journal found.

. . .

In the Medicare Advantage system—conceived as a lower-cost alternative to traditional Medicare—private insurers get paid a lump sum to provide health benefits to about half of the 67 million seniors and disabled people in the federal program. The payments go up when people have certain diseases, giving insurers an incentive to diagnose those conditions.

To find out how insurers use home visits to add diagnoses, the Journal interviewed nurses, patients, home-visit managers and industry executives and reviewed hundreds of pages of internal documents from home-visit companies. They described a system that used nurses, software and audits to generate diagnoses.

“They do the job with a purpose, and it pays off for the Medicare Advantage plans,” said Francois de Brantes, a former executive at Signify Health, a company that does home visits for insurers. “Identifying the diagnoses, that’s the job.”

. . .

Secondary hyperaldosteronism, a condition in which levels of the hormone aldosterone rise, is rarely diagnosed in traditional Medicare patients. HouseCalls documents show that its software would suggest the diagnosis if a patient had a history of heart failure or cirrhosis, and either took certain drugs, such as diuretics, or had swelling due to fluid retention. Nurses weren’t required to confirm the diagnosis with a lab test.

“In a million years, I wouldn’t have come up with a diagnosis of secondary hyperaldosteronism,” said Bell, the former HouseCalls nurse.

UnitedHealth diagnosed it 246,000 times after home visits, leading to $450 million in payments over the three years of the Journal’s analysis. All other Medicare insurers combined collected $42 million from making that diagnosis after home visits.

For the full story see:

Anna Wilde Mathews, Christopher Weaver, Tom McGinty and Mark Maremont. “Nurse Visits Made Insurers $15 Billion.” The Wall Street Journal (Tuesday, Aug. 6, 2024): A1 & A9.

(Note: ellipses added.)

(Note: the online version of the story has the date August 4, 2024, and has the title “The One-Hour Nurse Visits That Let Insurers Collect $15 Billion From Medicare.”)

Start-Ups Succeed When They Give Up Work-Life Balance in Order to “Work Like Hell”

(p. B4) Eric Schmidt, ex-CEO and executive chairman at Google, walked back remarks in which he said his former company was losing the artificial intelligence race because of its remote-work policies.

. . .

“Google decided that work-life balance and going home early and working from home was more important than winning,” Schmidt said at Stanford. “The reason startups work is because the people work like hell.”

For the full story see:

Joseph De Avila. “Ex-CEO Criticizes Google, Retracts It.” The Wall Street Journal (Thursday, Aug. 15, 2024): B4.

(Note: ellipsis added.)

(Note: the online version of the story was updated Aug. 14, 2024, and has the title “Eric Schmidt Walks Back Claim Google Is Behind on AI Because of Remote Work.”)

“Medicine Is Riddled With Flawed, Incomplete Evidence”

William Osler’s hospital residency system may have been an advance when he invented it. But it is far from perfect. We need lighter regulations so that medical entrepreneurs can create institutional innovations.

(p. D3) Medicine is full of young recruits writing veterans’ books, war stories full of hopes and fears for the next in line.

. . .

None in recent memory has wielded a set of intellectual and writerly tools to such dazzling and instructive effect as Dr. Nussbaum’s “The Finest Traditions of My Calling: One Physician’s Search for the Renewal of Medicine.”

. . .

. . .  Dr. Nussbaum steers his narrative directly to the hard questions about 21st-century medicine, a profession just about as variously troubled as his patients.

. . .  None of the usual medical heroes apply. Even the enduring William Osler, who started the hospital residency system at the turn of the 20th century and is routinely worshiped as a medical saint, comes up short. Osler was all about the physical evidence of illness, and Dr. Nussbaum faults him for seeing the body primarily as a collection of diseased parts, “a decidedly incomplete view.”

Few of Osler’s heirs strike Dr. Nussbaum as free of their own shortcomings.

He notes that partisans of today’s much promoted evidence-based medicine must determinedly finesse the fact that medicine is riddled with flawed, incomplete evidence. The leaders of genomic revolution trumpet a future that keeps being postponed. Quality-control gurus abound, but their work often fails to yield actual quality.

And those who would update and streamline medical routines offer up paradigms Dr. Nussbaum finds simply bizarre. He points to Atul Gawande, the Harvard surgeon and health policy writer who in a New Yorker article lauded the ability of large chain restaurants like the Cheesecake Factory to serve a uniform, reproducible product thousands of times over. Dr. Gawande charged medicine to do likewise, but that image of the physician as a line cook feeding faceless strangers does not inspire Dr. Nussbaum.

Still, if a doctor is to be neither parts mechanic nor line cook, then what? Dr. Nussbaum considers some alternatives.

. . .

Dr. Nussbaum considers the alternatives in a flowing, complex stream of anecdotes and reflections, all the stronger for its frequent uncertainty. He writes beautifully, in a lucid prose as notable for its process as its conclusions: The reader can actually watch him think.

For the full review see:

Abigail Zuger, M.D. “Unsparing Examination by a Young Doctor.” The New York Times (Tuesday, April 5, 2016 [sic]): D3.

(Note: ellipses added.)

(Note: the online version of the review has the date April 4, 2016 [sic], and has the title “Book Review: ‘The Finest Traditions of My Calling’.”)

The book under review is:

Nussbaum, Abraham M. The Finest Traditions of My Calling: One Physician’s Search for the Renewal of Medicine. New Haven, CT: Yale University Press, 2016.

Healthcare Competition Sometimes Reduces Prices

Numerous complex government healthcare regulations differentially increase the costs of small healthcare firms and independent healthcare practitioners that cannot afford to hire the specialized experts to understand and navigate the regulations. As a result the small firms and independent practitioners often give up and merge with larger organizations, thereby reducing competition. Also, in many locations, governments give incumbent hospitals veto power over the start-up of new hospitals, thereby also reducing competition.

(p. A3) Prices for surgery, intensive care and emergency-room visits rise after hospital mergers. The increases come out of your pay.

Hospitals have struck deals in recent years to form local and regional health systems that use their reach to bargain for higher prices from insurers. Employers have often passed the higher rates onto employees.

Such price increases added an average of $204 million to national health spending in the year after mergers of nearby hospitals, according to a study published Wednesday [April 24, 2024] by American Economic Review: Insights.

Workers cover much of the bill, said Zack Cooper, an associate professor of economics at Yale University who helped conduct the study. Employers cut into wages and trim jobs to offset rising insurance premiums, he said. “The harm from these mergers really falls squarely on Main Street,” Cooper said.

For the full story see:

Melanie Evans. “Hospital Prices Rise After Mergers, and Patients Bear Brunt.” The Wall Street Journal (Thursday, April 25, 2024): A3.

(Note: bracketed date added.)

(Note: the online version of the story was updated April 24, 2024, and has the title “The True Cost of Megamergers in Healthcare: Higher Prices.” The online version says that the title of the print version was “Hospital-Care Prices Rise After Mergers.” But my national edition of the print version had the title “Hospital Prices Rise After Mergers, and Patients Bear Brunt.”)

The forthcoming article co-authored by Cooper, and mentioned above, is:

Brot-Goldberg, Zarek, Zack Cooper, Stuart Craig, and Lev Klarnet. “Is There Too Little Antitrust Enforcement in the U.S. Hospital Sector?” American Economic Review: Insights (forthcoming).

Cloud Brightening Could Counter Global Warming

If the costs of global warming become large enough, we can brighten clouds to reverse global warming.

(p. A1) A little before 9 a.m. on Tuesday [April 2, 2024], an engineer named Matthew Gallelli crouched on the deck of a decommissioned aircraft carrier in San Francisco Bay, pulled on a pair of ear protectors, and flipped a switch.

A few seconds later, a device resembling a snow maker began to rumble, then produced a great and deafening hiss. A fine mist of tiny aerosol particles shot from its mouth, traveling hundreds of feet through the air.

It was the first outdoor test in the United States of technology designed to brighten clouds and bounce some of the sun’s rays back into space, a way of temporarily cooling a planet that is now dangerously overheating. The scientists wanted to see whether the machine that took years to create could consistently spray the right size salt aerosols through the open air, outside of a lab.

If it works, the next stage would be to aim at the heavens and try to change the composition of clouds above the Earth’s oceans.

. . .

(p. A14) Brightening clouds is one of several ideas to push solar energy back into space — sometimes called solar radiation modification, solar geoengineering, or climate intervention. Compared with other options, such as injecting aerosols into the stratosphere, marine cloud brightening would be localized and use relatively benign sea salt aerosols as opposed to other chemicals.

. . .

“I hope, and I think all my colleagues hope, that we never use these things, that we never have to,” said Sarah Doherty, an atmospheric scientist at the University of Washington and the manager of its marine cloud brightening program.

. . .

But it’s vital to find out whether and how such technologies could work, Dr. Doherty said, in case society needs them. And no one can say when the world might reach that point.

In 1990, a British physicist named John Latham published a letter in the journal Nature, under the heading “Control of Global Warming?,” in which he introduced the idea that injecting tiny particles into clouds could offset rising temperatures.

Dr. Latham later attributed his idea to a hike with his son in Wales, where they paused to look at clouds over the Irish Sea.

“He asked why clouds were shiny at the top but dark at the bottom,” Dr. Latham told the BBC in 2007. “I explained how they were mirrors for incoming sunlight.”

Dr. Latham had a proposal that may have seemed bizarre: create a fleet of 1,000 unmanned, sail-powered vessels to traverse the world’s oceans and continuously spray tiny droplets of seawater into the air to deflect solar heat away from Earth.

The idea is built on a scientific concept (p. A15) called the Twomey effect: Large numbers of small droplets reflect more sunlight than small numbers of large droplets. Injecting vast quantities of minuscule aerosols, in turn forming many small droplets, could change the composition of clouds.

“If we can increase the reflectivity by about 3 percent, the cooling will balance the global warming caused by increased C02 in the atmosphere,” Dr. Latham, who died in 2021, told the BBC. “Our scheme offers the possibility that we could buy time.”

A version of marine cloud brightening already happens every day, according to Dr. Doherty.

As ships travel the seas, particles from their exhaust can brighten clouds, creating “ship tracks,” behind them. In fact, until recently, the cloud brightening associated with ship tracks offset about 5 percent of climate warming from greenhouse gases, Dr. Doherty said.

Ironically, as better technology and environmental regulations have reduced the pollution emitted by ships, that inadvertent cloud brightening is fading, as well as the cooling that goes along with it.

A deliberate program of marine cloud brightening could be done with sea salts, rather than pollution, Dr. Doherty said.

For the full story see:

Christopher Flavelle. “Salting the Clouds to Cool an Overheating Earth.” The New York Times (Thursday, April 4, 2024): A1 & A14-A15.

(Note: ellipses, and bracketed date, added.)

(Note: the online version of the story has the date April 2, 2024, and has the title “Warming Is Getting Worse. So They Just Tested a Way to Deflect the Sun.”)

The article by the physicist John Latham, published in the one of the top two journals in science, and mentioned above, is:

Latham, John. “Control of Global Warming?” Nature 347, no. 6291 (Sept. 27, 1990): 339-40.

Low Government-Negotiated Drug Prices Will Slash Pharma Revenue Needed to Finance Government-Mandated Costly Phase 3 Trials

Mandated Phase 3 randomized double-blind clinical trials cost many millions of dollars each, and most of the trials fail. To fund all the trials that fail and the few that succeed, the few new drugs that succeed need to have high price tags. The only other way for new drug development to be economically sustainable, is to stop mandating Phase 3 clinical trials. If we stopped mandating Phase 3 clinical trials, we would, in other words, allow physicians and patients to try drugs after safety has been shown through Phase 1 and Phase 2 trials, but without the expensive proof of efficacy from Phase 3 trials. We would thereby allow physicians and patients greater freedom.

(p. B6) While many companies, from Pfizer to Bristol-Myers Squibb to Bayer and Novartis, have announced big layoffs, news from a key outsourcer on Wednesday [Aug. 7, 2024] showed that the industry’s cost-cutting ways are intensifying.

Charles River Laboratories International, which provides drug-development services, plunged 12.6% on Wednesday [Aug. 7, 2024], the most in four years, after sounding the alarm over pharma research spending plans. The Massachusetts-based company said it now expects to post a decline in sales for the full year, primarily owing to lower demand from pharma clients. The company previously expected to grow this year. “There are profound cuts at pharmaceutical companies,” James Foster, Charles River’s chief executive officer, told analysts. Foster called the reduction in pharma research spending “unusual” and “sudden.”

Foster said his clients are blaming the cuts on the Inflation Reduction Act, which allows Medicare to negotiate some drug prices directly with manufacturers, and a looming patent cliff, which will see more than $200 billion in annual drug sales come under threat from copycat generics.

For the past few years, pharma companies have been warning that they might need to cut back on innovation as the U.S. government forces some companies to negotiate prices of their top-selling drugs.

. . .

A reduction in preclinical testing, the kind of services that Charles River provides, is the sort of thing that will only be felt in the long term. By that time, current management teams, desperate to lift their stocks now, might be long gone.  . . .

Big pharma wants to clean house. Expensive studies of drugs that won’t make it to market for many years to come are an easy target.

For the full commentary see:

David Wainer. “Big Pharma Scales Back R&D, Sending Shudders Through Industry.” The Wall Street Journal (Friday, Aug. 9, 2024): B6.

(Note: ellipses, and bracketed dates, added.)

(Note: the online version of the commentary has the date August 8, 2024, and has the title “Big Pharma Cuts R&D, Sending Shudders Through Industry.” The quoted paragraph starting with “Foster said” appears in the online, but not the print, version of the commentary.)

The Benefits of the “Energy Transition” Are Distant and Uncertain, While the Costs Are Immediate and Large

(p. A15) The 2015 Paris Agreement aspired to “reduce the risks and impacts of climate change” by eliminating greenhouse-gas emissions in the latter half of this century. The centerpiece of the strategy was a global transition to low-emission energy systems.

. . .

The energy transition’s purported climate benefits are distant, vague and uncertain while the costs and disruption of rapid decarbonization are immediate and substantial. The world has many more urgent needs, including the provision of reliable and affordable energy to all.  . . .

U.S. and European governments are trying to induce an energy transition by building or expanding organizations and programs favoring particular “clean” technologies, including wind and solar generation, carbon capture, hydrogen production and vehicle electrification. Promoting technological innovation is a worthy endeavor, but such efforts face serious challenges as costs and disruptions grow without tangible progress in reducing local, let alone global, emissions. Retreats from aggressive goals are already under way in Europe, with clear signs of mandate fatigue. The climbdown will be slower in the U.S., where subsidies create constituencies that make it more difficult to reverse course.

. . . today’s ineffective, inefficient, and ill-considered climate-mitigation strategies will be abandoned, making room for a more thoughtful and informed approach to responsibly providing for the world’s energy needs.

For the full commentary see:

Steven E. Koonin. “The ‘Climate Crisis’ Fades Out.” The Wall Street Journal (Tuesday, June 11, 2024): A15.

(Note: ellipses added.)

(Note: the online version of the commentary has the date June 10, 2024, and has the same title as the print version.)

Koonin’s commentary, quoted above, is related to his book:

Koonin, Steven E. Unsettled: What Climate Science Tells Us, What It Doesn’t, and Why It Matters. Dallas, TX: BenBella Books, 2021.

IRS Has “Ridiculous” 675 Day Delay in Getting Earned Refunds to the Victims of Identity Fraud

Some federal politicians sanctimoniously seek voter approval by pushing new giveaway programs to select groups (like $25,000 to first-time home buyers). If they were sincere about wanting to help the most deserving among the least-well-off, they would instead prioritize getting earned refunds to the low-income victims of identity theft.

(p. B6) If a thief files a fraudulent return using your tax information and pilfers your refund, you’ll have to wait an average of 675 days to get the money rightfully owed to you, according to the Taxpayer Advocate Service, a group within the Internal Revenue Service that works on behalf of taxpayers.

“That period of time is just ridiculous,” Erin M. Collins, who leads the service, said in an interview.

For reasons not yet clear, Ms. Collins noted, many of those affected are lower-income tax filers, who often depend on tax refunds to cover basic living costs. Those filers often qualify for tax breaks for working families, like the earned-income tax credit, that can result in significant refunds.

“These are true victims,” Ms. Collins said. “The I.R.S. should be helping these people.”

About half a million tax returns are in limbo at the I.R.S. because of identity theft fraud, a spokesman for the Taxpayer Advocate Service said.

. . .

The lengthy processing time for identity theft returns can cause other problems, Ms. Collins said in the blog post, like difficulty applying for a mortgage. When taxpayers are flagged for identity theft, she said, the I.R.S. won’t send tax transcripts — a record of the filers’ income and tax information — directly to lenders. So taxpayers have to request the transcripts themselves and give them to the lender. The red tape delays the completion of their home loan applications.

Other issues can arise, such as when a taxpayer chooses to have a refund applied to a subsequent tax year but the I.R.S. hasn’t yet applied it because of an unresolved identity theft issue. The tax owed on the subsequent year then goes unpaid, and the I.R.S. system begins to send collection notices.

For the full commentary see:

Ann Carrns. “Long Wait for Victims of Tax Return Fraud.” The New York Times (Saturday, June 15, 2024): B6.

(Note: ellipsis added.)

(Note: the online version of the commentary has the date June 14, 2024, and has the title “First a Victim of Tax Return Identity Theft, Then a 2-Year Wait for a Refund.” Where there are a couple of small differences in wording, the passages quoted above follow the online version.)

The blog post by Collins mentioned above is:

Collins, Erin M., National Taxpayer Advocate. “Identity Theft Victims Are Waiting Nearly Two Years to Receive Their Tax Refunds.” In NTA Blog, June 6, 2024.br />

The New York Times Is Open to the Possibility and Desirability of Geoengineering

In the past, The New York Times either ignored, or was dismissive of, geoengineering to reverse or mitigate the alleged future effects of global warming. A few months ago, I was pleasantly surprised to see the paper publish a page one article, quoted below, that was open to the policy of geoengineering. This is progress because the left’s standard response to the alleged effects of global warming is to advocate reduced economic growth. Geoengineering would allow economic growth, and the human flourishing it allows, to continue, even if global warming becomes as severe as the pessimists fear.

(p. 1) On a windswept Icelandic plateau, an international team of engineers and executives is powering up an innovative machine designed to alter the very composition of Earth’s atmosphere.

If all goes as planned, the enormous vacuum will soon be sucking up vast quantities of air, stripping out carbon dioxide and then locking away those greenhouse gases deep underground in ancient stone — greenhouse gases that would otherwise continue heating up the globe.

Just a few years ago, technologies like these, that attempt to re-engineer the natural environment, were on the scientific fringe. They were too expensive, too impractical, too sci-fi. But with the dangers from climate change worsening, and the world failing to meet its goals of slashing greenhouse gas emissions, they are quickly moving to the mainstream among both scientists and investors, despite questions about their effectiveness and safety.

. . .  Once science fiction, today these ideas are becoming reality.

Researchers are studying ways to block some of the sun’s radiation. They are testing whether adding iron to the ocean could carry carbon dioxide to the sea floor. They are hatching plans to build giant parasols in space. And with massive facilities like the one in Iceland, they are seeking to reduce the concentration of carbon dioxide in the air.

. . .

(p. 12) A plant similar to the one in Iceland, but far larger, is being built in Texas by Occidental Petroleum, the giant oil company.

. . .

The Occidental plant, being built near Odessa, Texas, and known as Stratos, will be more than 10 times more powerful than Mammoth, powered by solar energy, and have the potential to capture and sequester 500,000 metric tons of carbon dioxide per year.

It uses a different process to extract carbon dioxide from the air, though the goal is the same: Most of it will be locked away deep underground. But at least some of the carbon dioxide, Occidental says, will also be used to extract more oil.

In that process, carbon dioxide is pumped into the ground to force out oil that might otherwise be too difficult to reach. Techniques like this have made Occidental a company worth more than $50 billion and helped send American crude production to a new high in recent years.

Of course, it is the world’s reliance on the burning of oil and other fossil fuels that has so dangerously sent carbon dioxide levels soaring. In the atmosphere, carbon dioxide acts as a blanket, trapping the sun’s heat and warming the world.

Today, Occidental says it is trying to become a “carbon management” company as well as an oil producer. Last year, it paid $1.1 billion for a start-up called Carbon Engineering that had developed a way to soak up carbon dioxide from the air, and began building the Stratos project. Today, what was a barren plot of dirt less than 12 months ago is a bustling construction site.

“It’s like the Apollo missions at NASA,” said Richard Jackson, who oversees carbon management and domestic oil operations at Occidental. “We’re trying to move as quickly as we can.”

For the full story see:

David Gelles. “Can We Engineer Our Way Out of a Climate Crisis?” The New York Times, First Section (Sunday, March 31, 2024): 1 & 12-13.

(Note: ellipses added.)

(Note: the online version of the story was updated April 4, 2024, and has the title “Can We Engineer Our Way Out of the Climate Crisis?” The sentence above that starts “Once science fiction” appeared in the print, but not the online, version.)

Prepare for Next Unexpected Disaster By Unbinding Nimble Entrepreneurs Who Can Pivot and Improvise

Governments have trouble preparing for uncertain and rare disasters, such as pandemics. So they “fight the last war,” expecting that the next disaster will look like the last disaster. Before WWII, France built the Maginot line, which they thought would have protected them against the kind of attack they had faced in WWI. The U.S. was more prepared for an Ebola pandemic than for a Covid pandemic. In an uncertain world, the best way to prepare for rare disasters is to allow and encourage nimble entrepreneurs who can resiliently pivot and improvise to counter whatever disaster arrives.

(p. A8) Britain’s government “failed” the country’s citizens in its handling of the coronavirus pandemic, a damning report from an official public inquiry said on Thursday [July 18, 2024], partly because officials had prepared for “the wrong pandemic.”

The arrival of Covid-19 in 2020 exposed flaws in Britain’s public health system and its pandemic preparedness that had been ignored for years, the report said. During the early waves of infections, Britain’s per capita death rate was among the highest in Europe, eventually leading to more than 225,000 deaths in total, according to official data.

“Had the U.K. been better prepared for and more resilient to the pandemic, some of that financial and human cost may have been avoided,” the report said.

. . .

Britain had a plan, but it was “outdated and lacked adaptability,” the report said.

It was also too focused on the possibility of a flu pandemic. “Although it was understandable for the U.K. to prioritize pandemic influenza, this should not have been to the effective exclusion of other potential pathogen outbreaks,” the report said.

. . .

Ministers, who are political appointees, did not have access to a broad enough range of scientific research and opinions that would have informed their policies, and advisers did not feel confident about expressing dissenting views.

“The advice offered to ministers and international bodies may well have been affected by a degree of ‘groupthink’,” the report said.

For the full story see:

Lynsey Chutel. “Before Covid, U.K. Prepared for ‘the Wrong Pandemic,’ Inquiry Finds.” The New York Times (Monday, July 22, 2024): A8.

(Note: ellipses, and bracketed date, added.)

(Note: the online version of the story has the date July 18, 2024, and has the title “U.K. Failed in Handling of Covid Pandemic, Inquiry Finds.”)

The “damning report” mentioned above, is:

Hallett, Baroness. “Uk Covid-19 Inquiry; Module 1: The Resilience and Preparedness of the United Kingdom.” July 18, 2024.