[stupac2]

<snip>
We also need to start having a national discussion about who should be given scarce ventilator service and who should be given hospice care because they are likely to die without a ventilator.

With respect, that is exactly what we do NOT need. The body politic is absolutely unable to make such a decision even at the best of times with no time pressure. Worse still, we have proven once again that our population is unable to understand the idea of constraints. Look at the people going to the beach in crowds when they should all know social distancing should preclude this. Most people will decide everybody should have a ventilator, even though that is impossible. Further, the people who have to actually make the decision at the moments of truth can't be bound by a policy that was established by majority votes cast by people who aren't responsible for actually deciding who lives and who dies. Let the doctors and hospitals make their policies. They are the ones who actually know what is going on when and if the decisions have to be made. They have ethics boards and have already considered these difficult problems as part of their professional training. They are also the only ones that can make a reasonable guess at the actual results of their decisions given the conditions on the ground at that time. In point of fact, those are the people who will decide, whatever the population might say.

National discussion pre-empted, per HHS bulletin released today: Federal civil rights office rejects rationing medical care based on disability or age https://www.hhs.gov/sites/default/files/...-28-20.pdf

Well they can reject it all they want, it's supposedly already happening in NYC and will surely happen in many more localities. I don't know what the answer is, but by definition when there's a resource where demand outstrips supply you have to ration it, whether by pricing mechanisms (I think everyone except sophomore libertarians can agree this would be ghoulish) or by prioritizing remaining years of life and odds of making it through (or whatever). I'm a bit terrified of places in the south with large racial disparities, will race end up being a de facto rationing mechanism? The way things sound in Louisiana (and with Mississippi's governor countermanding local SiP orders, there too) we'll start finding out soon...

At this point we're just left hoping that various engineers can come up with solutions, whether Dyson or GM or Ford or the various philanthropic groups forming about this. But I'm very, very afraid that there will be places where even a dramatic increase in supply won't be enough. What happens if 50% of Mississippi catches this by mid-May?

[stupac2]

<snip>
We also need to start having a national discussion about who should be given scarce ventilator service and who should be given hospice care because they are likely to die without a ventilator.

With respect, that is exactly what we do NOT need. The body politic is absolutely unable to make such a decision even at the best of times with no time pressure. Worse still, we have proven once again that our population is unable to understand the idea of constraints. Look at the people going to the beach in crowds when they should all know social distancing should preclude this. Most people will decide everybody should have a ventilator, even though that is impossible. Further, the people who have to actually make the decision at the moments of truth can't be bound by a policy that was established by majority votes cast by people who aren't responsible for actually deciding who lives and who dies. Let the doctors and hospitals make their policies. They are the ones who actually know what is going on when and if the decisions have to be made. They have ethics boards and have already considered these difficult problems as part of their professional training. They are also the only ones that can make a reasonable guess at the actual results of their decisions given the conditions on the ground at that time. In point of fact, those are the people who will decide, whatever the population might say.

National discussion pre-empted, per HHS bulletin released today: Federal civil rights office rejects rationing medical care based on disability or age https://www.hhs.gov/sites/default/files/...-28-20.pdf

Well they can reject it all they want, it's supposedly already happening in NYC and will surely happen in many more localities. I don't know what the answer is, but by definition when there's a resource where demand outstrips supply you have to ration it, whether by pricing mechanisms (I think everyone except sophomore libertarians can agree this would be ghoulish) or by prioritizing remaining years of life and odds of making it through (or whatever). I'm a bit terrified of places in the south with large racial disparities, will race end up being a de facto rationing mechanism? The way things sound in Louisiana (and with Mississippi's governor countermanding local SiP orders, there too) we'll start finding out soon...

At this point we're just left hoping that various engineers can come up with solutions, whether Dyson or GM or Ford or the various philanthropic groups forming about this. But I'm very, very afraid that there will be places where even a dramatic increase in supply won't be enough. What happens if 50% of Mississippi catches this by mid-May?