Category: Law

That was then, this is now — pandemic response capabilities

From 2005:

Before adjourning last week, the US Senate passed and sent to President Bush a bill providing $3.8 billion for pandemic influenza preparedness and a controversial liability shield for those who produce and administer drugs and vaccines used in a declared public health emergency.

The preparedness funding and liability protection were part of the fiscal year 2006 defense spending bill passed by the Senate on the evening of Dec 21. The bill had cleared the House 2 days earlier.

The $3.8 billion for pandemic preparedness is a little more than half of the $7.1 billion Bush had requested in early November. House Republican leaders said last week the measure would fund roughly the fiscal year 2006 portion of Bush’s request.

As reported previously, the amount includes $350 million to improve state and local preparedness and directs the Department of Health and Human Services (HHS) to use most of the rest on “core preparedness activities,” including increasing vaccine production capacity, developing vaccines, and stockpiling antiviral drugs.

The liability provision offers broad legal protection for the makers of drugs, vaccines, and other medical “countermeasures” used when the HHS secretary declares an emergency. The provision says people claiming injury from a medical countermeasure can sue only if they prove “willful misconduct” by those who made or administered it. The bill calls for Congress to set up a compensation program for injuries, but it provides no funds for that purpose.

…But Sen. Edward Kennedy, D-Mass., and some other Democrats, along with consumer groups such as Public Citizen, derided the liability provision as a giveaway to the drug industry.

I am pleased to have argued for this in the time period leading up to this legislation, let us continue to hope we do not need it.

Why are we letting FDA regulations limit our number of coronavirus tests?

Since CDC and FDA haven’t authorized public health or hospital labs to run the [coronavirus] tests, right now #CDC is the only place that can. So, screening has to be rationed. Our ability to detect secondary spread among people not directly tied to China travel is greatly limited.

That is from Scott Gottlieb, former commissioner of the FDA, and also from Scott:

#FDA and #CDC can allow more labs to run the RT-PCR tests starting with public health agencies. Big medical centers can also be authorized to run tests under EUA. For now they’re not permitted to run the tests, even though many labs can do so reliably 9/9 cdc.gov/coronavirus/20

Here is further information about the obstacles facing the rollout of testing.  And read here from a Harvard professor of epidemiology, and here.  Clicking around and reading I have found this a difficult matter to get to the bottom of.  Nonetheless no one disputes that America is not conducting many tests, and is not in a good position to scale up those tests rapidly, and some of those obstacles are regulatory.  Why oh why are we messing around with this one?

For the pointer I thank Ada.

An argument for weaker copyright in books

From Barbara Biasi and Petra Moser:

Copyrights, which establish intellectual property in music, science,and other creative goods, are intended to encourage creativity. Yet, copyrights also raise the cost of accessing existing work – potentially discouraging future innovation.This paper uses an exogenous shift towards weak copyrights(and low access costs) during WWII to examine the potentially adverse effects of copyrights on science. Using two alternative identification strategies, we show that weaker copyrights encouraged the creation of follow-on science, measured by citations.This change is driven by a reduction in access costs, allowing scientists at less affluent institutions to use existing knowledge in new follow-on research.

The paper title is “Effects of Copyrights on Science: Evidence from the WWII Book Republication Program.”

The bureaucratization of U.S. foreign policy

The NSC [National Security Council] was established in the 1947 National Security Act, which named the members of the council: president, vice president and secretaries of state and defense. The function of the council “shall be to advise the president with respect to the integration of domestic, foreign, and military policies relating to the national security.” The law required regular meetings…

Mr. Kissinger grew the council to include one deputy, 32 policy professionals and 60 administrators. By my count, alumni of his NSC include two secretaries of state, four national security advisers, a director of national intelligence, a secretary of the Navy, and numerous high-ranking officials in the State, Defense and Treasury departments as well as the Central Intelligence Agency.

But the NSC has only continued to expand. By the end of the Obama administration, 34 policy professionals supported by 60 administrators had exploded to three deputies, more than 400 policy professionals and 1,300 administrators.

The council lost the ability to make fast decisions informed by the best intelligence.

Here is more from John Lehman (WSJ).

Does GDPR even boost privacy?

Maybe not:

This paper studies the effects of the EU’s General Data Protection Regulation (GDPR) on the ability of firms to collect consumer data, identify consumers over time, accrue revenue via online advertising, and predict their behavior. Utilizing a novel dataset by an intermediary that spans much of the online travel industry, we perform a difference-in-differences analysis that exploits the geographic reach of GDPR. We find a 12.5% drop in the intermediary- observed consumers as a result of GDPR, suggesting that a nonnegligible number of consumers exercised the opt-out right enabled by GDPR. At the same time, the remaining consumers are more persistently trackable. This observed pattern is consistent with the hypothesis that privacy-conscious consumers substitute away from less efficient privacy protection (e.g, cookie deletion) to explicit opt out, a process that would reduce noise on remaining consumers and make them more trackable. Further in keeping with this hypothesis, we observe that the average value of the remaining consumers to advertisers has increased, offsetting most of the losses from consumers that opt-out. Our results highlight the externalities that consumer privacy decisions have both on other consumers and for firms.

That is from a new paper by Guy Aridor, Yeon-Koo Che, William Nelson, and Tobias Salz, emphasis added by me.  Via the excellent Kevin Lewis.

What does the stock market tell us about the T-Mobile/Sprint merger?

Here is an excellent post by Alec Stapp, easy to read but a bit hard to excerpt but here are the closing bits:

As a few others pointed out, these relatively small moves in AT&T and Verizon (less than 3 percent in either direction) may just be noise. That’s certainly possible given the magnitude of the changes. Contra Philippon, I think the methodology in question is too weak to rule out the pro-competitive theory of the case, i.e., that the new merged entity would be a stronger competitor to take on industry leaders AT&T and Verizon. We need much more robust and varied evidence before we call anything “bogus.” Of course, that means this event study is not sufficient to prove the pro-competitive theory of the case, either.

Olivier Blanchard, the former chief economist of the IMF, shared Philippon’s thread on Twitter and added this comment above: “The beauty of the argument. Simple hypothesis, simple test, clear conclusion.”

If only things were so simple.

Recommended.  Addendum: Philippon comments.

When defense is not a public good

Security measures that deter crime may unwittingly displace it to neighboring areas, but evidence of displacement is scarce. We exploit precise information on the timing and locations of all Italian bank robberies and security guard hirings/firings over a decade to estimate deterrence and displacement effects of guards. A guard lowers the likelihood a bank is robbed by 35-40%. Over half of this reduction is displaced to nearby unguarded banks. Theory suggests optimal policy to mitigate this spillover is ambiguous. Our findings indicate restricting guards in sparse, rural markets and requiring guards in dense, urban markets could be socially beneficial.

That is from Vikram Maheshri and Giovanni Mastrobuoni, forthcoming in Review of Economics and Statistics.  Via Peter Deffebach.

From Mark Lutter — charter city for Zambia?

I’m pleased to announce the Charter Cities Institute has signed a memorandum of understanding with the Zambian Development Agency. They are planning to propose changes to their special economic zone act to parliament, and we are working with them to improve their proposal and make it adhere closer to charter city best practices, namely, larger size, mixed use developments, deeper reforms, and local autonomy.

The memorandum of understanding is an important step in piloting charter cities. We are proud to partner with the Zambia Development Agency and Nkwashi in bringing charter cities to reality.

Mark, along with Tamara Winter, was part of the first cohort of EV winners.

Is the world fortunate that the coronavirus hit China first?

Is the world fortunate that the coronavirus hit China first? China’s government has totalitarian impulses but that–for the most part– is working to its favor in combating the virus. What other country in the world could quarantine a city of 11 million people on the basis of (at the time) 17 reported deaths?

CNN: Across China, 15 cities with a combined population of over 57 million people — more than the entire population of South Korea — have been placed under full or partial lockdown.

Wuhan itself has been effectively quarantined, with all routes in and out of the city closed or highly regulated. The government announced it is sending an additional 1,200 health workers — along with 135 People’s Liberation Army medical personnel — to help the city’s stretched hospital staff.

China’s response to the virus has been unprecedented and one cannot help but be a little bit impressed.

I was in India recently and if the coronavirus hits India it could spread very rapidly and millions could die not just in India but around the world. India does not have a strong public health system (it has invested instead in sickness treatment, another example of premature imitation), it also has plenty of other opportunistic diseases and bacteria which would magnify viral sickness and overwhelm the public health system, and India does not have a state strong enough to effectively lock down cities. India’s only big advantage versus China is that it’s relatively free press and communication system could make an outbreak more quickly spotted. China, in contrast, tried to hide the initial outbreak. This does, however, cut both ways. India’s 1994 outbreak of the plague quickly became news, which led to official action, but hundreds of thousands of people quickly left the epicenter in Surat–smart action at the time but deadly if those fleeing are infectious.

We need a Manhattan Project to research, develop and produce new vaccines at a faster pace; the US is best placed to be the world leader in this regard. On other actions, the United States stands somewhere in between China and India. US quarantine action would certainly be slower than in China but it could happen, probably through the military, as we are seeing now.

The US approach of slow but eventually decisive action is probably best but how slow is too slow? Right now most people assume that the coronavirus is a blow to China but if does create a serious pandemic then China may be the first to recover and stabilize.

Hat tip: Lunch discussions with Robin, John and Ajay.

What is the best model for thinking about this lack of higher ed reporting?

The Education Department opened investigations into Harvard and Yale as part of a continuing review that it says has found U.S. universities failed to report at least $6.5 billion in foreign funding from countries such as China and Saudi Arabia, according to department materials viewed by The Wall Street Journal…

The department described higher-education institutions in the U.S., in a document viewed by the Journal, as “multi-billion dollar, multi-national enterprises using opaque foundations, foreign campuses, and other sophisticated legal structures to generate revenue.”

…Universities are required to disclose to the Education Department all contracts and gifts from a foreign source that, alone or combined, are worth $250,000 or more in a calendar year. Though the statute is decades old, the department only recently began to vigorously enforce it.

Officials accused schools of actively soliciting money from foreign governments, companies and nationals known to be hostile to the U.S. and potentially in search of opportunities to steal research and “spread propaganda benefitting foreign governments,” according to the document.

In addition, while the department said it has found foreign money generally flows to the country’s richest universities, “such money apparently does not reduce or otherwise offset American students’ tuition costs,” the document said.

Here is the full WSJ story.

Transcript of my chat with Thomas Kalil

We have the transcript live on our Day One Project site: https://www.dayoneproject.org/cowen-kalil-transcript

Here was the video version, with some sound imperfections.  And from Schmidt Futures:

…some context on the broader event is here, along with details on our open call for innovation, science, and tech policy ideas to inform the priorities of the next presidential term – your community undoubtedly would have great contributions. We are accepting submissions of these ideas through the Day One Accelerator until March 1.

I am very much looking to my Schmidt Futures event coming up this March.

Might the coronavirus bring freer speech to China?

That is the topic of my latest Bloomberg column, here is one excerpt:

Chinese citizens are currently upset and panicked, and their online communication might exceed the ability of the censors to control it. Some censorship is done algorithmically, but much of it is performed by humans, if only because the algorithms are far from perfect and cannot pick up on the rapidly changing allusions and code words people use.

What happens if there are too many subversive messages to censor? The system might break down, and speech might become more free. Reimposing censorship might be difficult, politically and logistically.

There is yet another reason censorship might prove difficult. If you feel desperate and fear for your health, the penalties for speaking out online might not seem so bad by comparison. You might not care so much about that promotion at work or your standing in the party. Moreover, the stress of the situation may lower your inhibitions. And if public criticism becomes more common, it may seem safe to join the growing crowd. The eventual result of all this would be a partial collapse of censorship.

The link also considers the entirely possible scenario that Chinese liberties could instead decrease.

Utah sends employees to Mexico for lower prescription prices

Ann Lovell had never owned a passport before last year. Now, the 62-year-old teacher is a frequent flier, traveling every few months to Tijuana, Mexico, to buy medication for rheumatoid arthritis — with tickets paid for by the state of Utah’s public insurer.

Lovell is one of about 10 state workers participating in a year-old program to lower prescription drug costs by having public employees buy their medication in Mexico at a steep discount compared to U.S. prices. The program appears to be the first of its kind, and is a dramatic example of steps states are taking to alleviate the high cost of prescription drugs.

In one long, exhausting day, Lovell flies from Salt Lake City to San Diego. There, an escort picks her up and takes her across the border to a Tijuana hospital, where she gets a refill on her prescription. After that, she’s shuttled back to the airport and heads home.

Lovell had been paying $450 in co-pays every few months for her medication, though she said it would have increased to some $2,400 if she had not started traveling to Mexico. Without the program, she would not be able to afford the medicine she needs.

Here is the full story, via Jonathan Falk.

What causes car deaths and how to limit them

Perhaps the biggest reason why we don’t see more fatal crashes on freeways is that there are no intersections on them (with a few exceptions). In fact, there are more drivers killed in intersections (20%) than on freeways.

After accounting for freeways (18%) and intersections and junctions (20%), we’re still left with more than 60% of drivers killed in automotive accidents left accounted for.

It turns out that drivers killed on rural roads with 2 lanes (i.e., one lane in each direction divided by a double yellow line) accounts for a staggering 38% of total mortality. This number would actually be higher, except to keep the three categories we have mutually exclusive, we backed out any intersection-related driver deaths on these roads and any killed on 2-lane rural roads that were classified as “freeway.” So, to recap, 3 of out every 4 deaths in a car occur on the freeway, at an intersection/junction, or on a rural road with a single lane in each direction.

And:

In drivers killed on 2-lane rural roads, 50% involved a driver not wearing a seat belt. Close to 40% have alcohol in their system and nearly 90% of these drivers were over the legal limit of 0.08 g/dL. About one-third involved speeding, and 16% did not have a valid driver’s license.

Here is the full piece by Peter Attia, interesting throughout.  Via Anecdotal.

DIY Pancreas?

People suffering from diabetes have turned to sophisticated do-it-yourself technologies. Here’s the abstract to an excellent article on these developments by Crabtree, McLay and Wilmot:

Diabetes technology has been advancing rapidly over recent years. While some of this is driven by medical technology companies, a lot of the driving force for these developments comes from people living with diabetes (#WeAreNotWaiting) who have developed their own ‘do-it-yourself’ artificial pancreas systems (DIY APS) using continuous glucose monitoring, insulin pumps and smartphone technology to run algorithms shared freely with the intent of improving quality of life and glycaemic control. Existing evidence, although observational, seems promising but more robust data are required to establish the safety and outcomes. This is unregulated technology and the off-label use of interstitial glucose monitors and insulin pumps can be disconcerting for people living with diabetes, health care professionals, organisations, and diabetes technology companies alike.

Here we discuss the principles of DIY APS, the outcomes observed so far and the feedback from users, and debate the ethical issues which arise before looking to the future and newer technologies on the horizon.

Hat tip: Dennis Sheehan.