Circuit breakers

The blame game is rolling. “Regulations delayed American labs from deploying test kits.” “The WHO was too slow in declaring an emergency”. “Lack of public healthcare in the US means that patients getting tested for the virus are billed thousands of Dollars.”

(For once) it is not (only) about centralization or about lack of public coverage. It is about the lack of circuit breakers: emergency measures that bypass normal procedures.

My affectionate readers will know that I am an advocate for decentralized, bottom-up solutions. However, for what concerns the reactions to emergencies, what is being problematic is not centralization, but the unconditional reliance on it.

For example, the WHO. The idea of having a centralized organization pooling and coordinating medical resources to assist countries undergoing crisis is laudable. Relaying on a centralized organization to sound the alarm bell is utterly stupid.

Or globalization. There are many upsides to it, such as great products at low price available everywhere. The point is not to stop globalization, but the unconditional reliance on it. It’s okay to have thousands of planes flying from everywhere to anywhere. It’s not okay not being able to stop them when needed, for example to stop a pandemic.

Or private healthcare. The usual discussion people have regarding private or public healthcare is largely irrelevant regarding the epidemic. A private healthcare system with a circuit breaker would realize that it has to subsidize tests and other COVID-related treatments during the pandemic (like Singapore is doing). In a pandemic, everyone benefits from a fast diagnosis and a good treatment for everyone else who got the virus, because someone who doesn’t get diagnosed and treated becomes a spreader. All private healthcare systems should have a circuit-breaker to transition to public healthcare systems during a pandemic, at least for the matters relating to it.

The debate between centralization and decentralization or between private and public can go on, but there is no excuse – from both sides – not to implant, immediately, some circuit breakers into their current system.

Because any system without circuit breakers, no matter its nature, is vulnerable to disruption when it matters most.

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This short essay is built upon ideas from Nassim Nicholas Taleb (the paragraph on globalization) and Francisco Amadeo (the idea of circuit breakers).