The Vaccine Had to Be Used. He Used It. He Was Fired • Hacker News Board

Re: The Vaccine Had to Be Used. He Used It. He Was Fired

#291

Post by Wowfunhappy » Thu, Feb 11, 2021, 6:52 PM UTC

zamadatix wrote: post #269

Wowfunhappy wrote: post #176

Earlier quoted context omitted.

> A doctor driving around vaccinating whoever he can find at their house is clearly not how you want to distribute the vaccine in early December, it's not going to get to the most at risk people as soon as it can and any issues that arise are a huge liability problem unless he can fix it with what's in his car. No, but it is absolutely what I would want any doctor to do if the alternative was throwing away COVID vacc…

Not wasting a dose doesn't necessarily imply driving around and sticking the first person that says yes at the spot they happen to be though. e.g. standard policy could be to not open the next batch of 10 until certain conditions are met, call people on tomorrows list until you get 9 that can show up in the next 6 hours, or any other planned action. These are superior options because: 1) everything still happens in a…

I don't necessarily disagree with any of that, but I think it's a delicate balance.

If two people cancel one morning because, I don't know, a storm knocked down a bunch of trees in their area, and you've tried your future appointments list, do you now have to phone the other six patients and ask them to reschedule too? Or do you have a nurse go out and find two people off the street who want a COVID vaccine, and bring them to the office asap? Remember that the vaccines have a limited shelf-life even in the freezer, and that the ultimate goal is to get shots into arms as quickly as possible.

You can optimize for speed, or you can optimize for equity. I don't think we should throw out equity, but we should lean towards speed.

Re: The Vaccine Had to Be Used. He Used It. He Was Fired

#292

Post by robin21 » Thu, Feb 11, 2021, 6:56 PM UTC

nickpp wrote: post #273

upbeat_general wrote: post #259

Earlier quoted context omitted.

So just to be clear you’re suggesting that we should determine access to the vaccine based on how much money you have? This is ludicrous. The “free market” isn’t for everything. The US is going to get enough shots in part because the companies are US companies.

> you’re suggesting that we should determine access to the vaccine based on how much money you have? No, I'm suggesting people should get the vaccine based on how much money they are willing to spend on it. Just like everything else. This would in effect reduce demand (most people would decide a mask is enough protection or to simply wait) and make sure that only people needing the vaccine (or their sponsors) would s…

My first reaction was "this can't possible work", but it's interesting to think about.

I wonder how the market would price it.

If there was a "vaccination passport" in operation to let those vaccinated travel freely, I would be happy to pay up to 1/2K to jump-the-queue. It's a minor premium on the expense of an overseas summer vacation.

Would also be happy if part of the fee included a subsidy for low-income.

However, morally, I would prefer to wait for first-line responders and elderly at-risk to be prioritized with first doses. Which kind of leads us back to where we started with government prioritization.

Would be interesting to see how an SV startup revenue team would price it with their huge data points on pricing models. Worth an A/B test perhaps.

Re: The Vaccine Had to Be Used. He Used It. He Was Fired

#293

Post by thomastjeffery » Thu, Feb 11, 2021, 6:58 PM UTC

mgbennet wrote: post #272

lostcolony wrote: post #237

Earlier quoted context omitted.

Yeah. It's super easy to fix, if people wanted to fix it. Even with welfare, you just make it so every after tax dollar earned reduces the welfare check by 50 cents. Tada, incentive to work, and only when you're making double what welfare pays out do you stop receiving assistance. People may still 'take advantage' of it, by choosing not to work (if we got rid of all the systems requiring proof they're trying to find…

I don't know if the drop off of assistance can really work that well. Say UBI is 10000 fun-bucks. A person gets a crappy job that pays 5000 fun-bucks. Their total income is now 5000+(10000-5000*.5)=12500. By getting a job and working, they've only improved their situation by 2500. Any dollar they earn above the UBI is taxed at 50%, until they've "made it" to double UBI. This amounts to taxing the poor instead of the…

When someone has enough to meet their basic needs, $2,500 can go a long way.

Over the last year, Americans have gotten about that much in "stimulus", but many of us had to spend it all on rent and other bills.

Re: The Vaccine Had to Be Used. He Used It. He Was Fired

#294

Post by kbelder » Thu, Feb 11, 2021, 7:00 PM UTC

mgbennet wrote: post #272

lostcolony wrote: post #237

Earlier quoted context omitted.

Yeah. It's super easy to fix, if people wanted to fix it. Even with welfare, you just make it so every after tax dollar earned reduces the welfare check by 50 cents. Tada, incentive to work, and only when you're making double what welfare pays out do you stop receiving assistance. People may still 'take advantage' of it, by choosing not to work (if we got rid of all the systems requiring proof they're trying to find…

I don't know if the drop off of assistance can really work that well. Say UBI is 10000 fun-bucks. A person gets a crappy job that pays 5000 fun-bucks. Their total income is now 5000+(10000-5000*.5)=12500. By getting a job and working, they've only improved their situation by 2500. Any dollar they earn above the UBI is taxed at 50%, until they've "made it" to double UBI. This amounts to taxing the poor instead of the…

It also breaks down when there are multiple overlapping programs, as there are now. Maybe each program drops $0.25 for every dollar earned... but if you are on four or more means-tested programs, that's completely removed the benefit.

Similar are the many programs that have cutoff at, say, 150% poverty level. Individually not a big deal, but when you lose a multitude of different benefits going from 25k to 35k income, it can be a perverse incentive.

Re: The Vaccine Had to Be Used. He Used It. He Was Fired

#295

Post by rayiner » Thu, Feb 11, 2021, 7:02 PM UTC

floatingatoll wrote: post #231

BowBun wrote: post #203

Earlier quoted context omitted.

I'm generally for social welfare programs, however the idea of "welfare queens (and kings)" is NOT fiction. I come from Belgium which has this problem quite notoriously. It is quite common for people to be abusing the social programs to stay unemployed and make more income than blue-collar workers. Like you allude to, I think we need to look more deeply to address this issue - why are people satisfied doing nothing a…

I would think that given what we’ve done here in the US to the past forty years of workers, they’ve earned a decade off to live on UBI and heal from burnout and develop interests of any sort in anything at all again, before we could even begin to productively analyze their reactions to UBI. They’ve been traumatized and it will take time to heal and I certainly hope that we implement UBI and let them do so. We can aff…

But people mostly don’t do stuff like actively edit Wikipedia.

I’m a big fan of having a robust social welfare system, but we need to acknowledge realities that maybe we don’t prefer to acknowledge. Many people on welfare are idle don’t do anything meaningful with their time. The response to that isn’t necessarily to cut welfare. It could mean taking a bigger picture look at society to see how changes have affected peoples’ abilities to have meaningful lives and civic engagement without work.

Re: The Vaccine Had to Be Used. He Used It. He Was Fired

#296

Post by acover » Thu, Feb 11, 2021, 7:08 PM UTC

nickpp wrote: post #290

acover wrote: post #281

Earlier quoted context omitted.

The supply constraints for the vaccine are short term. > Canada is burning billions because it has decided to prioritize COVID protection above everything else in life. It was clear from the beginning that lockdowns were a bad idea because they weren’t feasible in the long term. Alas, this is the path most of the world's government chose. We'll be paying the price for years to come... How does this relate to money be…

Do not underestimate the power of human creativity and antreprenorial spirit when correctly motivated. The ability to sell this vaccine at obscene profits would've been extremely motivating. Now I am not in pharma I don't know how exactly the extra money would've helped, but I know that in pretty much any business more money help with new hires and better people, new machines for production lines, more wild ideas bei…

> only people that really need it would get it

I think this is where we disagree. If wealth was equally distributed I would agree but wealth follows a power law distribution. People with a 1000x less money than me but with 100x more risk should get the vaccine before me.

Do you know of the mythical man month problem? It seems to apply here.

https://en.wikipedia.org/wiki/The_Mythical_Man-Month

Re: The Vaccine Had to Be Used. He Used It. He Was Fired

#297

Post by defen » Thu, Feb 11, 2021, 7:18 PM UTC

topspin wrote: post #280

wycy wrote: post #239

Earlier quoted context omitted.

I guess this is just a point upon which we disagree. I'd rather any given dose make it into the arm of a some rich asshat than go down the drain.

Please consider that such views complicate efforts to deliver justice. Recognizing inequities and the potential for inequities before they emerge is crucial to achieving equity and justice.

This is like the trolley problem, but even dumber. You have a trolley headed for a bunch of people. You can throw a switch to take some people out of the path of the trolley, or do nothing. You are suggesting that doing nothing is better, because that way there won't be "equity" disparities in trolley victims.

Re: The Vaccine Had to Be Used. He Used It. He Was Fired

#298

Post by alasdair_ » Thu, Feb 11, 2021, 7:22 PM UTC

mc32 wrote: post #109

alasdair_ wrote: post #91

Earlier quoted context omitted.

Universal basic income.

Negative taxes are better. No need to give to the wealthy in the first place to come back and tax them later.

>Negative taxes are better. No need to give to the wealthy in the first place to come back and tax them later.

It's simpler just to give every citizen the same amount of money than to have to deal with all the edge cases of people having different income this year (and needing the money immediately) versus last year. If you get hit by a bus on January 1st, I'd hope that the money was available for you right away, not in another year.

Additionally, I'd like to see a "rolling average" approach to taxation. I think it's enormously unfair that someone who has a one time event (like making a million dollar commission on a sale they worked on for five years) is taxed massively more, and misses out on many more tax credits, than someone who makes $200K a year for five years.

Re: The Vaccine Had to Be Used. He Used It. He Was Fired

#299

Post by LorenPechtel » Thu, Feb 11, 2021, 7:23 PM UTC

In the general case actions such as these are quite rightly prohibited--it's so easy to engage in self-dealing behavior. The best solution would be a waiting list of people to be notified. However, this was the initial rollout, glitches are to be *expected*. He found one and scrambled to do the best he could with the situation. There was no right answer, he picked the least wrong one.

We have seen other places where the rules were followed and doses thrown away. As far as I'm concerned any bureaucrat who ordered that should be thrown in the same dumpster.

Re: The Vaccine Had to Be Used. He Used It. He Was Fired

#300

Post by Grustaf » Thu, Feb 11, 2021, 7:24 PM UTC

valarauko wrote: post #224

Grustaf wrote: post #122

Earlier quoted context omitted.

Obviously the best alternative is to make sure to vaccinate an even multiple of 10 people before you close. So if you're about to close, just finished a vial and a single person shows up, then don't open a new vial and put yourself in the position where you have to run around and find patients.

That's how the appointments are given out, but not everybody shows up. For my second shot, I drove out 30 miles in a snowstorm, and waited two hours in line. Other people probably waited longer. Should the last couple of people be turned away after waiting 2 hours because there aren't neat multiples of 10 at closing time? Your solution, while reasonable, optimizes vaccinate utilization but at incredible cost to an un…

For me the main point is really to avoid moral hazard, not saving those 9 doses. It would be worth wasting a few doses here and there if it greatly decreases the level of corruption in the system.

But if people waiting for 2 hours is common, then turning away the last ones doesn’t seem like a good solution. If they really wanted to they could of course come up with an efficient, low corruption system but they don’t seem terribly organized in the first place.