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Comment by ttul | Hacker News Reader

It's absolutely insane that PPE isn't something that's being procured on a national level. Why are hospitals and clinicians having to deal individually? If there were a monopsony buyer (i.e. the Feds), suppliers could be bullied into providing reasonable terms.

Well, I suppose the real answer is: Because that's not how healthcare works in America...

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Anyhow, in Canada, the federal government has created its own global supply chain to produce and distribute PPE as needed within the country, hiring two international firms to store and verify equipment sourced from China. Meanwhile, national air carriers are re-fitting their unused jets to carry PPE and the feds are happily paying them to fly them.

"The ministry of procurement has signed a deal with two international firms to temporarily store and verify equipment in China – awaiting Canadian jetliners to safely retrieve the materials and return home.

Bollore Logistics – of France-based Bollore Group, a multi-national transport and logistics firm – is providing storage and transportation services within China, as well as preliminary testing capabilities."

This is the sort of war-time posture that every country needs to take. It's sad to see the lack of federal government leadership in the US leading to hospital staff becoming PPE supply chain experts. What a horrible waste of their talents.

https://www.ctvnews.ca/politics/canada-establishes-its-own-p...

Would you even trust the current administration to not interfere and distribute with partisanship in mind? On the remote chance they chose anyone competent to manage it.

I sure as hell don't, we have our head of state literally saying governors need to be nice to him to get their states federal help and stirring up in-person quarantine protests against governors from the opposite party. Unfortunately in this vacuum of leadership states are all we have. I am glad the north east and west coast seem to be starting to coordinate on a larger level.

I'm going to repeat your question: why isn't ppe being procured on a national level, and instead why is dhs seizing supplies, and why is not a war supplies act being declared when the national government is clearly needing them and not able to procure them.

It is insane on multiple levels.

Is a war supplies act different from the Defense Production Act that has been invoked?

The coronavirus task force has talked somewhat candidly about why the centralized monopsony buyer has been a problem. Because everyone is lying. A hospital might really need 100k masks, but they ask for 500k because they're afraid there won't be any more in the future. NYC demanded 40k ventilators, but it turns out they needed I think less than 10k. Multiply this by every hospital in every municipality across the country. There's no way a hand full of bureaucrats in Washington could make sense of that in reasonable time. I understand why pricing feels cruel, but it's a better system at more efficiently allocating resources. Anyone with some money can allocate some masks to a place with need that's in their line of sight. This provides much better coverage than the central planning models of: price controls, purchase limits, and confiscation/redistribution.

That creates a single point of failure. You then have to trust that federal bureaucracy will do a better job than everyone scrambling.

In perfect conditions, it's likely true. But in actuality, I doubt it's better.

I doubt federal purchasing agents would be doing deals with local painting crews who have 2-3 boxes on N95 masks in the back of their truck.

Same reason we do not have (health) records in the same place in a common format that would allows us to intelligently coordinate moving what supplies we do have around in a proactive fashion.

We do not have a national health care system.

We already have the ability to measure COVID status because diagnostic labs are required to report the presence of certain things to CDC in real time upon positive test result. COVID-19 is almost certainly one. Further, countries like Britain tried what you are describing and the process was a total shit show ultimately leading to failure.

What makes flawless real-time communication hard is that you're talking about integrating thousands and thousands of groups of various sizes, with various technical capabilities and budgets, with various requirements, and with various legacy systems in place. You have multiple stakeholders who all want something different out of the project. You have very real security, availability, privacy, and fraud concerns. Oh and did I mention the government would really rather not pay for it?

Just creating a practical UUID for every citizen in the US is unprecedented, let alone associating all existing historical data for one person from all over the country / world with that handle, parsing that data into a standard format, and creating a system where that record could be updated in real time in a secure manner. Unsurprisingly, it's a monumental undertaking.

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