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Comment by nikofeyn | Hacker News Reader

> This crisis is the first event in my lifetime that's given me any optimism about our ability, as a global civilization, to solve problems and get things done.

would you mind elaborating? because i find it extremely difficult how one could hold such an optimistic and apparent naive opinion.

from where i sit, this crisis is showing the exact opposite. there is very little international communication and cooperation, and even internal to countries, like in the u.s., there is very little communication and cooperation. aside from a few outliers, the while thing has just been wave after wave of delayed and reactive actions that were underprepared to begin with.

people keep thinking we'll solve this with technology (the typical human way), but what would have been better is if everyone simply communicated, listened, and cooperated.

the human race could not face a dumber enemy. think about it. if everyone on earth just sat still for a couple of weeks, this thing would just vanish. can you imagine a more simple foe? and yet, this thing is crippling econmies, healthcare, and more.

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I've also felt very encouraged by this. To see my own town almost completely shut down before any legal order even required it shows me that people will still voluntarily make sacrifices for the benefit of the whole. Everyone I know is doing their part. And beyond that to see the scientific community come together, to see that even with the blunders there is real cooperation between the various states and the federal government (I'm in the U.S.---we have gigantic hospital ships in the ports of two of our largest cities right now, federal troops mobilized, hundreds of billions of dollars authorized, and that's just part of what the federal government is doing), to see that individuals, corporations, research institutions, universities, foundations, etc., are all stepping in to fill the gaps, the ingenuity of people finding ways around resource limitations, debunking myths, providing encouragement and guidance and hope in a challenging time... and to have something as simple as a virus so powerfully remind us that we're all in this together, yes we could do much better, but I've been heartened by all of it.

> I'm in the U.S.---we have gigantic hospital ships in the ports of two of our largest cities right now

Not true. The west coast one is deploying soon, but the east coast one was undergoing repairs at the time and is weeks away from deployment.

yea, and they are missing the point. those ships are being deployed because shit is hitting the fan. it isn't a positive thing.

The Comfort is already in NYC. It was undergoing maintenance that was scheduled to take weeks, but they got it done in 8 days.

The Mercy is also already in LA.

I would focus on the actual words and actions of decision makers at the state and federal level. The communication and collaboration is happening, agreed it’s still reactive.

At this point the media is in an abusive relationship with their audience, sitting around all day trying to think how they can scare them, leading to deeply dishonest headlines like this

https://www.bloomberg.com/news/articles/2020-03-21/nigeria-r...

> there is very little international communication and cooperation

Indeed. The EU didn't really mind about Italy's problems and potential economic unease until it started affecting other european countries too.

If you assume the european union being based, fundamentally, on cooperation then that really make you question the whole thing.

Yeah, and you can't really leave things to be some other country's problem -- especially a transmissible disease -- when that country shares a (for the time being) open border with you on land.

I think you're paying too much attention to Trump and politics. The people actually getting work done are cooperating and moving at a pace that has really never been done. The articles I've read and podcasts I've heard with scientist all echo the same sentiment. Ignore Trump and the politics, the science is happening at a pace unseen before.

> the while thing has just been wave after wave of delayed and reactive actions that were underprepared to begin with.

I do agree the US has been slow to ramp up, but that is quickly changing. Although, I would once again offer up to ignore Trump and watch the governors. They have been acting quickly and decisively.

Underprepared with respect to supplies is always easy to say in hindsight because now we know the war we are fighting. There is a saying that armies are always tooled to fight the last war. Until you know what the next war will be, it's impossible to fully prepare.

> if everyone on earth just sat still for a couple of weeks, this thing would just vanish.

IMO, that is naive and optimistic. The problem, for lack of a better word, is that the large majority of cases (80-90%?) are mild. For many, it's mild enough that they would have not deviated from their normal routine. Once this thing escaped China, and definitely once it got out of SEA, it was going to be incredibly hard to stomp out without herd immunity either through infection or vaccine.

> The articles I've read and podcasts I've heard

I share your optimism, but I don't think this bit helps your argument. Podcasts in particular do not scream "credibility"

> Podcasts in particular do not scream "credibility"

Except when they have on doctors who are experts on viral disease. For example: https://peterattiamd.com/category/podcast/

Parent means that everyone should sit still whether they have symptoms or not.

I too share a dim view of the world's ability to work together. Even now when faced with such a disease that is essentially everyone's problem, countries first and foremost chose to safeguard their own interests at the expense of others. It is a situation where if we survive, we did so because we worked together and if we die, it is because we only cared for ourselves and nobody else. If course this is oversimplifying a very complex interplay of things but my drift is that no country seems to be able to look beyond their borders and see that if we were to win this, we have to work together.

Even more dismaying is the refusal to lift sanctions on Iran. Even a narrowly crafted exception to the sanctions for supplies needed to combat the onslaught of the virus would be good but so far nothing. This is according to what I have read this far and if this is in error, I would be happy to be shown that.

I know it’s hard to believe but the regime (who any lift in sanctions would have to flow through) hates America enough to kill their own people.

https://twitter.com/ap/status/1241658649224925184?s=21

Aid is the only way to help Iran.

I view a pandemic like what happens in an airline emergency. The first thing you do is put on your own oxygen mask to make sure you are stabilized before helping others. It sounds selfish, but if the most powerful options lose control because they are busy helping others then they can cause everyone to lose.

Also, let me say that I'm not saying it's all rainbows and butterflies out there. I just think about all the things that were going to end humankind in my lifetime alone, yet here we are arguably in the best position we have ever been to fight something like this. As a kid we were genuinely afraid of nuclear war. Then there was the HIV epidemic. Y2K, tech bubble busting, 2008 financial crisis, and all the smaller things in between I'm forgetting about.

I look out and see the people on ground sharing information, being incredibly cooperative, and trying to stabilize their situation so then they can effectively help others. That is why I'm optimistic we'll work through this.

> I think you're paying too much attention to Trump and politics. The people actually getting work done are cooperating and moving at a pace that has really never been done.

A pace that is constantly hindered by wrong/misleading statements made by Trump. You cannot pretend he is not actively making their jobs harder and thus putting us all in more danger.

> Although, I would once again offer up to ignore Trump and watch the governors. They have been acting quickly and decisively.

Not all of the governors have and that is in part because they themselves or their constituents will do just about anything Trump says and/or anything to avoid his ire. We still, to this day, have people parroting things from Trump/Fox about how it's just the flu, it's not bad if you are young, vacinee is right around the corner, we already have drugs to fight this, etc. That is because of one man caring more about his reelection/markets than the people of the United States. Period.

His comments have been and continue to be extremely detrimental to fighting COVID-19. Even now, he is more concerned with re-writing history ("I always took this seriously") and downplaying the threat suggesting we don't have to worry because we already have a vaccine in testing (without saying it's ~14mo out) and by talking about the malaria drugs as if they are cures (we still have to test). Look at how they spend insane amounts of time in press briefings: attacking the press, talking about how the markets will boom after this, repeatedly having the POTUS make false/misleading statements that have to be corrected, and having almost every official start by "I'd like to thank Trump for his leadership...".

> Underprepared with respect to supplies is always easy to say in hindsight because now we know the war we are fighting. There is a saying that armies are always tooled to fight the last war. Until you know what the next war will be, it's impossible to fully prepare.

That's just not true though. They knew about this as early as Jan 3rd and waited months before doing anything substantial, they had a team designed to spearhead the fight against a virus like this and they disbanded it, they had a simulation of a virus outbreak just last year and failed spectacularly but decided to make zero changes.

One more thing to leave you with, /yesterday/ he suggested the reuse n95 masks and just clean them with "very good liquids". And 2-3 days ago he gave the /wrong/ set of symptoms for COVID-19. To ignore "Trump/Politics" is pretty naive as it's not like the experts are in control, he is actively making the situation worse.

> I think you're paying too much attention to Trump and politics

not at all. there are plenty of things wrong beyond him, and i have personally been dealing with the outbreak for months. i don't think you or most understand how some of the government's inaction has truly got us to where we are today and has been harmful. everyone complaining about a less than week long "quarantine" hasn't dealt with this for two months. that being said, one can also not ignore trump and the sycophantic government. he is blatantly misleading people and is ridiculing china for no reason. it's childish and petulent and extremely harmful in the long. we have a senator that says "gag and vote for it anyway" to provide support for people. that tells you the sentiment. and these are things they say in public! it amounts to treason in my book. you cannot ignore the massive narcissitic nature of our "leaders".

> IMO, that is naive and optimistic.

it was hyperbole, although it does have a ring of truth to it. the point is that our enemy is not complex, and as with most things, the true enemy is ourselves. humans laud ourselves for being above animals and our ability to predict the future. however, we don't. we have very short term views and rarely deal with something unless it is right on our doorstep. i don't care about the reaction afterward. it isn't good enough to be this way.

and the idea is that there are far deeper problems than just dealing with and reacting to viral outbreaks when they happen. a more organized society could start preventing or reducing the frequency of the outbreaks in the first place, although i doubt we ever get there.

this is a good article: http://m.nautil.us/issue/83/intelligence/the-man-who-saw-the...

I've become more pessimistic about the human race to work together to solve problems now. So much jingoism around me, and around in the news. I understand that's not everyone, but to be it seems like it's every country for themselves.

> if everyone on earth just sat still for a couple of weeks, this thing would just vanish.

Actually that in itself would cripple economies, despite being a really good idea (sitting still for a while I mean).

The whole world is operating under an economic paradigm that requires infinite growth forever; the model is decoupled from reality. If we all sat still for a couple weeks, everyone would be better off, but the economy would tank. Better get back to work!

If you are focused on the U.S., then I understand your sentiment. But if you look beyond, it is really promising. Medical science and biology are producing new scientific knowledge about CoViD-19 and SARS-Cov2 at break neck speed. That alone is amazing to see. On the other hand, you really see that people get it and that they have to do social distancing to help them and everybody else. On top of that you see, e.g. China helping European countries in their crisis. That is unprecedented. The outlook for the U.S. might be more grim, at least as seen from Europe. It seems pretty obvious that medicine as a business is not the right setup to tackle a pandemic. Germany moved into that direction into the last 20 years. And everybody is realizing the downsides of that move, now. Although it could be seen for 20 years if you bothered to look. Back to the U.S., I find it deeply worrying that people started to buy guns. Do they believe they could shoot the virus? Or do they expect looting and civil uproar? That would be the worst people could do in such a crisis. I hope it doesn't come to that. And finally, Trump. I think I don't have to write anything about him by now.

I know it’s OT but would love to understand more about the health insurance situation in Germany and what’s happened in the last 20 years. Ideally in English which is a big ask I guess.

Moved to Germany in 2011 and still can’t work out the whole insurance thing (and don’t understand German enough to read and figure those nuances)

To make it short, 20 years ago most hospitals were privatized, before they were run by universities, cities, and states and some other public actors. There were already some private hospitals, but not too much. Since, then most hospitals were sold to companies or in the better case transformed into companies, partly owned by their previous owner. Companies optimize for revenue, so they don't spend money on stocks of masks or reserve capacities that are only needed once in a lifetime. Nevertheless, there are significantly more ICU beds per capita in Germany than in most other european or western countries.

The insurance system is split in two almost separate systems. One for everybody, the public health insurance system, where you can choose and switch between a range of public insurers. You must have health insurance in Germany. E.g. you cannot spend a semester as an exchange student without health insurance. If you earn above a certain amount per year, you are assumed to be able to provide for your own health insurance. You can opt-out of public health insurance and get a private one. They are very competitevly priced for young and healthy individuals. And they usually have way wider coverage. But you cannot go back after a certain age. So it is a risk, and there have been insurers that raised the cost of private insurance for elderly people by multiple hundred percents. On the other hand, the cost of public health insurances depends on your income and not on your health. If you are unemployed and you show that you try to get a job, your public health insurance is free as well. And children are free, if both their parents are in public health insurance. Then, there are private insurance policies that add on top of public health insurance coverage. Most people are in the public health insurance system in Germany.

I have public health insurance, but if you need some better treatment you can always pay for it by yourself. Some minor surgery for 300€ isn’t big deal. Or one can get additional insurance packages to mandatory insurance for all the special needs. My all older colleagues tell me, that private insurance is kind of scam. You pay almost nothing when you are young, but with age it costs more and more. You pay for kids on top and barely get better treatment than regular insured.

An insurance lawyer (friend of mine) also advised me to stay on a public plan and add up private addons where needed - those can be canceled very easily. I’ve not regretted that decision since.

I’d love to talk to you or your friend if you don’t mind. My contact details are on my HN profile.

Probably not better treatment but my private insurance almost always gets me faster appointments. I just mention the magic word and suddenly there’s an available slot next week (otherwise only in a few months). Happened more than once.

My insurance broker said that the price I pay now should cover future payments and increases are only allowed if there are some overall increases to the treatment options. ie new more expensive treatments become available... so cost can increase but within certain boundaries. Was I misguided on that one?

I think the Dutch system gives you the best of both worlds. Everyone is required to have at least basic health insurance. Every year, there's a new definition of what "basic insurance" entails and all insurance providers are required provide a "basic insurance" package at a specific cost. Of course, there are all sorts of addons to increase your coverage.

If you are unemployed or earn below a certain treshold, you get a monthly stipend to pay for basic insurance.

In the end, I can choose where to get my insurance from, but "basic insurance" is the same price everywhere and if I lose my job or I have very little income, I am guarenteed to get that stipend to help pay for it.

Basic insurance is roughly ~100 euros/month.

As others stated, you have the public and the private system. The latter is accessible after you earn above a certain threshold for a certain number of years (no idea about the specifics as I would have been eligible but never bothered to change). You also have niche solutions for certain free professionals (doctors, artists,...).

I would call the system pretty robust, as you cannot be uninsured. From personal experience: Having my kids insured under my name, under my wife's name when I earned less than her, being insured under my wife during a certain time of a sabbatical, insured through unemployment and now as an entrepreneur I never changed insurance provider. Only the status changed.

Interesting detail, even the public health insurance sector is run by commercial insurance companies. The minimum plans are defined by the state. Regardless of how many people are insured under your name, premiums don't change and stay at a certain percentage of your salary. Again, slight differences between providers but usually around 15 or so percent. Currently I pay much less, as there is no revenue yet.

Also nice, premiums don't change with previous sickness and preexisting conditions. Also 6 weeks of paid sick leave per sickness, resets for each sickness after a certain number of months (again, don't ask the exact number).

One important insurance to add is continued salary after the six weeks are over. Costs close to nothing when done early and can save you. Non serious things tend to be over well within 6 weeks. But serious ones can take considerably longer. And the last thing you want is money problems the. I spend 6 months on sick leave once, didn't have to worry about my job nor money. Was a nice thing.

Unemployment in the United States is not like unemployment anywhere else in the world. This situation is exposing all of the gaping holes in the American system.

Mass layoffs already, leading to mass loss of health insurance, and bills for COVID treatment already surfacing in the many thousands of dollars.

If people start to have trouble putting food on the table, shit could get ugly real fast.

Though the employer-tied insurance issue is a problem generally, it’s somewhat less dire for the situation you describe above because of COBRA. (Especially less dire for the first 60 days, because you can retroactively opt-in for some period.)

https://www.healthcare.gov/unemployed/cobra-coverage/

Have you seen COBRA prices? You could easily go from $400/month (group rate + employer subsidized) to $2k+ for a good plan that covers a family.

No.

If I were laid-off, I would receive a maximum of $1600/mo from unemployment in my state for 6 months.

So, the trade-off is either COBRA or mortgage payment.

I doubt the US medical system will get better in the short term.

As someone outside of the US, news about people of the City of Corona queuing to buy guns was quite shocking. Things are difficult everywhere but a rush to buy guns, not least in the most powerful country, is probably one of the most shocking of all the responses I have read and seen so far. I hope none of those guns will need to be used. The virus is already enough of an enemy

Eh calm down people always buy guns and ammo on every crisis that happens, even after every elections. It's nothing new.

Strangely there can be a calming effect, with many people armed. Believe it or not, unscrupulous folk may hesitate to act in times of shortage if their neighbors are armed.

I’d be much more worried they’d be carrying out the looting if layoffs continue with no relief.

Again, that'd be short-lived. Literally.

"It seems pretty obvious that medicine as a business is not the right setup to tackle a pandemic" . . Hospitals have already put a virtual "lock" on the supply chain of chloroquine and hydroxychloroquine to make sure they get the bulk of it and you have to come to them to get the drugs . . they are sharpening their teeth and their billing offices are humming. I bought my chloroquine before all the independent pharmacies got raided, with medicare and suppl. insurance it cost me 70 cents for the entire prescription - - what do you think hospitals will be billing for that same 'script ? From what billing gouging examples that are posted on the 'net likely $700.00

"I find it deeply worrying that people started to buy guns" . . . Look at history, what do you expect when you have 20% or more of the lowest tier of the working population laid off for months or more (60 million people) . . . crime will definitely increase and there won't be adequate police to control it. It could get real bad - - real fast. Only liberal Dems want to take away all our guns and then risk our families to be raped, robbed and plundered . . . buying guns and ammo and 99% a defensive, preparatory, and protective reaction - - not offensive. It is completely within the rights of Americans to protect their families and their property from criminals.

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