This is Naked Capitalism fundraising week. 1536 donors have already invested in our efforts to combat corruption and predatory conduct, particularly in the financial realm. Please join us and participate via our donation page, which shows how to give via check, credit card, debit card, or PayPal. Read about why we’re doing this fundraiser, what we’ve accomplished in the last year, and our current goal, more original reporting.
By Jerri-Lynn Scofield, who has worked as a securities lawyer and a derivatives trader. She is currently writing a book about textile artisans.
One thing I promised in my recent fundraising post is to inform the Naked Capitalism readership of facts about countries that are successfully managing the COVID-19 pandemic.
I’m looking at countries based on the number of deaths recorded – from 105 in Hong Kong for a population of 7 million; to 35 in Vietnam for its population of 100 million; to 7 in Taiwan for a population of 24 million; to 25 in New Zealand for a population of 5 million.
I am focusing on death counts rather than cases. Why? Governments are following different rules for reporting their COVID -19 cases, including only reporting symptomatic cases. Now, we know most – if not all- governments have a propensity to lie. This includes about reporting the number of Covid-19 deaths downwards as well.
But in the era of social media, it is much more difficult to manipulate death figures. Not impossible but difficult. So I am paying attention to those, as I think they are more or less accurate – although I wouldn’t hazard any guesses as to the margin of error. I am glad I am neither an epidemiologist, nor a medical doctor, nor a public health expert charged with holding a hard and fast point of view on such questions.
Now, a major right-wing talking point is that the U.S. overstates its COVID-19 deaths. I think this argument has receded as the pandemic has worsened, but not entirely. And maybe one positive consequence of the unfortunate diagnoses of the Trumps and leading Republicans as the latest victims of the disease will be the abandonment of this point.
I think it not very likely, but we can hope. As we can hope that the U.S. will finally get the mask religion that links the successful COVID-19 policies of several countries. So, please read to the end of this post for my debunking of this point about overstate U.S. death statistics. I have yet to share this with someone who’s raised the argument with me. Yet I encourage you to discuss it in comments, as well as share it if you are also subject to right-wing propaganda from people who don’t realize they are actually spreading a right-wing meme.
Hong Kong. Regular readers know I have written extensively about Hong Kong’s success, in several posts, relaying on the expertise of my Oxford friend, Canadian medical doctor Sarah Borwein, who currently practices in Hong Kong and is a veteran of the SARS crisis from her timepracticing in Beijing. I’m not going to repeat points I made in those previous posts, except to say early and comprehensive mask wearing; excellent widespread access to good, affordable medical care; and comprehensive contact tracing were all part of the mix. Interested readers can click on links to previous posts, which discuss these points at length (and there are there, but I didn’t want to overwhelm readers; if you are interested, use the Naked Capitalism search function.)
One point I have not emphasised before: Hong Kong has never had to lock down completely, but it has more or less sealed its borders. Even Hong Kong residents have faced barriers to their return, and when they did make it home, they were immediately tested. If necessary, they were subject to a quarantine.
Even essential workers who left and reentered the territory faced quarantine provisions. Sarah’s new husband is a Cathay Pacific cargo pilot, and he faced restrictions upon returning home.
Vietnam. For months, this country of 100 million people, reported no COVID-19 deaths, until it was hit with a second wave. Despite being a relatively poor country, Vietnam has benefitted from a well-developed public health system, combined with tight border controls, its testing policy, extensive contact tracing, and its quarantine policy.
The country has made extensive investments in public health, and these have paid off in the COVID-19 crisis. According to Emerging COVID-19 success story: Vietnam’s commitment to containment:
Vietnam has invested heavily in its health care system, with public health expenditures per capita increasing an average rate of 9.0 percent per year between 2000 and 2016. These investments have paid off with rapidly improving health indicators. Between 1990 and 2015, life expectancy rose from 71 years to 75 years, the infant mortality rate fell from 36.9 deaths per 1,000 live births in 1990 to 16.5 deaths in 2018, and the maternal mortality ratio plummeted from 139 deaths per 100,000 live births to 54 deaths. The 2018 immunization rate for measles in children ages 12 to 23 months is over 97 percent [citattions omitted].
In addition, the country learned from its recent exposure to SARS:
Vietnam has a history of successfully managing pandemics: it was the first country recognized by the World Health Organization (WHO) to be SARS-free in 2003, and many interventions Vietnam pioneered during the SARS epidemic are being used to respond to COVID-19. Similarly, its experience with epidemic preparedness and response measures may have led to greater willingness among people in the country to comply with a central public health response. In fact, a survey conducted in late March by a public opinion research firm found that 62 percent of people in Vietnam believed the level of government response was the “right amount,” ranking higher than any of the other 45 countries surveyed.
Now, the strong role of the state in Vietnam means that it has faced little opposition from its people to its COVID-19 policies, and perhaps its model for virus control can not be replicated elsewhere – or so many have claimed. I admit I have thought less about the Vietnam example than the others I am offering today. This may be because there is comparatively less information available in English, or at least I have found so far.So these thoughts are preliminary and may be modified in future. But it is worth mentioning the country’s success – as elements of it – strong public health system, tightened border controls, extensive testing, thorough contact tracing, and quarantine for the known or presumed sick – have been practiced elsewhere and also yielded impressive results.
Taiwan. The Taiwan Ministry of Foreign Affairs has prepared extensive domentattion outlining the reasons for Taiwan’s success in battling COVID-19, The Taiwan Model for Combating COVID-19:
When a SARS-like virus, later named as coronavirus disease 2019 (COVID-19), first appeared in China in late 2019, it was predicted that, other than China, Taiwan would be one of the most affected countries, given its geographic proximity to and close people-to-people exchanges with China. Yet even as the disease continues to spread around the globe, Taiwan has been able to contain the pandemic and minimize its impact on people’s daily lives. The transparency and honesty with which Taiwan has implemented prevention measures is a democratic model of excellence in fighting disease. This webpage shares the Taiwan Model for combating the pandemic, as well as links to related international media coverage and video clips. The materials found here also help explain the different aspects of Taiwan’s epidemic prevention work, and how Taiwan is helping the international community.
Once again, well-known public health measures — rapid and ample testing, extensive quarantines- combined with a healthy dose of transparency about policy, and some reliance on technology, have led to Taiwan’s success so far. It has entered a second wave, but since it starts from such a low baseline, an uptick in infections is manageable.
The country rigorously controlled its borders, according to the Toronto Star, Quarantine and COVID testing are key to Taiwan’s border reopening:
Constantly tightening and relaxing the leash of a quarantine according to changing risk factors — and testing — are key in pandemic travel restrictions for Taiwan in its effort to strike a balance between economic interests and the need to protect its border from the threats of a global pandemic.
As of Monday, Taiwan recorded a total of just 509 confirmed cases — with seven deaths.
“Quarantine of arrivals is a major strategy for handling cross-border transmission,” said Chen Shih-chung, Taiwan’s Health and Welfare Minister and head of its Central Epidemic Command Center. “Strict border-control measures will remain in place for the foreseeable future.”
Since March 19, all inbound travellers to the island — citizens or not — must undergo a two-week mandatory quarantine.
Visitors can only board an inbound flight if they can provide negative COVID test results from within three days before boarding. Taiwanese nationals, temporary residents, migrant workers, international students and diplomats are exempted.
Notice the emphasis on low-tech measures. according to The World, How Taiwan is battling coronavirus with tech, crowdsourced data and trust:
Well, the most important technology is soap and alcohol hand sanitizers. But in Taiwan, we see democracy itself as a technology. And the counter-pandemic effort is mostly about getting people understanding the science and the epidemiology so that people can innovate and wash their hands more vigorously, wear a mask to remind oneself to keep their unwashed hands away from their faces, and making sure that each pharmacy has sufficient supply. And of course, there’s also the border quarantine.
I only have space to quote part of the interview with digital minister Audrey Tang, but I encourage readers to click on the link and read the entire thing; it’s well worth it. Here she discusses the all-important border quarantine:
Yes. Anyone returning to Taiwan has two choices. Either they go to a quarantine hotel for 14 days, in which case they’re physically barred from leaving; or, if they live in a place with their own bathroom and with no vulnerable group of people, they can also choose to digitally quarantine, placing their phone into the digital fence. In that case, the nearby cellphone tower will measure the signal strength, as they always do, and send out an SMS whenever the phone runs out of battery or breaks out of the 50-meter or so radius. So, the idea is that during those 14 days, we pay each person in quarantine about $33 a day as a stipend. But if they break out of the quarantine, then they pay us back a thousand times that. So, very few people break the quarantine.
And also access to mask. In Taiwan, a citizen helped democratise access to masks. Compare that to popular agitation about the the mask situation in the U.S. or the UK or even Germany:
There was a person named Howard Wu in Tainan city who developed a map so that people could see the nearby places and exactly how many masks there are in stock. So, we very quickly supplied them, every 30 seconds, the real-time mask levels of all the pharmacies, and later on convenience stores, so that people who queue in line can keep this system accountable.
And unlike most of the rest of the world, Taiwan has reaped an economic benefit from the COVID-19 pandemic, affording to Quartz, The pandemic barely dented Taiwan’s economy:
While most of the global economy is still reeling, damage to the hospitality and tourism sectors in parts of Asia has been offset by swelling demand for technology goods, according to economic researchers at JPMorgan. That surge is particularly powerful in Taiwan, where manufacturing production is almost a mirror image of the US.
The country’s economy is benefiting from the demand for technology that powers 5G servers and artificial intelligence, and it’s been turbocharged by home-schooling and work-from-home trends around the world. Taiwan’s GDP will grow 1% this year, according to JPMorgan, one of the very few economies that’s expected to expand. The US and German economies are forecast to shrink more than 4%, while those of France and the UK may contract more than 8%.
“Taiwan stands out for its scant evidence that a global pandemic has even occurred,” JPMorgan’s economists wrote.
New Zealand. One major advantage NZ has it’s at the end of the earth and shares no land borders with other counties. So it was able to quickly isolate itself. Its cases have come from overseas. The Ministry of Health (MoH) has an aggressive contact tracing program, for two types of contacts: close contacts and casual contacts. According to the Ministry of Health’s online circular, Contact tracing for COVID-19:
If you have been identified as a close contact of someone with COVID-19, you can expect to be contacted by the Ministry of Health or your local district health board’s public health unit (PHU).
We call this ‘contact tracing’. Contact tracing involves a phone call from the Ministry or PHU providing you with advice on self-isolation and checking on your health and wellbeing. The Ministry call centre staff will identify themselves and inform you that they are calling from the National Close Contact Service. They will also verify your name and contact details. These calls from Ministry call centre staff will usually come from 09 801 3009 or 09 306 8748.
Following this initial phone call, your details may be passed onto Healthline who will make follow up calls during your isolation period to check how you are doing. The calls from Healthline will usually come from 09 306 8748. There may be a delay before your call is connected. If you are concerned that a call from Healthline isn’t genuine, you can email Healthline and request a call back.
It is important to answer your phone, so the PHU, Ministry and Healthline can get in touch with you during this time.
Now, once the Ministry of Health traces a contact, close contacts need testing – which is rapid and is readily available – and self-isolation for 14 days, whereas casual contacts require to test and see-isolate only if they are symptomatic. Per the circular::
We are tracing all close contacts of cases, and getting them tested for COVID-19. All close contacts will remain in self-isolation for 14 days.
Most casual contacts do not need to self-isolate and only need to be tested if they develop symptoms.
In some specific situations, usually early on in an investigation, some casual contacts may be asked by health officials to get tested and self-isolate until they have returned a negative test.
In all situations, if a casual or close contact later develops symptoms, they should get tested, even if they had an earlier test, and self-isolate while awaiting the test result.
One important point: NZ has ac contact tracing app, but it is largely an after-thought, rather than a core part of their strategy. Again, over to the MoHcircular:
NZ COVID Tracer is a Ministry of Health app that supports fast and effective contact tracing by creating a digital diary of the places you visit.
*****
I’d like to make a couple of points.
You Cannot Monetize Contact Tracing: It Does Not Lend Itself to a Neo-Liberal Approach
First off, countries with contact tracing success have not tried to monetize the process. And I believe you can’t. It’s a net cost. Like so much of public health. And to do it properly, it will be a drain on public resources – not a gain.
No less an authority than our own Ignacio agrees with this (as I previously quoted in my fundraising post). Also, it cannot be done properly via app alone:
An app to do massive contract tracing is equal to laziness or unwillingness to do the right thing. But you know contracting people to do the good work is not in the neolib agenda. Importantly, it was expected to fail, so it is a failure by design.
I note the irony that Hong Kong – which IIRC has always been a low-regulation jurisdiction – even realises that public health – and health care – are indeed state functions. We could debate whether spending ample money on public health actually ends up saving the state in the long-run. It certainly seems to be the case in Taiwan. But I do not want to go there.We should just accept that adequate public health spend9ing is a net cost and cannot be monetised.
Asian Civil Liberties
I recognize sloppy journalism when I see it, and a recent NY Times article on the subject suggests that the main reason that the U.S. and European countries have failed at contact tracing is that they have greater appreciation for civil liberties, Contact Tracing, Key to Reining In the Virus, Falls Flat in the West
Then why the success in NZ?
Also I don’t see obvious constraints on civil liberties in Taiwan.
The NYT article also highlights greater public trust and rapid testing as keys to success. These are both things we can do something about.
I also suggest the reason for failure is the unwillingness to recognise to recognise that proper contact tracing comes at a cost. It’s not and never will be a profit centre. We have a lot of work to do in purging the neo-liberal mindset, which persists despite the severity of the global pandemic.
We could have such trust too. By setting up known numbers for contact tracing calls. And coming down hard on anyone who uses that number to scam people.
Maybe there are difficulties here I do not see. But have the countries that have failed at contact tracing actually tried? And been willing to spend real public resources in doing so?
No, instead, they’ve give us neo-liberal talking points. And my right-wing friends continue to scream it’s all China’s fault.
Well, so what if it is? Who cares who is at fault for starting the pandemic? Or the initial slow response of much of the world community? Shouldn’t we now deploy our vast resources in mitigating the spread of COVID-19, and cleaning up the mess? Instead of using this as yet another convenient stick with which to beat China.
I note that when I was compiling today’s Links. the U.S. has so far not managed to do proper contact tracing for those exposed to Donald Trump, according to this article in the Washington Post, Little evidence that White House has offered contact tracing, guidance to hundreds potentially exposed Are you kidding me? Note many of these are movers and shakers – so-called VIPS. And I assume the Secret Service had already collected their contact details before allowing them to see With Trump.
Debunking a Ridiculous Right-Wing Talking Point
Finally, I close with another right-wing talking point I heard repeated often earlier this year, before the huge rise in US deaths. It was that the US overcounted its COVID-19 deaths for the following reason.
Suppose you had terminal cancer, and were expected to die within a couple of months. When you actually did die, your death would be attributed to COVID-19, rather than cancer, if you indeed had COVID-19 when you passed away.
And that, I suggest, is as it should be.
But it was a steady right-wing claim that this was a travesty. Well, is it?
Consider the following example. You and 20 other hospice patients go on a picnic. On the way back, your vehicle has an accident. Everyone dies. What is your cause of death?
Why, the vehicle accident of course. Until that happened, you may or may not have succumbed to your terminal illness that landed you in the hospice. When you would die was not known. If you had terminal cancer, for example, you may have ended up being one of these lucky patients who survived longer than expected despite a terminal diagnosis. Until you died, we cannot accurately predict your cause of death.
Same thing with Covid-19. For many elderly people, with or without a terminal diagnosis, a run-in with the virus was equivalent to having a traffic accident.
These Rules are Publicly Available
To paraphrase that fierce S & C partner who was renowned for reminding associates who didn’t bother to read the SEC rule before opining on an aspect of basic securities law: these rules are publicly available. So also for some of the basics of pandemic control. Some Asian countries learned them again or for the first time during the SARS crisis. And they have stood them in good stead even today.
Why have we not been able to learn these lessons?
86 comments
Comments are closed.
PlutoniumKun made a great comment back in July so I will quote it here which I hope that he does not mind-
‘I’ve been referring to Coronavirus for a while as the worlds most effective stress test of institutions, maybe the biggest such experiment in history. It has unerringly found the weak link in every country and society its hit – whether that weak link being weak institutions, stupid politicians, sclerotic bureaucracies, religious nutcases, institutional groupthink, authoritarian tendencies or whatever. In the US its found not just one, but a whole series of weak links it can exploit. The results are not pretty.’
And that is what is happening here. Each one of those countries decided to take the pandemic seriously and acted accordingly. They did not throw their hopes into an app that could be also used for harvesting people’s data or monetizing it. Most country’s approach was distinctly low tech in fact. And now they are reaping the benefits. I see countries like my own where the “leader” is saying that we have to learn to ‘live with the virus’ for the sake of the economy. Open up to international tourists again in fact. How did that work out for Greece? The fact of the matter is that through miserable communications with their people and safety theater, that most people are getting jack of the whole thing and are just going back to their old lives again, regardless of the fact that this virus has not gone away. Again, it is just a matter of which countries passed their stress test and which did not.
You just managed to summarize what it took me more than 3K words to say. Great comment!
Thank you so much for remembering that!
+1
I’ll add one thing here. NZ is of course middle of nowhere, which is an advantage. Well, was, until LotR, and the mass tourism flying to NZ (in 2019, NZ had 3.8m tourists, and 5m total population), and a lot of Chinese studends come to the NZ too.
What I’d say put NZ apart is that it had leadership that people trusted. Even after they made mistakes (like the quarantinees being release early, and the whole mess around it). Even after the second lockdown (and the first was drastic, way more so than say what the UK had – it closed all non-essential business nationwide), they didn’t like the second lockdown but accepted it, because they trusted the government.
It have to say it’s amazing that we find it amazing that people are actually willing to trust their government.
We (in NZ) also wonder why the trust thing has worked so well.
Ironically the Mosque shooting in March 2019 might have been critical in the Covid response. The PMs very firm, very compassionate response won her a lot of Mana locally. In fact, early on in the severe lockdown I heard a radio interview with the head of the Maori language commission — a post of considerable prestige — and he commented that the Iwi up and down the country accepted what the PM said because she had the Mana to make those demands.
There are certainly those on the right who are not, shall we say, fans of the PM. We’re in the last two weeks of our election and listening to coverage I heard about a talk Judith “Crusher” Collins, head of National (right of center, other main party) was giving a talk to GreyPower (retirees) in Nelson and the crowd began chanting “crush kindness”. Bizarre that the mere act of kindness would become a hated political thing. But people are weird.
Your PM is an outlier in Western leadership, in that she is so obviously not engaged in a partisan activity. Unlike Trump. BoJo, Morrison etc, there is no discernible ‘them’ in her approach to politics – it is always ‘us’ as in all of us. The childishness is absent. I don’t follow her every utterance but I can’t recall an instance of sarcasm or contempt marking her public interactions. Now this may be Machiavellian calculation but my nose, by now a fairly good judge of that sort of thing, does not detect a whiff of it. Christchurch brought this aspect of Ardern out into the spotlight, but it was already there.
This quality it seems to me lies at the heart of her mana, which is a wonderful word. Another wonderful word, this time from Catalonia, might be a good fit to describe the essence of that quality.
I can’t say I know much about her, although she has undoubtedly done an excellent job during the pandemic. Sometimes a lot of luck is involved – its not so much having a good leader, as having the right leader at the right time. She seems to be a perfect fit for the times.
In Ireland, when the pandemic broke out, our health minister was widely mocked for his ineptness up to then. He was clearly out of his depth with the day to day job of trying to keep all the stakeholders in the Irish health service happy during ‘normal’ times. But he actually grew in stature during the pandemic, as he had the good sense not to rely on the usual politicking, but to let the specialists deal with policy why he focused on keeping lines of decision making and communication clear. With the new government he was replaced with a high profile up and coming politician who within a matter of weeks pretty much destroyed his reputation and career by coming in with an ‘I know best attitude’.
As I’ve said before, the virus is an outstanding stress test for leaders and institutions.
I haven’t been in the NZ for a looong time now, but still talk to my Kiwi friends now and then.
The last chat I had on Arden with a good friend – who’s normally a bit right of centre I’d say, but right of centre in the NZ is well left of Democrats in the US – and his take on Arden was that she’s very epathetic and has the ability to put people together – but is a horrible manager on actually getting nitty gritty things done (and IIRC, he mentioned she didn’t have any good hands on executive person on her team).
Grey power were weirdos even when I still was in NZ (and then weirdness was less wierd than its weird now). Crush kindness? Sure, let’s take all the pensioner rights from Grey Power members, after all, they are now just a baggage to the society, right?
I just would add to the well pointed comment that there is a collective failure, a failure in values and attitudes. Maybe excess individualism, inertia, impotence that prevent us making what would be sensible including not only preventive measures but profound changes in our views and uses. Think for instance on debt forgiveness that would eliminate a lot of pressure during this crisis.
That’s an excellent summary.
The healthcare system in the US is good at what it is designed to do – extract money from people. It is not intended to improve public health, in fact that runs counter to it’s intended purpose. Add in a government system firmly in the hands of the rich, and I’m actually surprised the US did as well as it did. But we’re not over this yet, and we have created a couple other crises to “family blog” up too, so I’m confident we will met my rather low expectations.
Good point Glen. Exactly. The purpose of the US health care system is to make money. People often forget or don’t know how our employer based health care came about. It had nothing, NOTHING, to do with improving public health or making peoples lives better. Rather it was a hiring incentive offered to workers by business in order to get them to sign on during WWII (due to the wage and price freezes in effect). After the war Truman tried to get universal health care for the US but was foiled mainly by the AMA (in 1945 they spent $1.5 million lobbying against the measure, which is over $21 million today). The AMA said it opposed universal health care because it was socialism, but in reality their main concern was they did not want fees regulated or lowered. Again the entrepreneurial nature of US medicine raised its head. One thing Truman did manage to get passed even with a Republican legislature in power; funding to build hospitals. That measure only resulted in the building of more private hospitals however.
Check out the NYRB piece included in today’s Links.
One of our weakest links is American Exceptionalism – the willful ignorance of what goes on outside our borders. The US vs EU COVID19 comparison is only the latest instance of “The rest of the world doesn’t /could never have something to teach us.”
Yes, I hear this regularly from relatives and friends in the southeast quadrant of the US, on any topic.
“If what other countries do is right, then our country would be wrong. Our country is never wrong. Therefore what those other countries do is not right.”
Jerri-Lynn
Not surprised that you failed to include The Country That Shall Not Be Mentioned in your review. But after all it is a Designated Enemy, and every country needs one to keep the “defense” industry humming along. And using the name of the country would probably result in your article being censored.
The Country That Shall Not Be Mentioned
Population 11 million
Total Corvid19 deaths to date: 39
Active cases: none
Doctors per capita: 2.8— by far the highest in the world
Long history of using anti-viral medicines to combat tropical diseases
Survived economic attack and coups from the most powerful country in the world for four decades
New York City
Population +- 8 million
Corvid19 deaths to date 17,000 ++
Used elder care facilities as dumping sites for known infected, multiplying the initial impact of the pandemic.
All countries lie, but it is not possible to fabricate such radical differences in outcomes.
If you were one of the ordinary American lower class 95% of the population, would you rather contact Corvid19 in New York in April 2020 and have an intubation tube crammed down your throat so the hospital could collect their $35,000 bounty (with a probability of death of about 80%, or be a citizen of The Country That Shall Not Be Mentioned?
Country that cannot be mentioned?
Cuba?
DaveC
Looks like the Free Press has done a great job of keeping you uninformed if you don’t know which country I am referring to! Which country has the USA been at war* with for the longest period? No, it isn’t Afghanistan.
*economic and export sanctions, restrictions on medical imports, currency restrictions, attempted assassination of leaders, coup plots, and direct military invasion,
By the way, The Country That Shall Not Be Mentioned offered to lend their considerable public health system resources to assist the USA in the hurricane aftermath when New Orleans was flooded but were turned down.
For a while I was spelling Covid wrong and kept getting crow-related pages when I searched.
:>)
Crow vid news…
Man befriends crows
https://www.youtube.com/watch?v=VOmRNeYZVfE
Hello, Thor’s Hammer,
The elephant in the room in the successful treatment and prevention of C-19 is hydroxychloroquine. The nine countries with the lowest death rate all use HCQ, and Cuba uses it heavily. Here a link to a study of 88 nations (51 peer reviewed) C-19 death stats. The nine countries including Cuba with the nine lowest death rates all utilize HCQ, see:
https://www.palmerfoundation.com.au/c19study-com-update-now-88-international-studies-51-peer-reviewed-show-positive-hydroxychloroquine-treatment-outcomes/
Also, here is a link to over 400 articles beginning in early March, studies and research from around the world demonstrating the effectiveness of HCQ., see: https://www.palmerfoundation.com.au/hydroxychloroquine-stories-as-it-happens-timeline/
So in my opinion, HCQ, the most economical and effective prophylaxis and treatment for C-19 has been shut down by the global health organizations to advance their financial interests and gain social control.
“Show me the incentives and I will show you the outcome.” — Charlie Munger
No one is going to become a billionaire by implementing M4A, or good public health programs.
But, create and sell a $3,000 per treatment drug—whether it works or not—and a few people are going to become extremely rich, extremely fast.
I’m sensing a common theme here:
Hong Kong “more or less sealed its borders”.
Vietnam has implemented “tight border controls”.
Taiwan “rigorously controlled its borders”.
New Zealand “shares no land borders with other counties. So it was able to quickly isolate itself.”
So it appears that if you’re able to get internal virus transmission fully under control, you have to close your borders to maintain it. Alas, I have difficulty imagining the US doing either of these well.
I’m so very sorry to disagree. COVID is a super infectious disease where a person in an given environment can infect everybody. If you get sick or not COVID pretty such follows the data to date. It is a mistake to think this disease as “country” wide. COVID 19 simply does not infect people in that manner of a cold.. America due to both the stupidity of its Citizens and large geographic space, and I guess the complete lack of any public health policy is perfect for the continuing infection of every last Citizen. Neoliberalism is great isn’t it‽
New Zealand has had only 20 or so “significant clusters” through all of 2020. While Kiwis did cooperate pretty well in enforcing their lockdown earlier this year, it is likely that the main reason NZ’s lockdown measures eliminated the virus in only 6 weeks was low prevalence of the virus from the beginning. I suspect that by late March the virus was much more extensively seeded across places like California and the various European countries that also began lockdowns around that time.
I’d love to see a similar article about the response to Covid 19 in Latin America. It does appear that three of the countries which are doing the best in terms of containing the disease are the dread Troika of Tyranny: Cuba, Nicaragua, and Venezuela.
Since Cuba and Nicaragua are very poor, and all three countries are subject to extreme US sanctions (and in the case of Venezuela an ongoing bipartisan attempt to overthrow the government), it’s even more impressive, to me, that they are doing so well.
Why? They are all socialist countries. They have made an effort at universal health care. Since they are comparatively poor and unable to obtain high-cost health care solutions they have concentrated on small local health centers and preventative care. Cuba is an island, of course, but – as with Nicaragua – its principal industry is tourism, so ironically the bipartisan sanctions and aviation shutdown has probably helped reduce the spread of the disease. But Nicaragua and Venezuela are contiguous with neoliberal states which have experienced far worse coronavirus figures and disfunctional responses.
I appreciate that you are not a public health expert, but would love to learn more about Latin American responses to the disease.
As a retired doc having dealt with and participated in epidemic panels in the past, I can tell you that fighting a Pandemic is much like engaging a War. And War is when our arsenal of democracy tends to lean towards socialism, central management and mandates.
Venezuela is a basket case, for a number of reasons (both foreign and domestic), and I’d not believe any numbers that come out of it – the official or the opposition, as all sides have not just one, but numerous dogs in the fight.
I can’t comment on Nicaragua.
Cuba is an interesting case, for a few reasons.
Cuba, few decades back, decided that healthcare would be one of its export and worked on it very hard. It’s actually a pretty good (in more than one sense) example of exporting your ideology via your deeds – in this case, health workers and services.
Unfortunately for Cuba, even before CV hit, it’s economy was (I can’t remember now exactly why) going downhill – tourism, another of main earners was actually down in 2019 (from 4.7m to to 4.3m, so almost 10%, which, under normal circumstances is quite a drop. Now, as in other countries, it’s pretty much dead). That impacted hospital supplies and similar.
But yes, overall Cuba did pretty well.
Well, Colombia also has a public healthcare system, which is ranked much higher (#20, iirc) than the miserable US (#37). It did not help them, in part because of some poor decisions by the President. Declaring a tax-free shopping weekend was one.
The last time I checked, Medellin was showing good results. I included this example in a post but have not yet done an update. High time to see what they’ve been up to.
My wife is Colombian, so feel free to reach out.
fwd Colombia Reports’ English-language reporting (btw a good anti-Establishment media) is that Colombia is doing a poor job on COVID, among the worst in the Americas https://colombiareports.com/covid-19-colombias-healthcare-capacity-and-collapses/ .
covid19-projections has projected Nov1 602 deaths/Millions for Nov1 in Colombia, on par with among the worst in the world alongside USA at 698.
Note that there continues to be political violence/murder is some rural regions of Colombia, which may at least somewhat worsen the COVID response.
I recall articles that the main public hospital in regions of a Choco (NW part of nation) & Amazonas (SE) Departments (analagous to a USA state) closed for some time. In the Amazonas case there was alleged embezelling in COVID money by a health official. It is quite possible that classism & racism makes the response worse in these 2 Departments than in the large urban areas like Medellin/Antioquia Department. Both are rural Departments with higher Indigenous population proportions, & Choco has a high Afro-Colombian population proportion.
There was another article where a local indigineous journalist in Amazonas was caring for his COVID-sick elderly uncle, & successfully (at least prevented death) treated his uncle by setting up an IV drip on calls & emails from his physician friend. This has to be among the most fugazi COVID newsstories I have read. Imagine debugging a Win10 Fail by getting advice from an InfoTech buddy on the phone, but instead giving live-saving emergency medical care in an apartment in the remote area like Amazonas this way *smh*
Uruguay has done fairly well, with just over 2,000 cases to date after the March 13th arrival of the disease. We also have 48 deaths in a population of 3.5 million that skews older.
We had one lockdown in the first wave and it was voluntary. We have extensive mask use and it’s voluntary. Restaurants, bars, shopping, and schools are all open now, but large music venues remain closed.
We have an excellent test trace and confinement program. Our positivity rate, which is the number of positive results divided by the number of total tests, hovers around 1%. We have conducted over 240,000 tests to date. All contacts are traced, tested, and asked to confine themselves in their homes. Extensive testing is done when a cluster is discovered in a school, an old home, or wherever.
We have socialized medicine here, along with private mutualistas that provide affordable Care. People with covid-19 receive Medical Care in their homes through a pre-existing in home Medical Care Network.
We have had to overcome some challenges in responding to coronavirus. 1, the newness of our political leadership, which was installed mere days before our first case. The new center-right party has done an amazing job of earning the trust of the general population without reducing civil liberties. The left-wing opposition party has not been entirely helpful, trying to score political points. 2, We also have a well-used public transit system, masks are required. 3, We have long land borders with two South American covid-19 hotspots, Brazil and Argentina. Although we have closed our borders to all international travel, we still have Trucking that crosses the borders and a couple binational cities that border Brazil. Our diplomats have done a good job negotiating with Brazilian authorities to provide tests and tracing on both sides of the Border. 4, all of this success has been accomplished during the winter cold weather season when people stay indoors for long periods.
Of course, I’m very happy to be in Uruguay during this time and am expecially thankful that the spirit of the country remains calm and friendly without fights, political or otherwise, over mask-wearing and other measures to reduce the spread of the pandemic. It is so surreal to live in this tranquil nation of respectful and responsible citizens while reading about the chaos in the US. Uruguay No Mas!
I wonder if one cultural trait that may be one of the factors in limiting Covid in Asian countries is respect for ones elders.
Just a point on Vietnam – I’ve a good friend here in Dublin from Ho Chi Minh and she keeps a regular contact with home. The people there are quite proud of the governments (and peoples) response and how they kept it at bay, but there was some anger at the favouritism shown to the tourism industry which led to the outbreak in late August, the result of opening up some resorts to foreign tourists.
I think Vietnams’ outbreak was probably very severe early on in the pandemic (more than they admitted), which makes their success all the more impressive. I think there were two reasons for their success – the first being practical experience with both SARS and Bird flu. Northern Vietnam is right in that mountainous tropical zone where a lot of diseases emerge, so they’ve had a lot of recent experience at fighting outbreaks. I think one thing is clear is that fighting a new disease is like war – you can do all the military exercises you like, but nothing prepares you for a battle like the real thing. This was a huge advantage that South Korea, HK, Taiwan and Vietnam shared. This I think gave them a vital few weeks start on countries like the UK which had excellent systems on paper. Just a pity, as the old saying goes, the battle didn’t happen on paper.
The second point about Vietnam is that they took very aggressive action to shut down movement. Entire towns were cut off from the public – in Vietnam, this is not advisory, the police and army mean business when they say don’t go out. I had one encounter in my life with Vietnamese police and I most certainly do not want to repeat it, and locals are even more, shall we say, respectful. My friend told me that even in HCM, which was relatively unscathed relative to the north and Danang, the shut down was extremely strict, even for her fairly well connected parents.
Another point about Taiwan and South Korea – while they are both democracies, there is a level of existing surveillance in those countries well beyond what you’d expect. In the case of South Korea its a legacy of always expecting war with the north, in Taiwan its a legacy of the old KMT days (its astonishing how large the police stations are, even in a very small village), and its still very militarised. South Korea is bristling with surveillance towers of all sorts in public spaces, and their contact apps were able to use a lot of information that would take time to merge I think in any other country (for example, they used travel card information to track peoples movements through the subway). While I’m not suggesting it was all about technology, I think those countries had immediate access to high tech track and trace which was probably not available anywhere else, except perhaps in China.
As a final point, its worth noting that while all the attention has been paid to Sweden – the other Nordic countries have been relatively successful at keeping a minimal mortality rate, so far as can be seen from the data. Their systems worked very effectively so far, but they did have a significant time advantage over central and southern Europe. There was definitely an element of luck at play for some countries.
Great review .thanks.
One quibble: you write “We could debate whether spending ample money on public health actually ends up saving the state in the long-run”
That investments in PH save money is not up for debate I think. We have data for this that is extensive.
You’re no doubt correct. Have forgotten the point I was trying to make. Would like to see some of that data,
here is one:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5537512/
“Yes”
You could include a few other jurisdictions: Western Australia is one.
All of these share a fee things besides robust contact tracing. You mention border control. You mention effective isolation and quarantine. Most of all They all share a desire for excellence
They also I’d imagine have good health care systems.
at least somewhat equitable ones
Its not even the lack of an equitable system, but the US lacks a unified healthcare system and instead has a hodge podge of institutions which as pointed out above are dedicated to profit extraction, the health insurers and HMOs. The US doesn’t have the bureaucratic systems in place to manage or even pretend to manage.
Regarding Contact tracing, I think that the way people view the effort is different in SK, Vietnam, Taiwan compared with the US or Spain as examples. In the former group, they probably understand this is a protective measure that helps preventing disease spread in two ways (detection and isolation is one and identification of Covid hot-spots, superspreading events and conditions that favour that is the other).
My personal experience with cases I have known in Spain, on the contrary, suggest that testing and contact tracing is seen as a source for stigma and a violation of our rights. According to this view shared by the public, it is not rare to see that some HC authorities do not rush for proper contract tracing and let the thing to voluntary use of mostly useless tracing apps. These, to be useful, would require a change to the SE Asian view..
Great article in the Atlantic by Zeynep Tufecki.
https://www.theatlantic.com/health/archive/2020/09/k-overlooked-variable-driving-pandemic/616548/
Later on, Tufeciki explains the difference between deterministic disease (flu) and stochastic disease (CV19) dispersal as well as the fact that almost all contact tracing systems in the West are prospective (who did the rare infected person contact) and a complete waste of time vs. retrospective (who infected this person and who else might have been infected by the person who transmitted to them).
Hellbiter (and Lambert) – that Atlantic piece was fascinating and I think absolutely should be central to the ongoing debates regarding future policies. I’d also add the increasing modelling evidence that effective herd immunity may be reached with levels of exposure well below the oft-touted 60% should be more widely discussed too. Moving from the Imperial/Sage assumption that everyone is equally succeptible to catching the virus can lower this to just 15% population exposure – let’s hope this is so. See here for instance:
https://www.medrxiv.org/content/10.1101/2020.09.26.20202267v1
The Tufecki article has been linked to and discussed. I would like very much to see spreading in clusters linked to the built environment (as IIRC one argument for aerosols was that a dispersed and long-listing “mist” enabled superspreading in a way that fomites and droplets do not).
The prospective vs. retrospective contact tracing is interesting and perhaps even more critical. I believe that Japan does retrospective. It’s as if we’re deliberately cutting ourselves off from the opportunity to learn..
This is. Much better explained than I did. Contract tracing done retrospectively should drive preventive policies. We could go on with only the restrictions that really prevent spread disease and not stupid street masking, for instance. We are forced masks in the street but enter restaurants where masks are out to eat, drink and talk. Does this make any sense?
Social distancing should mean that socializing in closed spaces while having snacks, lunches or drinks is not good idea.
Wasn’t there one or two states in India who had very good responses to the virus?
Kerala initially had a great response, due to its contact tracing policy,
What are your thoughts on Japan? It’s been a curious outlier despite severely limiting testing (lowest in OECD iirc).
Japan can be added to the list. Good insights from one of its leading virologists at this link.
Japan is concerned to ID clusters to stop transmission. It accordingly uses backward contact-tracing to ID individuals who may have triggered a cluster, so they can be isolated; the US apparently uses forward contact-tracing, to ID individuals with whom a newly infected person has come into contact with testing positive.
“The core of Japan’s strategy was not to overlook large sources of transmission. By accurately identifying what we call “clusters”, which are sources that have a potential to become a major outbreak, we were able to take measures for the surroundings of the clusters. By tolerating some degree of small transmissions, we avoided overexertion and nipped the bud of large transmissions. Behind this strategy is the fact that, for this specific virus, most people do not infect others, so even if we tolerate some cases go undetected, as long as we can prevent clusters where one infects many, most chains of transmissions will be dying out.”
https://www.japanpolicyforum.jp/diplomacy/pt20200605162619.html
Japan, whether through good fortune or good science, seems to have had a better grasp of the nature of the virus than most other countries. Again, I think the west was far too focused on the flu (deterministic) pattern of dispersal rather than focusing on potential super spreaders. I still regularly hear scientists talk about Covid as it if was the flu, even while they say things like ‘Covid is not the flu’. I find it remarkable how difficult it has been for many scientists to escape the flu paradigm. Its still very apparent in WHO policy.
My Japanese friend have been very dismissive and angry about the governments response. They undoubtedly got things badly wrong at the beginning – partly because they seemed genuinely out of their depth when those cruise liners arrived, but also because of the governments initial determination to protect the Olympics at any cost. But they do seem to have had a lot of luck – for whatever cultural reason, the virus just didn’t get a grip as it did in other countries.
But most importantly I think Japan shows the value of a ‘deep’ level of institutional strength. Even with an inept leadership, at ground level the public health system did an outstanding job in identifying the threat and dealing with it in a calm and rational way.
They seem to have dodged a number of bullets. When they cut loose all those passengers from the “Pacific Princess” back in February, I thought that for sure they were going to cop it after they started to spread to all points of the compass.
Jeez, the “Pacific Princess” seems so long ago now. Almost like in olden times.
It’s good to be an island.
It’s good to have a compliant population.
It’s good to have few obese people.
It’s good to have some experience with pandemics in recent years.
It’s good to have some built in immunity.
it is good to have an equitable healthcare system
it is good to have a government that actually cares to do the right thing
it is good to have a population that care about one another
Dave
Plus:
It’s good to have 2.8 times as many doctors per capita as any other country in the world.
It’s good to have an array of tested anti-viral medicines in your pharmaceutical system.
It’s good to have tens of thousands of para-professionals that can be mobilized rapidly.
It’s good to have a 30 year history of placing a high national priority on the public heath system.
It’s good to have free universal access to health care.
It’s good to have a civil defense system that is trained in hurricane recovery.
It’s good to have a budget that has no room for financing a military industrial complex and high tech weaponry.
Another example that merits study would be Italy in Europe, compared with France and Spain. Three countries that followed similar paths this spring and are similarly complex. Why is it that there is not that Covid resurgence in Italy while cases are climbing dramatically in Spain or France?
I don’t have any idea, would be nice to read an Italian commentary on this but my intuition is that for some unknown reasons, Italians have been able to keep Covid awareness well and alive. Whether this is a cultural or political thing (or both and these are related) I don’t know.
My wife, who lived in Italy for 17 years and reads the Italian newspapers, says that the fact that Italy was the first country in Europe to have an outbreak, along with both the government and the population being very serious subsequently, are the reasons that Italy hasn’t had a resurgence like Spain or France.
Kudos to Taiwan, excluded as it is by China from the WHO. Having an epidemiologist as a VP and not trusting China from the beginning certainly helped. But, Taiwan has made enormous strides in building democratic and civil elements into its society over the last 30 years. These and an excellent health care system (that I have experienced for myself) which uses technology wisely have aided the effort immensely.
The other interesting area to look at is the Atlantic bubble in Canada – New Brunswick, Nova Scotia, PEI and Newfoundland/Labrador. Despite having infections seeded from travel, they have been able to quash the cases down to basically zero.
I believe that Mr. Dylan covers an aspect of it :
“Disease Of Conceit”
There’s a whole lot of people suffering tonight from the disease of conceit
Whole lot of people struggling tonight from the disease of conceit
Comes right down the highway straight down the line
Rips into your senses through your body and your mind
Nothing about it that’s sweet
The disease of conceit.
There’s a whole lot of hearts breaking tonight from the disease of conceit
Whole lot of hearts shaking tonight from the disease of conceit
Steps into your room eats into your soul
Over your senses you have no control
Ain’t nothing too discreet about the disease of conceit.
There’s a whole lot of people dying tonight from the disease of conceit
Whole lot of people crying tonight from the disease of conceit
Comes right out of nowhere and you’re down for the count
From the outside world the pressure will mount
Turn you into a piece of meat
The disease of conceit.
Conceit is the disease that the doctors got no cure
They’ve done a lot of research on it but what it is they’re still not sure
There’s a whole lot of people in trouble tonight from the disease of conceit
Whole lot of people seeing double tonight from the disease of conceit
Give you delusions of grandeur and evil eye
Give you the idea that you’re too good to die
Then they bury you from your head to your feet
From the disease of conceit.
From Ilargi: How Not To Do Corona
And now what you see is the politicians don’t know what to do anymore. They turn to “their scientists” again, but many have before given advice that is different from what they say now, that hasn’t worked, and that often contradicts what their colleagues in other countries say. And so everyone starts blaming “the people”.
But the people have mostly obeyed the lockdowns and become experts themselves, or so they think, and seen them go nowhere. That makes the positions of politicians and “experts” much weaker than it was 6-7 months ago. It’s about credibility, and they’ve squandered it. Why “must we listen to the scientists” if that does us no good?
https://www.theautomaticearth.com/2020/10/how-not-to-do-corona/
To answer the question in the title, would it be too cynical to say “Because ‘failure’ is very profitable”?
indeed it is: can we please have an essay about that?
Disaster capitalism at its finest hour IMO
I have often wondered why there are so few comparisons betw the US and Canada. After all, we are neighbours, with similar population and culture, and our outcomes are considerably better here in Canada. Oh I forgot, we have healthcare for all here — can’t mention that out loud, USians might get ideas. And we have not yet decided that ‘the economy’ (*translation: rich people) is more important than society.
Canada seems to be almost invisible to the rest of the world’s big media, punditry, think tanks and governments so it didn’t surprise me too much that there hasn’t been too much comparison between the US and Canadian experiences during the pandemic – even though it should make for a very relevant study given our proximity and similarities. Of course there have also been considerable differences between the various regions of Canada too. Here in BC we have the vast majority of the population packed into the Vancouver area which is both very close to the border with Washington where a large early outbreak occurred and we have a lot of communication with mainland China where it all started.Despite this we’ve done better than many Provinces and territories – so far. We’ve been pulled down the neoliberal road to hell in Canada too but fortunately not quite as far as many nations have – so far.
Well I don’t mean to be snide but here at Naked Capitalism in the aftermath of the 2008 Financial Crisis very few posters were all that interested in the fact Canada went through the crisis far far more successfully than most other countries largely because Canada’s experience went against the preconceived notions of the causes and solutions to the crisis.
Welcome to Naked Capitalism, where Lambert frequently mentions that Canada is the ideal demonstration that healthcare for all is compatible with North American culture and economy. But Canada is certainly invisible to most USians who don’t live near the 49th parallel—except as a prop. Canada’s health care system is deployed all the time in political arguments here: “Oh my God you don’t want to be like Canada where they die waiting in line.” Yes, that’s nonsense. But we’re not big on facts here.
Over past ten years I have experienced a steady increase in friction for USians crossing border.
Its almost as if TPTB don’t want people to visit Canada and compare the current US system to a functional social system.
I would speculate that part of NZ’s success was what some are now suggesting was an over-reaction – a very hard lockdown to stop the spread of the disease before it became established. I see several reasons underlying this.
In her almost daily addresses to the nation in the early days Ardern frequently referred to us as a team, and even ‘team New Zealand’ which, with the Nation’s fixation on rugby and other team sports and the success of Team New Zealand in the America’s Cup, struck a chord with the subtext that if you didn’t follow advice and directions you weren’t playing the game. I’m not sure that would have worked as well anywhere else.
There was no hiding that the country was not prepared to handle a pandemic. The Public Health Service was already at nearly 100% capacity dealing with ‘ordinary’ day-to-day health matters and intensive care beds, ventilators and even masks were in short supply. As a result it was recognised that a pandemic here would quickly get out of control with a Hospital system unable to cope with it. Hence action was quickly taken to stamp on it. Other countries such as the UK, of course, were clearly in a similar situation but here it was acknowledged rather than glossed over – no claims were made that we were ‘world leaders’ in anything and the was no pretence by those in charge that everything was under control, that the system could cope nor any patently bogus fortune-telling as to how it was all going to pan out.
And perhaps it is significant that with primary health care heavily subsidised and hospital care including major surgery and intensive care ‘free’ it has always been the case that any medical care is at the taxpayer’s expense, and hence the emphasis has been on limiting its use by stopping health problems before they become a social cost – ie the ambulance at the top of the cliff – rather than making provision for concentrating on medical events after they arise – the ambulance at the bottom of the cliff. Hence preventative Public Health is seen as being in everyone’s interest and made it more acceptable and effective.
Your experience may differ.
I suggest also looking at Uruguay and Costa Rica, two Latin countries which have done relatively well without being too authoritarian.
I posted above about Uruguay
Crucially, one more observation that needs to be emphasized
From today’s NYT:
“many Western governments have failed to cushion the
financial and psychological blow of self-isolation by guaranteeing
people tests or giving them enough money to weather two weeks
without work”
This post and thread are why I begin my day with naked capitalism and check back throughout the day as time allows and into each evening. Thank you all! Even dave. I don’t know why my few but semi-regular comments seem to get stuck in terminal moderation so often, but that’s a minor issue.
This place rocks!
As this post points out, the obvious is becoming visible.
The triumph of the monetization of living requires the denial that humans evolved and live in communities on a finite planet. The 0.1% being allowed to keep the ill-gotten gains from their great crimes necessitates the destruction of democracy, eliminating taxes and ending the rule of law. Being a salaried manager or cubical employee requires denial of this immoral reality to stay sane. The end result of the corruption and denial is a super-spreader event a week ago at the White House. The US government failed. It cannot protect itself let alone its citizens.
As long as there is no national public health system, COVID-19 will continue to spread and the economy will remained depressed. The two-headed one-body US political party will do nothing – waiting for a for-profit vaccine next year that may or may not work. Doing something is contrary to their donors wishes.
This unstable situation cannot long stand.
Great post. In particular the concept that one of the things that make us human is the need to live in communities. Forcing children to live in isolation stunts their ability to develop as full humans and will have repercussions that follow their age group throughout their lives.
I’m surprised Singapore hasn’t been mentioned. The city-state has been very successful testing, contact-tracing and has had 27 deaths (I think) out of ~58000 cases.
Thailand?
There are lots of good suggestions in these comments – proving once again that the NC commentariat is the best commentariat. The only reason I concentrated on these four was that even a cursory treatment makes for a very long post, maybe 2 times as long as my average length post. So I chose these four for this post.
As I pledged in my fundraising post, I will be continuing to look at these issues, as I have done since earlier in the course of the pandemic. And the robust comments suggest that readers have an appetite for this subject. So, within Asia, that means at minimum Singapore, Thailand, even South Korea, and China. For Latin America, I think I saw the suggestion of Uruguay, Costa Rica, Colombia, and Cuba. And Canada, especially Atlantic Canada. And Italy. Why so much better now than France or Spain? And I am sure there are other European examples I should be exploring. I can’t promise to follow up on every suggestion, but if you make it, I can either try (or decide not to, for sane and solid reasons.)
This is the attitude that makes naked capitalism such a great place!
Here’s an article about Uruguay, describing the test pooling that is done here.
https://www.bmj.com/content/370/bmj.m3575
Hello? When has the US ever taken the experience of other countries and used that as a model or informative information? Ever? I can’t think of a time. For example, when “reforming” our health care system, did we consider Switzerland’s system, which is run entirely through private insurance companies (albeit strongly regulated)? Would that have not appealed to the “privatize” everything crowd? Didn’t even get a mention.
Nope, we are exceptional, damn it, and none of that experience applies.
Arrogance is its own reward I guess.
Most of this we can lay in the lap of a governance system that starts with solutions: “My solution! No mine!” Real problem solving starts with the problem, considers the interests of all involved, and then explores options before selecting a solution. The way we do it we have winners and losers. The other way, everyone’s fingerprints are on the solution … if they contribute and we all win.
FWIW, I once lived in Switzerland (academic year ’86-’87) and well remember paying my health insurance premium.
American exceptionalism includes another country that shall not be mentioned. This country is larger than the little island ninety miles from Key West. It has a population of approximately 100 mn.
My wife and I arrived in Saigon on 21 Jan 2019 for a one month holiday. Within days we watched spellbound as television news bombarded us with more videos of victims falling dead in the streets of Wuhan. Bodies on the floors of hospitals, twitching on the street and of people forcibly shoved into police vehicles. A short time later the Vietnamese government closed airports to Chinese flights and sealed the border with that country. The first country to do so.
That the Vietnamese government was willing to forego Chinese tourist spending (their largest visitor group) in favor of tackling the disease really impressed us. It gave us a feeling of security.
Fast forward a week or so and the VN government put together an ongoing stream of Covid cautioning public service announcements on TV. On the street posters and signs appeared about wearing masks. Then what really impressed us was seeing groups of very polite and smiling young people handing out face masks free to passersby. By our second week in-country it was rare to see a mask less person.
And all of this was effected during the the Tet new years holiday period when most people are enjoying their time off.
To this day we are left with a combination of awe and respect for a government that moved immediately to put their people ahead of profit. We saw what is possible.
Jimmy V
The country you did mention was the subject of a US goal to “bomb them back to the Stone Age.”
Not only did the US fail in that policy, but this little country of rice paddies and jungle defeated the US military and sent them scrambling for the last seats on the evacuation helicopters with their tails between their legs.
Their stone age economy has managed to build a modern high speed rail system, another thing the US has utterly failed at. I wonder how the history books approved for use in our public school system report the outcome of the Vietnam War in the context of the Vietnam you saw today?