Shifting the Focus of Our Conversations
I was listening to the latest episode of The Grumpy Economist, and John Cochrane raised several interesting questions. Two involved the purpose of vaccines and tests. He asks:
Is the purpose of the vaccine to protect an individual from a disease that will run rampant no matter what you do? Or is the purpose of the vaccine to stop the spread of the disease so that fewer people get it in the first place?
Similarly, is the purpose of a test to diagnose whether an individual patient has that disease and how do you treat him/her? Or is the purpose of testing to test everybody to find out who’s got it and stop them from spreading it to someone else?
In both instances, Cochrane claims we’ve focused on the wrong aspect. Then he posited a view that hadn’t occurred to me.
A bit of background first. From a 30,000 foot view, our government serves to centralize planning in certain areas (military, social security, etc) where a free market system would definitely not suffice.
Now, in a hypothetical scenario, say we were focusing on getting the vaccine to the people most likely to spread the virus. There would be multiplicative benefits from making sure those people were vaccinated first, because future infections would be reduced. I know Nassim Taleb was a proponent of this order of vaccination:
However, our current system is designed to protect individuals, not necessarily society as a whole. Like Cochrane says, our first instinct is to protect the people most likely to get really sick and die first, and it’s not a bad instinct to have.
If that’s the case, he asks why the government has to be in charge of the vaccine supply. If only individuals benefit, there’s less of a reason why the government should run the market. It’s not an action that’s consistent with managing externalities.
Having everyone wear masks, however, is certainly a case of managing externalities. My understanding of the science is that a homemade mask is more for the benefit of the surrounding group rather than the individual wearing it.
Now our story that began yesterday will come full circle. Do you notice how debating the order of vaccinations is easier than talking about the logistics of vaccinations?
For me, there’s a world of difference.
Selecting the order is akin to a car rental company taking a reservation. As Seinfeld put is, “Anybody can just take them!”
How do we create a large-scale vaccination distribution network? I can barely even list a few of the obstacles: 1) having a large enough space that allows for proper distancing throughout (unlike Taleb’s analogy of the financial market, a large movie theater with a small door), 2) the requisite cold chain capabilities, and 3) hiring people at scale to run the operations.
We currently have 50 states utilizing 50 different methods. Reminiscent of an episode of EconTalk where Robert Pondiscio talked about the Success Academy centralizing the process of lesson planning for teachers. They found that more than 90% of teachers were curating material to teach themselves. The Success Academy wanted their teachers to plan to teach the lesson instead of planning the lesson.
Certainly a difficult conversation, but one that we should be having more of.