HN Theater @HNTheaterMonth

The thing Sam Altman could have done, and still could do, that would have by far the most impact in this and similar crises, is support the adoption of universal health coverage and sick leave policies, as well as financial assistance for those devastated by these shutdowns.

Startups are cool. But to the extent the Silicon Valley community has fought against a social safety net and effective public sector they’re part of the problem.

Not singling him out specifically here as my understanding is that he actually has done some political work along those lines, but the first sentence here implies that investing in startups is the only thing he knows how to do. That rings false.

He’s very wealthy and powerful. He has enormous influence over people who set employee policies at important companies and has the ear of world leaders.[0]

There’s many things he could do that are much more effective than investing in startups.

[0] https://youtu.be/rKoACC5iOhQ

⬐ kick

I think implying that he doesn't support those isn't necessarily in line with his previous statements.

He's previously made statements in favor of at least universal healthcare, and it seems incredibly unlikely that he doesn't support sick leave policies.

⬐ claudeganon

Ycombinator funds several startups whose success depends on Medicare for All not happening.

⬐ kick

They've also funded startups in bids to try and make universal healthcare happen:

https://blog.ycombinator.com/yc-research-universal-healthcar...

Also, you shouldn't refer to universal healthcare/single-payer as a concept with "Medicare for All." Medicare for All is a compromised American policy proposal inferior to what most countries have had for years.

⬐ claudeganon

Medicare for All is the only meaningful proposal with mass support inside the Overton Window of American politics right now. I’d prefer a robust national healthcare service, but that’s not on the table.

Watsi is more akin to GoFundMe for care in the developing world, which, while admirable, has little to do with creating a universal healthcare system anywhere.

⬐ tomhoward

Even if politicians could agree to enact this tomorrow, it would take years to get up and running.

Sam is looking for projects that can help with the crisis that’s happening now and have a meaningful impact within weeks/few months.

⬐ adrr

Sick leave is in the house bill that passed yesterday along with paid family leave. White house supports it so it should pass the senate with little problems.

⬐ CPLX

No it isn’t. It excludes almost everyone.

That bill is an embarrassment. Doing something about that is kind of exactly what I’m talking about.

⬐ None

None

⬐ gji

Those benefits only apply to people who work at companies that have less than 500 employees. Unfortunately, that leaves most people in the lurch.

https://www.nytimes.com/2020/03/14/opinion/coronavirus-pelos...

⬐ cheez

Those are the companies that won't survive without it. The bigger companies are expected to fund it themselves.

⬐ throwaway8291

How true. I believe the US will see an even worse fallout than Italy - because people who can afford private medical personal tend to question whether healthcare is a business model at all ("Is curing patients a sustainable business model?", GS).

America has the most uplifting and free-spirited legacy, but it has been transformed in the past decades into the most primitive form of greed and selfishness possible. Covid-19 is only the eye-opener.

FTR: I believe the US will lose 5% of its population to the coronavirus in 2020. Not being panicky, just multiplying.

⬐ CyanLite2

5%? That's like 15-20 million people. Doubt it. We, the United States, have a lot of problems. We're greedy. We're arrogant. While we can't prevent all deaths, we're not going to let 15-20 million people die to a virus in this modern age of technology and healthcare.

⬐ onetimemanytime

>>we're not going to let 15-20 million people die to a virus in this modern age of technology and healthcare.

well, you have to take measures weeks and months ahead, or else it doesn't matter...lungs need oxygen.

⬐ throwaway8291

I hope for the best.

⬐ heretoo

Technology doesn't help once the number of cases needing intensive care exceed the capacity. Healthcare doesn't exist without technology.

Italy exceeded that limit in the last two days, so now they have to decide who has the highest chance of survival, and those people get intensive care, if it is available.

⬐ ma2rten

Coronavirus has death rate of 1-2%. It might be slightly higher if the health care system gets overwhelmed, but the US has a head start on Italy/China in terms of social distancing measures.

⬐ varjag

3.4%

⬐ ma2rten

That number is a crude estimate based on reported cases. The real number of cases is obviously higher than the ones being reported.

⬐ varjag

These are WHO figures. You are speculating.

⬐ ma2rten

While the true mortality of COVID-19 will take some time to fully understand, the data we have so far indicate that the crude mortality ratio (the number of reported deaths divided by the reported cases) is between 3-4%, the infection mortality rate (the number of reported deaths divided by the number of infections) will be lower.

https://www.who.int/docs/default-source/coronaviruse/situati...

⬐ D_Alex

>The real number of cases is obviously higher than the ones being reported.

Yes... and the number of dead people will also obviously be higher - because the disease has not yet run its course in all of the reported cases.

Here is Lancet from 12 March estimating 5.7% final mortality rate among confirmed cases.

https://www.thelancet.com/journals/laninf/article/PIIS1473-3...

⬐ darawk

I will make a bet with you for whatever amount of money that you want that every single prediction you just made is false. On a per capita basis, the US will have a better time than Italy. The US will lose nowhere near 5% of its population. Not even 1%.

Happy to formalize it and bet for real, if you'd like.

⬐ D_Alex

What odds are you giving on "On a per capita basis, the US will have a better time than Italy"... the worst affected country so far?

⬐ ISL

What odds are you giving for the 5% prediction?

COVID-19 is going to hit us hard, but I believe deeply in America's ability to adapt and pull together. We are fractured and almost-leaderless today, but the United States tends to do very well against a common challenge, once the scale of the challenge is understood.

⬐ throwaway8291

It's just using population * long-term infection ratio * mortality rate (not counting anything unknown yet, like some in-flight mutation).

Currently, the cases are doubling in Europe (Italy, Spain, Germany, ...), so exponential growth, which the human mind can hardly deal with - so people are still freely moving around. China shutdown a 11M people city facing a few thousand cases, Germany will see 10k cases tomorrow but people still walking around like normal (even though counter-measures are being deployed).

The US being a country valuing individual responsibility a lot will suffer, because there is no money in treating people with little money. How many Americans live paycheck to paycheck, have maxed-out credit cards, auto-loans, mortgages, or merely a few hundred bucks saved? Millions.

I'd say the 5% prediction might become reality with a 0.75 chance.

Also, do you trust a guy like Trump to enter a bad deal? Like giving away billions for nothing?

----

Update: And, oh yes: with the current spread rate (t_d ~ 2.4), you have about a good month left, 3000*(1.4^35) = 390483334.

⬐ aaronbrethorst

The United States's greatest challenges of the 20th century were only dealt with after the country had strong leadership at the top. There is zero chance the U.S. will get that aforementioned strong leadership before January 2021 at the earliest.

⬐ i_am_proteus

Neither agreeing nor disagreeing with your point, but deliberating over what could have been done in the past does not help solve a crisis in the present.

⬐ CPLX

I mean today, literally, he could call Nancy Pelosi, who most certainly knows who he is and would call him back, and scream at her for the insane lack of direct federal action to help regular workers affected financially by this crisis in the bill they just passed.

If enough people like him did that to our world leaders you can be damm sure it would make a difference.

⬐ whiddershins

Who isn’t affected? Are you arguing we should simultaneously bail out the whole country?

⬐ CPLX

Yes of course. The government should take steps to stabilize the whole country and reduce the damage caused by mass disaster events. That’s what governments are for.

⬐ whiddershins

I don’t disagree, but I find your general stance of “of course my ideology is reality” totally problematic.

Edit: To clarify there is a wide array of opinions about “what government are for” and “what governments should do” ... I think it is important to acknowledge that when expressing an opinion about what you think.

⬐ hn_throwaway_99

I very much disagree. The mistakes that were previously made (both broadly socially and specific instances, such as closing the pandemic response team and the delay in testing) were all incredibly foreseeable. I find it the height of dishonesty to say "Gosh, we had no idea what would have happened, we just have to focus on the present". Now, I don't think you're saying that, and you're right that the current situation is where we are and we should focus on what we can actually do. In the "never let a good crisis go to waste" vein, though, one thing we can actually do is make people realize that the health and well-being of your neighbors is inextricably linked to your own.

⬐ throwGuardian

Italy has both universal health coverage and sick leave policies, but is still reeling with a 7% mortality rate [1] and crisis. Neither replaces good leadership and policy/decision making by public health officials, and certainly has ZERO effect on pandemics.

FYI, countries routinely provide free health care [2] during pandemics because it typically is an existential crisis for it's civil society and economy.

[1]: https://www.ccn.com/coronavirus-death-rate-soars-to-7-in-ita...

[2] : announcement about US COVID-19 testing and treatment:

For USA -

Where to get COVID-19 test?

Enter your zip code to find out the nearest COVID-19 test site. (from US HRSA.gov website) https://findahealthcenter.hrsa.gov/

1. Go to clinics instead of crowded large facilities.

2. Fees: Testing and Treatments are free.

If confirmed, home isolation for 14 days, please help stop spreading COVID-19. Proactive screening to stop the spreads.

⬐ randomsearch

> 7% mortality rate

Please don't use such misleading figures. Spreading fear is dangerous. This number is known as a "naive case fatality rate", with the emphasis on naive. And you're even quoting just for one country - cherry-picking.

The UK CMO has said the mortality rate for COVID-19 is likely 1% or less.

Please, act responsibly. The situation is serious and difficult enough.

⬐ throwGuardian

The only person taking anything I said out of context is you. I've been very specific about the 7% estimate being unique to Italy, replete with a source. I've never claimed that to be the overall wordlwide mortality rate, so read before accusing someone.

> Please, act responsibly ..

I suggest you practice what you preach, and read someone else's well intentioned, informed opinion without attributing malice or intent to spread falsehoods.

Most of all, the false narrative that a universal health care system somehow handles pandemics any better is clearly being proven wrong in the case of Italy, which is what I was trying to point out

⬐ danenania

No one really knows how the number will turn out. There are factors that could push it down: lack of testing, lots of mild cases; and factors that could push it up: the disease takes a long time to either recover or succumb to, so many of those who will end up dying from it haven't died yet.

Resiliency of healthcare systems also clearly has a major impact. It might be well under 1% in a "first world" country where hospitals can keep up, and well over 10% in a "third world" country where they can't.

While a 7% mortality rate certainly isn't some kind of objective fact, it's unfortunately not out of the realm of possibility for us in a worst-case scenario where the healthcare system is completely inundated. It's better to face up to that possibility than downplay it even if it scares people, because we urgently need people to act so it doesn't get that bad. While I agree that people shouldn't fear-monger, it's far more irresponsible at this point to downplay the risk than to (arguably) overstate it.

⬐ whiddershins

This is a negative and overall unhelpful comment.

Not only do I not agree with your characterization of what is useful for him to do, your ideas about health care policies and mandatory sick are irrelevant, distracting, unimaginative, and an example of moral posturing that takes the form of demanding employers somehow take this burden, basically it is moral for you to demand someone-not-you foot the bill for something you think should happen.

I deeply wish this wasn’t the highest voted comment on this submission.

⬐ saiya-jin

Well here is where you disagree with most of the HN crowd including me. Maybe you are rich enough or insensitive enough to not care. That in fact doesn't matter at all.

Free/almost free good enough healthcare, and education in similar vein are cornerstones of any society that would like to call itself fair, just and overall good place to live, not only for few elites. Everybody benefits from it, whole effin' mankind benefits from it long term.

Heck, even though I am relatively young and properly healthy, so I don't need to spend a cent on healthcare, I am happy to pay (swiss) one so that other benefit. Fuck society that doesn't do that.

⬐ whiddershins

Also “Fuck Society that doesn’t do that” [you are Swiss?] Am I understanding you correctly?

That’s grossly insulting and jingoistic. Maybe you should rethink your nationalism and arrogance.

⬐ whiddershins

These things aren’t free. It is merely shifting the costs.

Shifting costs to employers (mandatory paid sick leave) is generally immoral.

If people want to provide a benefit, do it with government spending, and remind yourself it is your money (taxes) that funds it.

If you are still willing to do it, at least you are putting your money where your mouth is.

⬐ burfog

It's nice that we have a choice, isn't it?

Those who don't want a socialized medical industry can live in the USA. Those who want it can live almost anywhere else in the world.

Choice is good. Make your choice. (seems you did, picking Switzerland?) Don't deny me my choice.

⬐ pmorici

This seems obviously false. Italy has universal health coverage and they have one of the worst outbreaks and worse fatality rates of any country. This doesn't feel like the right time to promote preferred political agendas. Doesn't matter who pays for it when there is no vaccine and no cure.

⬐ js2

We'll soon see how America's broken healthcare system combines with its undocumented immigrants and homeless.

⬐ Alex3917

And also people of color not filling out the census because they're afraid the government is going to send people to lynch them. Healthcare resources are completely misallocated because people are scared to tell the government where they live. During the last census, the response rate in Harlem was something like only 65%, which the government can tell based on electricity usage and toilet flush data.

⬐ nrp

On universal paid sick leave, the intent is to enable people to not go into their workplace when they could be contagious. The choice between risking getting others sick or going broke and getting evicted isn't one people should be forced to make.

On universal health coverage, the major difference is what the recovery looks like (potentially after the vaccine in countries where it's too late for containment). If there's any silver lining to this pandemic, hopefully it's that politicians who oppose universal health coverage become unelectable.

⬐ pmorici

I understand that but the op is advocating that those things would do more than having an ample supply of PPE and an effective treatment and vaccine which is total nonsense.

⬐ melenaboija

Partially agree with you.

Universal health coverage in this situation is meant to treat everybody in equality for same problem and I would say it doesn't matter who pays for it as long as everybody will get treated in a similar way.

Agree on European governments did not the right thing, but again, not sure if that has something to do with universal health.

⬐ ma2rten

Health insurance companies have already said they will cover COVID without copay/deductibles. I am sure that there will be free/low cost options for people without any insurance.

The people who profit from the current system know that there is a presidential election in November. They can't afford to let public opinion go against them. Ironically, I think that this event will cement the current system more.

⬐ amluto

Which means that, once a treatment or vaccine is available, the vendor can charge essentially whatever they please.

I think the federal government should buy or acquire by fiat the rights to produce remdesivir and contract, immediately, with multiple vendors to start mass production. If the trial pan out, the US alone may need enough to treat a few million people. If the trials don’t pan out, some money is lost.

(I’m not saying Gilead shouldn’t be fairly compensated. By all means, pay them a few billion dollars. But don’t allow them to extract $50k per case. And don’t allow them to delay widespread availability while negotiating.)

FWIW, China appears to be doing this right now. A Chinese company is manufacturing the drug now and is essentially ignoring the patent.

⬐ rjzzleep

Let's not forget that the US did that with the Anthrax vaccination.

https://www.theguardian.com/business/2001/oct/23/anthrax.bus...

⬐ fma

If I recall, in addition to ignoring the patent, the Chinese company is taking the Gilead drug, repurposing it and then owning a new patent for the Corona virus...

⬐ amluto

To some extent the legal wrangling its irrelevant. China is likely to want large amounts of the drug, and they aren’t waiting. Presumably there will be a lawsuit and a settlement. Gilead has very little leverage in China, unless they are able to outproduce the home grown manufacturer.

⬐ claudeganon

> Health insurance companies have already said they will cover COVID without copay/deductibles.

This has been said about testing and coverage for testing is included in the bill that passed the house. But I’ve seen it nowhere reported that this is true for treatment. What’s the source for this claim?

> I am sure that there will be free/low cost options for people without any insurance.

The only provision currently on the table is Medicaid expansion to states for treatment, but the amount of people who are or will be ineligible for Medicaid (assuming they got laid off) is quite large. I’m not certain how you can be “sure” of this.

⬐ ma2rten

It turned out it was a misstatement by Trump:

https://www.cnn.com/2020/03/12/politics/fact-check-copays-co...

⬐ dang

Please don't take HN threads on generic tangents. They're predictable.

https://hn.algolia.com/?dateRange=all&page=0&prefix=false&qu...