This article is a strong argument for invoking the DPA – the medical market has become a deeply dysfunctional Wild West, and desperately needs some top down coordination.
That said, I’m growing less optimistic on its prospects – a brief thread. 1/
washingtonpost.com/business/2020/…
That said, I’m growing less optimistic on its prospects – a brief thread. 1/
washingtonpost.com/business/2020/…
Effective top down coordination in a crisis would be great. As that Post article shows, US hospitals are in the dark negotiating with shady middle men, bidding up prices against each other. No one knows where these goods are coming from. It’s a mess. 2/ 
But the recent record of the USG doesn’t give much reason to expect effective coordination. Partially this is about Trump himself, and the appointees/high level advisers around him, who don’t exactly inspire confidence. 3/
But it’s also a much longer trend of underinvesting in the administrative and regulatory capabilities of the state, driven by a mix of ideology and austerity. Which is how you end up with the FDA asking on Twitter for info on supply chain bottlenecks. 4/
In the abstract, top-down coordination in a time of crisis makes tons of sense. But in the actually existing world we find ourselves in, we should temper our expectations. 5/
To paraphrase from Donny Rumsfeld, you go to (pandemic) war with the administrative state capability you have, not the administrative state capability you might want or wish to have at a later time... 6/
Ultimately, I still think we need a more coordinated, DPA-driven approach here. But we should be realistic about the stumbles the administrative state - the one we have, not the one we might want - is likely to face. 7/
And, crucially, we should interpret such stumbles as evidence of the need to rebuild our administrative state capability, not evidence that bureaucratic coordination and regulatory interventions are always doomed to failure. 8/
Because there are likely to be similar disruptions to supply chains in the future, and we should aim to be better prepared for the next one. 9/end
