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The U.S. tried to build a new fleet of ventilators

nytimes.com

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Re: The U.S. tried to build a new fleet of ventilators

#21

Post by pdonis »

fyfy18 wrote: post #11
pdonis wrote: post #4

Earlier quoted context omitted.

> Governments are so utterly broken and inefficient that they can’t do it. Exactly. Which means we should not be depending on governments to do it. This is exactly the sort of thing that private startup companies should be doing, without trying to involve the government's bloated and inefficient bureaucracy. > even if they produced a design now we have supply chain problems globally For this particular crisis, yes. B…

Wait... isn't that exactly what the article says they tried to do?

The government tried, but then canceled the contract at the request of the big company that had bought out the small company they originally had the contract with.

Re: The U.S. tried to build a new fleet of ventilators

#22

Post by pdonis »

onetimemanytime wrote: post #15
pdonis wrote: post #4

Earlier quoted context omitted.

> Governments are so utterly broken and inefficient that they can’t do it. Exactly. Which means we should not be depending on governments to do it. This is exactly the sort of thing that private startup companies should be doing, without trying to involve the government's bloated and inefficient bureaucracy. > even if they produced a design now we have supply chain problems globally For this particular crisis, yes. B…

Why should hospital X buy 100 ventilators...just in case, unless the gov made them do it?

> Why should hospital X buy 100 ventilators...just in case

Well, of course. That's what we're talking about, right? Somebody has to do the long-term planning for emergencies like this one.

I understand that most of us thought it was the government's job to do this long-term planning so individual facilities wouldn't have to, but this article shows that the government failed at that job. Unless we have some reason to think the government wouldn't fail next time, it seems like the only alternative is for private entities to do it.

Re: The U.S. tried to build a new fleet of ventilators

#23

Post by Nambia »

toomuchtodo wrote: post #9
lukevp wrote: post #7

what is so complicated about ventilators? Serious question as I don’t know enough about this. I see a lot of DIY posts that are probably not 100% the same thing but are they even close? This opens up a bigger question too, is there such a thing as a path for open source medical devices to be built and certified and deployed? Is there a company that supports something like this? I follow Scott hanselman, a Microsoft e…

There is a narrow range of pressure where you're not damaging the alveoli from underpressure, but not bursting the lungs from overpressure. You need a mechanical scalpel, not a butcher's knife.

Honest question: is the pressure range actually that narrow?

People can survive at high altitudes, which will see pressure of 70% sea level (or less, especially when considering mountain climbing). Additionally, when SCUBA diving, something like 30 feet of depth = 1 atmosphere.

I feel like I'm missing something here. Any ideas?

Re: The U.S. tried to build a new fleet of ventilators

#24

Post by blunte »

appleshore wrote: post #20

I always criticized the idea that “radical technology could exist but the competition buys it up” as a naive conspiracy theory. It’s pretty remarkable that the government paid for this but somehow the international medical corporation can swoop in, buy the competitor who is threatening their margins, and void the contract.

> somehow the international medical corporation can swoop in, buy the competitor who is threatening their margins

Perfectly normal and common in the US low-regulation economic system.

> and void the contract

Most likely the government officials with the ability to allow this cancelation were bribed, or rather lobbied, to allow it.

Re: The U.S. tried to build a new fleet of ventilators

#25

Post by gregoriol »

lukevp wrote: post #7

what is so complicated about ventilators? Serious question as I don’t know enough about this. I see a lot of DIY posts that are probably not 100% the same thing but are they even close? This opens up a bigger question too, is there such a thing as a path for open source medical devices to be built and certified and deployed? Is there a company that supports something like this? I follow Scott hanselman, a Microsoft e…

Here is an interesting read on the subject: https://hackaday.com/2020/03/25/ventilators-101-what-they-do...

Re: The U.S. tried to build a new fleet of ventilators

#26

Post by worik »

pdonis wrote: post #4
m0xte wrote: post #2

I’ve always said that governments should use our tax money to design and validate key health and infrastructure components and only outsource manufacturing and only to local businesses. Governments are so utterly broken and inefficient that they can’t do it. However even if they produced a design now we have supply chain problems globally. Edit: I seem to have stirred up capitalist defence here. To clarify: The gover…

> Governments are so utterly broken and inefficient that they can’t do it. Exactly. Which means we should not be depending on governments to do it. This is exactly the sort of thing that private startup companies should be doing, without trying to involve the government's bloated and inefficient bureaucracy. > even if they produced a design now we have supply chain problems globally For this particular crisis, yes. B…

I completely disagree.

If the government had done it in house they could have succeeded.

The problem here was the profit motive. Cheep ventilators endanger profits.

It is a side effect of free markets (I like free markets) that big firms get bigger, get more market power, kill off competition then price gouge. Health is a bad bad place to have free markets as the incentives are almost all wrong (exceptions: E.g. running clinics as a service for state run health systems turns out to work well here in Aotearoa - but even that is under pressure from consolidation)

Nationalise the whole ball of wax. Use waiting lists not wealth to ration access. FFS the richest country in the world is heading to a health catastrophe. What a bunch of idiots!

Re: The U.S. tried to build a new fleet of ventilators

#27

Post by neffy »

pdonis wrote: post #21
fyfy18 wrote: post #11

Earlier quoted context omitted.

Wait... isn't that exactly what the article says they tried to do?

The government tried, but then canceled the contract at the request of the big company that had bought out the small company they originally had the contract with.

Exactly. The issue in some sense isn't government, it's the corruption of government by corporations that have been allowed to become to big and to powerful, to the extent that the US Government itself has been deliberately defunded. (Sure, I know Government spending grows every year, but so does the money supply and corporate profits. Control for monetary expansion, and the US Government's portion of the economy has been steadily shrinking.)

Re: The U.S. tried to build a new fleet of ventilators

#28

Post by mistermann »

appleshore wrote: post #20

I always criticized the idea that “radical technology could exist but the competition buys it up” as a naive conspiracy theory. It’s pretty remarkable that the government paid for this but somehow the international medical corporation can swoop in, buy the competitor who is threatening their margins, and void the contract.

We believe many things to be true, that are not true. And not only do we believe them, we passionately defend them!

I don't think many of us would recommend writing software on top of such uncertainty, yet we seem to think it's possible to do so with a society and economic system. Then we're surprised when it blows up in our faces every decade or so.

The surprised Pikachu meme seems fitting.

EDIT: To those who disagree, I'm rather curious to know the specifics of why you disagree. Do you actually believe that humanity, and each individual in it, has evolved to the point of something resembling omniscience? Perhaps we don't know everything, but that the subset of everything that we do "know", is absolutely perfect, not the slightest imperfection, however small?

Have our various societies and financial systems evolved to the point of near perfection?

And if it isn't that, then is it something else I'm off on? Just trying to get a better understanding of what the situation is here.

Re: The U.S. tried to build a new fleet of ventilators

#29

Post by worik »

blunte wrote: post #10
m0xte wrote: post #2

I’ve always said that governments should use our tax money to design and validate key health and infrastructure components and only outsource manufacturing and only to local businesses. Governments are so utterly broken and inefficient that they can’t do it. However even if they produced a design now we have supply chain problems globally. Edit: I seem to have stirred up capitalist defence here. To clarify: The gover…

This story, if accurate, is simply an illustration of how low-regulation capitalism works. "Working as intended." Profit is the only motive, and thus as long as the company/investors profit, then it is a success. The fact that national or global human well-being suffered is irrelevant (so long as we accept that capitalism (as currently implemented) is the right way). Now, there's a strong likelihood that the governme…

The USA has the worst government that money can buy

Re: The U.S. tried to build a new fleet of ventilators

#30

Post by oefrha »

I find it strange that all we hear about these days is the shortage of ventilators (okay, PPE too), as if it’s the only bottleneck. The reality is ventilators are useless without intensivists to operate them, and you need anesthesiologists and probably other skilled personnel too.

I learned through a personal connection who was actually on the ground in Hubei (but not Wuhan) caring for serious but non-ICU patients that doctors and nurses in their ward outnumbered patients, and they were at capacity. The staff-to-patient ratio should be higher in the ICU. With an overwhelming number of patients you simply can’t care for them, whether you have the machines or not.

It’s relatively easy to ramp up production of machines. It’s much harder to ramp up production of medical professionals.

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