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Comment by nickff | Hacker News Reader

If you want an increase in mask supply, you have to either allow the pricing mechanism to do its job, or force people to make masks. Given the (very popular) laws against price gauging, it seems like the only viable option is to force some companies to manufacture more masks. Production capacity is available, but at a higher cost than is currently economical.

All that being said, your second point seems correct to me, and I doubt anything will be done (as a result of the political quagmire).

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> If you want an increase in mask supply, you have to either allow the pricing mechanism to do its job, or force people to make masks.

Those aren't the only options. Some mask manufacturers could scale up manufacturing as long as they had a medium/long term contract to make the investment worth it. The current administration keeps blaming the previous one for drawing down on the federal PPP supply without replenishing it (dubious claim), so there was exactly zero reason for this[1] to happen.

[1] https://www.washingtonpost.com/investigations/in-the-early-d...

> The current administration keeps blaming the previous one for drawing down on the federal PPP supply without replenishing it (dubious claim), so there was exactly zero reason for this[1] to happen.

The claim is "dubious", so (therefore) there was exactly no reason for this to happen?

https://www.merriam-webster.com/dictionary/dubious - "questionable or suspect as to true nature or quality"

https://www.merriam-webster.com/dictionary/exactly - "in a manner or measure or to a degree or number that strictly conforms to a fact or condition"

https://www.politifact.com/factchecks/2020/apr/08/donald-tru...

> One thing the stockpile clearly doesn’t have enough of is face masks. News reports found that the N95 face masks were not substantially replenished after H1N1 in 2009, the first year of the Obama administration. (continues)

https://www.dailywire.com/news/obama-admin-allegedly-deplete...

> “The national stockpile used to be somewhat more robust. In 2006, Congress provided supplemental funds to add 104 million N95 masks and 52 million surgical masks in an effort to prepare for a flu pandemic,” Bloomberg News continued. “But after the H1N1 influenza outbreak in 2009, which triggered a nationwide shortage of masks and caused a 2- to 3-year backlog orders for the N95 variety, the stockpile distributed about three-quarters of its inventory and didn’t build back the supply.”

https://www.npr.org/2020/04/06/828303817/surgical-mask-manuf...

> KELLY: I mean, I have read that since that experience, you have been sounding the alarm. I know you wrote to President Trump. I know you wrote President Obama before him, warning that it wasn't going to be if but when that there would be another...

> BOWEN: I'm not. No. No, no, no. You know, I have been off and on. Of course, I've been selling this message for 14 years, but I'm really not angry. I'm puzzled. And I think what I've been fighting is not the government, not President Obama, not President Trump. I think it's human nature. I think since everybody ignored it - I mean, reporters ignored it. Pandemic experts ignored it. Our government ignored it. Hospitals ignored it. Everybody ignored it. So to me, it's a human nature problem. So I'm over my anger.

https://webcache.googleusercontent.com/search?q=cache:XMOzAY...

> “Prestige Ameritech is presently the lone voice warning of the insecure U.S. mask supply,” Bowen wrote to President Barack Obama in June 2010. “Apathy and inertia are our biggest hurdles.”

(Note that this is from The Washington Post)

I don't disagree that there's no GOOD reason for this to happen, other than the unfortunate reality that human beings are not very good at thinking, at least compared to how well we perceive ourselves to think. As far as I can tell, almost all humans are living in some sort of a severe state of delusion at all times, our minds and societies haven't had nearly enough time to evolve to accommodate the massive increase in complexity in the last few hundred years, let alone the last 20.

The "dubious" claim (I was imprecise and meant to credit it to the president's quote, not the "without replenishing it") was basically affirmed by your Politifact link.

More importantly, the current president didn't spend the first 3 years in office replenishing the stockpile and didn't take an offer from a former mask manufacturer very early in the outbreak to increase the production rate.

[1] https://www.usatoday.com/videos/news/nation/2020/04/02/trump...

> More importantly, the current president didn't spend the first 3 years in office replenishing the stockpile and didn't take an offer from a former mask manufacturer very early in the outbreak to increase the production rate.

Obama behaved no differently.

There's no point in further engaging with you if that's your take on the presidential responses to 2009 H1N1 versus 2020 SARS-CoV-2.

The presidents could not differ more in:

  - lead time between inauguration and first epidemic reaching the USA (6 weeks versus 3 years)
  - seriousness with which the presidential transition team took pandemic response
  - the authority given to pandemic response (Obama made NSC responsible while Trump made HHS responsible)
  - speed and intensity of initial response once the outbreak was identified
  - empowerment medical professionals
  - use of Defense Production Act
  - treatment of WHO, CDC, and FDA as institutions

> There's no point in further engaging with you if that's your take on the presidential responses to 2009 H1N1 versus 2020 SARS-CoV-2.

"the presidential responses to 2009 H1N1 versus 2020 SARS-CoV-2" was not the topic of conversation. The topic of conversation was:

>>> If you want an increase in mask supply, you have to either allow the pricing mechanism to do its job, or force people to make masks.

>> Those aren't the only options. Some mask manufacturers could scale up manufacturing as long as they had a medium/long term contract to make the investment worth it. The current administration keeps blaming the previous one for drawing down on the federal PPP supply without replenishing it (dubious claim), so there was exactly zero reason for this[1] to happen.

>> [1] https://www.washingtonpost.com/investigations/in-the-early-d....

You are now expanding the scope of your original argument. Before we do that, can we finish with your first point?

Did the Obama administration refill the inventory of masks after they were drawn down, or not? My reading of the evidence is that they did not, does your reading leave you with a different conclusion, are you maybe referring to different evidence than what I posted above?

Curious. Is there anything stopping individual states from doing this? Surely a federal system should enable individual states to act independently to some extent. They must have their own budgets and are to determine how resources are allocated. No?

States are resource constrained in ways that the federal government is not. Most, if not all, local governments are required to balance their budgets on an annual basis. Conservative politicians insist on tax cuts during economic boom times that prevent these governments from being able to withstand downturns without dramatic cuts in services (which is the real end goal of the conservatives).

IIRC, states are mandated against running deficits, and their budgets are set 1-2 years in advance (eg, Texas, whose legislature sets the budget every 2 years), which limits their maneuverability in this regard. Also, states don't have the equivalent resources and bargaining power of the federal government.

In many cases states have tried to obtain supplies directly from manufacturers and suppliers only to have the Federal Government step in and prevent them from actually taking possession of the needed materials.

https://nymag.com/intelligencer/2020/04/hospitals-face-a-whi...

https://www.snopes.com/fact-check/trump-admin-seizing-ppe/

There were three major disincentives for states to do this.

First, without a coordinated response there were dozens of high demand buyers and low supply. The market did its thing and State Governments were being forced to pay very high prices for PPE. States were bidding against each other and bidding against the Federal Government, this drove the price even higher.

Second, even when States could secure PPE, the Federal Government was seizing PPE and testing supplies to send it to Coronavirus Taskforce approved vendors who would then sell the seized goods back to the States at inflated prices. This got so bad that Maryland's Governor, after using his South Korean wife's connections to secure testing supplies from South Korea, placed them under the protection of the National Guard to prevent the Federal Government from absconding with them. https://www.wusa9.com/article/news/health/coronavirus/maryla...

Third, the State budgets are shot to hell. When the public health crisis started it was easy to say, let's do what it takes to keep people safe. Now a sizable chunk of the citizenry is refusing to wear masks or social distance, and the State coffers are running empty. State leaders are faced with deciding if they want to use the limited funds left at their disposal to try purchasing PPE in the face of a constituency that is going to spread and worsen the public health crisis regardless. It's lose-lose for the decision makers, so they are disincentivized to follow this path. They can spend the last of the treasury on PPE just to watch it evaporate as cases soar.

That’s the removing price gouging solution, just at the wholesale level. Unless the plan is for the government to tell the manufacturers what kind of pay they should find acceptable.

That's why we have mechanisms like the Defense Production Act. Under normal circumstances the free market works well, but sometimes in a crisis it isn't enough. We are in a crisis.

> seems like the only viable option is to force some companies to manufacture more masks

This doesn't have to be complicated: We can subsidize masks.

The manufacturer prices would be higher, thus triggering price gouging laws.

Price gouging is based on a reasonable price and is subjective. If the present situation results in inflated prices due to lack of materials or needing to run at a higher capacity, that's still reasonable. California, for example, has this written into their penal code, limiting it to a 10% increase in price of the total cost of manufacturing, which includes the increased cost of production, transportation or storage.

If those companies decided that they were going to stop selling their current stock of masks completely until they sold for a higher price, that would be price gouging.

Would you take on the cost and risk of additional machines and employees for an ephemeral market and small margins?

But you wouldn't be taking on that cost and risk. That's the whole point of subsidizing manufacturing. To alleviate said cost and risk in desperate times.

You know, like a global pandemic. That's a pretty desperate time, IMO.

For the public good? Absolutely. Even more so if the government subsidized part of it to help ensure those goods were available to their citizens.

You’re missing a whole world of how governments can get market actors to do things, unless you’re putting “incentives and guarantees” under “force people”. In fact that approach of using market actors to the benefit of the country used to fall under the umbrella of conservatism, in the distant past of 3ish decades ago.

HN really needs to be more aggressively critical of comments like these, that try to construct arguments on ideological foundations without any deeper investigation of the relevant facts.

First, production capacity is not available, as the VP of Prestige Ameritech tried to explain to everyone months ago [1]. The equipment required to manufacture suitable PPE is big and expensive and there isn't enough demand to offset the capital or the maintenance costs for the equipment, except when there's suddenly a pandemic and everyone wants PPE yesterday.

Despite this, Prestige Ameritech -- having foreseen this scenario a long time ago and spent over a decade begging different administrations to prepare for it -- offered to ramp up production early this year. The Trump administration said no [2]. The issue has now been made even worse with everything reopening nationally, which has not only caused a huge spike in hospital demand for PPE, but has also caused a huge spike in demand for masks specifically [same article].

And these are just the immediate, short-term, direct issues that should be easy for outsiders to grasp. There are many other related, harder-to-solve problems:

> The blame, experts agreed, goes beyond any single person or agency but is the culmination of decades of change in the nation’s manufacturing capabilities, a worldwide shift in how goods are delivered and the country’s long battle with medical costs. Warnings about how these factors set the stage for shortages during a worst-case scenario went unheeded, leaving the country unprepared for a pandemic.

> By the time the coronavirus arrived, it was too late. The nation was left with massive shortages and a ruptured supply chain that won’t be an easy fix. [3]

Furthermore, prices did rise dramatically, and -- gasp! -- this did not magically fix the supply chain [4].

Allowing unregulated price gouging would not (and did not) change the supply shortage. It would have just been a pinata party in the shape of the US, and would have left front line medical workers without necessary PPE while wealthy people hoarded supplies.

An effective, less corrupt federal government could have dramatically increased PPE supply just by taking the pandemic seriously at the start and putting competent people with relevant expertise in charge of oversight and response. There still would have been shortages, but they would have been far less severe and they would largely have been resolved by now.

[1]: https://www.npr.org/sections/health-shots/2020/03/05/8113874...

[2]: https://www.vox.com/recode/2020/7/10/21319960/n95-masks-shor...

[3]: https://www.usatoday.com/story/news/2020/07/01/coronavirus-u...

[4]: https://www.washingtonpost.com/outlook/2020/05/21/why-dont-h...

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