In Philadelphia, a scandal erupts over vaccination startup led by 22-year-old
npr.org
npr.org
> Doroshin told NBC's "Today" show that his company didn't think like a traditional medical institution. "We're engineers, we're scientists, computer scientists, we're cybersecurity nerds. We think a little differently than people in health care do."
> "We took the entire model and just threw it out the window," Doroshin added. "We said to hell with all of that. We're going to completely build on a new model that is based on a factory."
It’s mind boggling how many times we see this belief that some groups (among many) who are thought to be prone to analytical thinking can solve problems and “throw out” knowledge, learnings, experience and wisdom from core groups who have been in the space for longer. There is a space for disruption, thinking outside the box, etc., in every field, but many a times this seems to be based solely on hubris.
It doesn’t have the same ring as “throwing things out the window” outright, and it’s a lot of extra work. Stopping to see where the old solutions failed, and if they had any merit to begin with? Ugh, out with the old already.
I would argue it probably is necessary to know what the intellectual framework of a field is though
"We took the entire model and just threw it out the window," Doroshin added. "We said to hell with all of that. We're going to completely build on a new model...'
These kinds of statements from founders should always be a red flag. Dig deep, if you hear some variant of domain experts are hidebound and dogmatic. The parable of Chesterton's Fence[1] applies.
[1] https://en.wikipedia.org/wiki/G._K._Chesterton#Chesterton's_...
The issue with tech people is that they are so far outside of the real-world thought process and feelings. Full of grandiose ideas that fall short of delivering on the expectation and PR hype.
The problem isn't with tech people, it's with the sleazeballs using us for cover.
The running joke is that AI actually stands for Anonymous Indian's rather than the tech we wish it to be.
It's PR and investors jumping on the word 'tech'. This is the best example of non-tech getting tech love - https://www.wired.com/story/how-the-trendiest-grilled-cheese... (grilled cheese food truck btw)
A private organisation run by non-doctors and non-nurses allowed to administer vaccines? WTF?
Get rich quick scheme: do what this guy did, scurry away some doses (e.g. if you have no shows), and bring in the millionaires who are willing to pay a lot of money to get their doses.
If you have less of a soul, just inject the normal patients with placebos, and keep more of the vaccines for your paying clients.
I LOL'd in horror at this, wouldn't surprise me if somewhere this has happened.
I don't see at all why that couldn't be unbundled.
(Ok, it's not 100% clear to me that it should, but again, I don't see why it couldn't).
Agreed, in part, but if you only knew what a clusterfuck the underlying system is even with incredibly expensive employer based medical insurance was you'd probably be more open to seeing things like this take palce. And before you start with 'but in my country...' just know I've lived in countries with socialized medicine, where having to wait months for appointments to see a specialist is the norm, years for a surgery is nearly guaranteed and even needing a Dr's RX for aspirin (Germany!) is needed which is equally absurd to me as I got injured and ended up just drinking vodka to endure the pain instead of just having something available that is OTC in most countries.
None of these systems are what I would call 'good,' and are all in need of massive reform. And while this does have a lot of sensationalism behind it that makes it look bad, I say just look at my earlier post and just focus at the results and what comparable rollout efforts look like before condemning them entirely.
The US is an experiment, and one that has been failing most people at large for several decades now because of entrenched bureaucratic power deterring or outright denying these kind of accelerated forms of disruption to their monopolies and business models. I now see COVID as an opportunity as much as I see it as catastrophic shock to the system now.
Poor overgeneralisation.
I’m in Sydney. We have a hybrid system.
- Insurance is generally affordable (I pay $1200AUD, just over $900USD, a YEAR).
- GP visits are free. There are a few privates that might cost $50++ per consult. But a decent GP that works in the public system can be found.
- Specialist visits are subsidised without needing insurance and are similar cost to a GP consult in the US depending on who you see. Wait times can be long, but your GP will know several specialists whom they trust and can give several referrals. I’ve never waited more than 4 weeks.
- Mental health consults are free with a referral. You get Max 12 free a year.
- Specialist procedures can take many months in the public system. True. But they are available for free. And a free system that saves some lives and gives everyone a shot is better than a private only system that just serves the rich.
- Insurance is affordable so you can enter the private system. Some procedures just cost the excess. This is very quick.
- All billable items must be disclosed upfront. There are no surprises.
- Medication is cheaper.
No system is perfect, but ours are vastly more affordable and effective per dollar than the US system. To argue about waiting for specialist procedures when a GP consultation could cost $100USD without insurance (source: last American I spoke to who visited a doctor in the US) is simply ludicrous. Last year I maxed my mental health allowance, had GP appointments at least once a month and did a range of tests. Total cost: $0. Specialists and hospital: $800-900AUD. Meds: $200AUD. It was a bad year for me. Still way less than a year of US insurance.
Agreed, and the Australian system does have a stronger platform to model others off of by the sound of you analysis, but as you said: it too needs reform, and that is extremely needed in the US.
As for your ~$100 estimate, that's really funny try $700 and be on a waiting list(the orthopedic specialist I saw was the head guy for CU Boulder's football team on campus and the Sports Medicine Complex) for months before imaging, most of it was billed to my insurance and I paid $140 on top of a ~$96/week premium for my insurance through my employer and then another $75 for a 'discounted' session of Physical Therapy the same day, and my insurance only covered half the cost of my x-ray images because they deemed more than one an 'elective procedure' even though they were referrals from the ortho to make his concluding assessment on the weakness of my injured side. Which he deemed non-determinable.
They billed me for each and everyone of those images separately but their broken system made it impossible for me to pay for my half of the images, apparently this has its own billing department on campus and seems like it was a 3rd party service, so after several attempts to register via their broken website I gave up and it went into collections as no one ever answered the phone in the billing department at the Medical center on Campus over the Summer when I went.
I ended up just going to a well renown spine specialist in the new year for more images and nerve electrode impulse tests, all for another $250 that ended up with me seeing yet another Ortho specialist (I hope you see where I'm going here with all of this) who recommended me for an MRI due to observable muscular atrophy as a result of possible neural deterioration caused by trauma that I never got in the end as it would be $700 after jumping all the hoops and the insurance finally getting enough paperwork and wasting my time to make it available.
I think you can see why this system bankrupts more people in the US than anything else, so I'm glad a startup is not just talking about about it's grandiose visions and actually took this head on tried to distribute vaccinations during a pandemic. Was it messy, sure, but that's to be expected. They'l learn from this I'm sure.
I really wish them well because if they succeed it could set a much needed precedence for other startups that want to disrupt the medical industrial complex in the US. This is way better than 95% of the BS startups coming out of Silicon Valley with inflated valuations and several rounds of VC funding, and I'm afraid to say includes a lot of YCs alumni.
As for you situation in OZ, all I can say is: got any room for one more? ;)
AlwaysHasBeen.jpg
Thinks SSADM.
"Chesterton's fence is the principle that reforms should not be made until the reasoning behind the existing state of affairs is understood."
Ok great.
"The quotation is from Chesterton's 1929 book, The Thing: Why I am a Catholic"
So, Catholicism?
The big question is how do you implement such a thing? I think the English had the right idea by expelling them though I don't know if such a thing would still work in 2021...
- Very free movement between regions.
- No norm of distrust for strangers. In a traditional society, when someone new shows up, the default is that nobody trusts them to do anything. Any transaction that doesn't settle immediately can't be done, etc. But modern people are supposed to treat strangers as if they didn't just show up because they got ejected from their home. This means exiling people more or less corresponds to screwing over the hapless, trusting society they get exiled to.
There is a solution implemented in the US, the sex offender registry, meant to address this exact problem. ("What if someone enters our community, but they're not trustworthy?") The problem is that the formalization of the sex offender registry (1) is the same everywhere -- not a big problem; the old norm of distrust for strangers doesn't differ in that regard -- and (2) supersedes the old system whereby a stranger could, over time, become trusted. You might personally trust someone who once urinated in public, but he'll never be officially trustworthy no matter what happens.
There are no hapless, trusting societies any longer. The way the criminal justice system works, if we exile these guys running the vaccine scam, the nations we exile them to will immediately deport them back to the US. No one wants the criminals from other nations. So unless your crime is not terribly serious, exile won't work.
It certainly won't work in this instance. This is not some trifling misdemeanor.
We're talking about someone getting kicked out of Phoenix and moving to Austin.
https://www.digitalpanopticon.org/Convicts_and_the_Colonisat...
AstraZeneca is not as their deal with Oxford University is to produce and distribute the vaccine at cost.
Two different approaches.
The EU has just created a huge problem for themselves (which will result in extra people dying) by insisting on paying 2 dollars per dose for the AZ vaccine instead of 3 dollars or whatever. If you do the maths on that, it’s hard to find a rational or humane justification for trying to “save money” this way.
Israel by contrast decided to pay double the list price for their vaccines, and half their population is now vaccinated.
https://www.politico.eu/article/europe-coronavirus-vaccine-s...
Plus, in Israel it's just half of the Israeli population, strange nobody is talking about the Palestinians.
My point being ... They came pretty far for a startup 'led by a 22-yr old' (ageism) and seem to have done a lot of things right, primarily starting planning very early. The city of Philadelphia could have fared worse. Perhaps the suggestion of a pivot in the money grab direction is the worst ethically, but I'd like to see more facts. This is mostly a hit piece. Without financial incentives in play, at least in one country professional bureaucrats have fared lots worse than this startup.
I did notice that NPR did not really tell his side of this tale, but added a few selected quotes that were rather inflammatory in this context.
e.g. "In a press conference at his apartment building Friday, Doroshin called the city's decision to dissolve the partnership "dirty power politics" and alleged it was part of a political conspiracy. He said that if given the chance, he wouldn't have done anything differently.
It's a quote that sounds like he's a bitter, self-absorbed, crazy person. Could indeed be true, but given that the Principle of Charity is not a journalistic practice, we did not learn his argument and cannot judge for ourselves.
Unfortunately, NPR is considered among the best of US news.
What makes that article a "hit piece"?
I'm not confident hospitals are doing much better in getting people vaccinated.
For one, the vaccine requires two doses to achieve anything approaching an acceptable level of immunity. So all those people have effectively not been vaccinated yet, and I'm not confident that the organisation will follow up on all their second doses properly (considering that they're already screwing up appointments for elderly people's first shots).
For another, given everything we know (including outright urging to ignore best medical practices) I wouldn't necessarily take as a given that the shots administered were all done so correctly and safely. I suppose it's a question of the staff's ethics vs the CEO's...everything.
The rest doesn't seem different enough from whats happening everywhere to really warrant Farley’s PR campaign here to prevent his resignation. Everywhere has bungled scheduling errors or vaccines logistics leaving extra thawed vaccines that need to be used that day irregardless of the order.
I was shocked reading this article but stepping back I just cant get behind this, my pitch fork is put away. I bet the CEO wasn't even wrong about the irrelevant best practice that was cited in this article.
Testing is different than vaccinations. The article doesn't distinguish that well except for “ahh theyre a for-profit company now omg oh noes.” A medical company with no actual contract with the municipality making money? How is that even a footnote. Their insurance reimbursal plan had to pivot who gives a fuck.
Like I said its just not different enough. Figure out what their logistical problems are and fix them. The end.
This honestly reads like Farley’s PR agent trying to prevent his forced resignation. My PR agent would typically make articles not seem to be about me by mentioning me/my organizations deep in the listicle or at the end of the article, and we would put a competitor at the top of the listicle to deflect the idea it was advertising to begin with, and then use the coincidence of being mentioned in the same article together to open a dialogue. We didnt actually care about engagement or the clout of being in a particular publication, it was all backdoor ploys. The commonality here is that the city is “competing” with this organization and confusing everyone, within a week of one logistical issue. This reads like that to me.
This isn't worth our attention.
The "irrelevant best practice" of observing a freshly-vaccinated person for half an hour to rule out (or promptly respond to, as the case may be) any immediate and acute reactions to the vaccine? Irrelevant? As in you think that is something healthcare providers should...just not do, as though the human body is a server that can just be restarted if it crashes?
Like I made pretty clear, this article is to save Farley’s political career by denigrating this other founder who isn’t getting a different enough outcome from every other pandemic response organization in every other city. Nobody should care about Philly drama whether it was vaccines or anything else. All of those midatlantic carcasses of a prior civilization are not worth our thoughts for something this petty. They pretty much have to go after character, even the news organization “investigated” and all they found was that the underlying company was... a company. Wow. Let’s reiterate that its a for profit company, the default, just to ruffle the feathers of impressionable people and Europeans.
People are using their heads and finding the perspectives insightful.