michael lewis’ “the premonition.”

Michal Lewis’ new book “The Premonition” couldn’t be more newsworthy.  Through the stories of three individuals who worked in the public health system, Lewis makes plain just how we ended up with a dysfunctional CDC at a time of a global pandemic.

In an interview with Nicolle Wallace of MSNBC (5/12/21) Lewis notes that we should question whether any of our government is best run by political appointees.  The CDC went from an institution run by experts to a home for those who needed to be politically rewarded.

Lewis also notes that there are characteristics of our economic system that made us unable to respond adequately to a crisis, in this case the pandemic, but the problems would be there in any crisis.   

Lewis notes that the for-profit system is so entrenched in the society that we are unable to avail ourselves of solutions even when they present themselves unless they exist within the for-profit world. 

He tells a story of a non-profit testing lab. When the owners of the lab saw that the CDC was not going to be able to adequately test people for COVID, it developed its own test and tried to give it away for free.  But, accepting a free testing service was problematic for some.  In one case, the agency approached could not use the free testing because its computer system could not accept any entry that had a $0 for the price. 

The testing lab went to San Quentin prison and warned them that if no testing was done in such a confined institution, the result was likely to be a disaster.  Those in charge initially accepted the testing but then quickly backed out.  When asked why, those in charge explained that they already had established contracts with big testing labs and they were afraid that accepting another test would infringe on their contracts or at the very least, make the big testing firms angry.

The testing provided by the big labs was more cumbersome and took more time.  The result, prisoners were transferred into the facility with COVID and twenty people died.  Twenty people died needlessly because the big labs needed to make money off their monopoly control over testing at San Quentin. 

As Lewis points out there are risks in the social environment that only the government can manage.  If we hollow out the ability of the state to manage these risks we do so at our own peril.  People like Ted Cruz may be able to fly off to another country and stay in a sealed community, but the rest of us can’t. 

Lewis also notes that the entire structure of incentives for health care is defective.  There are, for example, no incentives for preventive medicine. 

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