Scenario Plans (& Delphi Research)

I looked into the future, and the time to act is now.

Tag: compounding

PREDICT a Pandemic: First Kill those Pesty Scientists

Rough Road Ahead

Oh My God!

Trumps administration completely stopped the PREDICT program that did USAID training and response world-wide for pandemics.  Since the Bird Flu of 2005 (H5N1), the US presidents (Bush II and Obama) have moved toward building a program to identify potential pandemics and to help countries (including the USA) deal with such an eventuality. Of course, the PREDICT program got to deal with several pandemic-type events including SARS, MERS, Ebola and even Zika (mosquito). The idea, which apparently worked very well, is to fight a pandemic where it originates in other countries, so that you don’t have to fight it here in the USA. Of course, the train-the-trainer program would be developed and applied here in the USA.

Foreign aid through the US Agency of International Development (USAID) was frozen by the first few days of August 2019 (Trump administration freezes foreign aid funds pending review). The money of $2B to $4B that was unspent was to be frozen. An obvious indication that the aid programs and the employees associated with them were moving to temporary status. The end of PREDICT was predicted.

Donald McNeil discusses the closure of the PREDICT program in October 25, 2019:

“The program, known as Predict and run by the United States Agency for International Development, was inspired by the 2005 H5N1 bird flu scare. Launched 10 years ago, the project has cost about $207 million.

The initiative has collected over 140,000 biological samples from animals and found over 1,000 new viruses, including a new strain of Ebola. Predict also trained about 5,000 people in 30 African and Asian countries, and has built or strengthened 60 medical research laboratories, mostly in poor countries.”

McNeil, October 25, 2019

A letter to the USDA Administrator Mark Andrew Green summarizes, with footnotes, the phantom shutdown of the PREDICT program in 2019, with the promise of “something” to replace it going out for bid. The letter of Jan 30, 2020 by Senators Warren and King documents and articulates the key questions that arise for killing off this program to deal with pandemics. The senators’ full letter can be read HERE. [Yes, I know, they are mouthy Democrats, but check their footnotes. Footnotes in a letter!?]

In a prior ScenarioPlans blog post, the question was posed: How is it possible that we in the USofA did not have early warning signposts about the COVID-19 back in November or December of 2019?  Pandemic Scenario in Trump Transition Team, Days before Office. A practice drill on a hypothetical pandemic scenario was apparently wasted on the incoming Trump transition team.

The Real Donald Trump admiration in action has systematically pared back government organizations and killed off the scientists. Here’s what two past scientist, former undersecretaries of research, education and economics, say about Trumps war on science and scientist. When Trump simply cut the budgets for departments, the budget was restored by congress. So, apparently, new approaches were needed. Within the USDA, he relocated DC scientists and researchers to Kansas City, with a couple weeks’ notice. (Read about Mulvaney’s praise of the effective firing of half of the DC staff by USDA’s head Sonny Purdue.) Now he apparently shut down an entire global pandemic department, while also closing down the Pandemic Reponse team in the White House. What could go wrong?

If you were a bet’n man, and we know that Trump-the-Casino-Man is, you would expect to get 2 to 5 years before some pandemic swipes through the world. Even then, what’s the chance of it being a really, really bad pandemic?

The thing with scenario planning, is that you build detection mechanism (signals and signposts) so you identify potential changes in the future. Then as part of the scenario planning process (every couple years typically), you develop contingency plans including modifications to disaster recovery plans (DRPs).

Or, you simply kill off (fire) the voices of science and fact.

Out of Control Healthcare Costs, Delinkage may help?

We have a new blog post in IPZine about trying to control healthcare costs by taking a new twist on the linkage in BIG phara to patent protection. Check that out this article on delinkage of intellectual property protection.

In 2017 we talked about scenarios that jump out at you.

Scenarios that really stand out, including compounding effects.

One that always is front-and-center is the out-of-control escalation of healthcare costs in the US, now up to 18% of GDP. In an Nov 20 2019 blog over at IPZine there’s discussion of “delinkage” related to pharma patents that has some potential for taming the out-of-control healthcare costs.  Included in that blog post is a discussion of how long it will take before healthcare costs escalate from 18% of GDP (approx. $3.6T of the $20T GDP) to 50% of GDP, and even 100% of GDP?

Here is some of the math. You can do your own figures. Assume that Healthcare costs increase by 10% per year as they have for decades (even though that rate is lower currently). Say that GDP growth is 2.5% and inflation is 2% (real GDP growth is =+0.5%). How many years before all healthcare costs in the US reach 25%, 50%, 75% and even 100% of the US GDP!???

Year Description (+10%) Targe%GDP # of Years
2025 Years til % of GDP 25% 4.5
2034 Years til % of GDP 50% 14.1
2040 Years til % of GDP 75% 19.7
2044 Years til % of GDP 100% 23.7

That’s right, with 4 or 5 years, the total healthcare costs of the US could be 25% of GDP. In 14 years it could be 50%, and in 20 years it could represent 75% of GDP. If this doesn’t scare you into taking some actions, then you obviously don’t understand the magnitude of the problem! This was the problem that we faced for decades when Healthcare costs were increasing at 10% or more each year.

Okay, so healthcare costs are lower now since the Great Recession; let’s say they may have dropped to 5% to 7.5 increase per year (2 to 3 times CPI inflation).

At 5% healthcare inflation:

Year Description (+5%) Targe%GDP # of Years
2033 Years til % of GDP 25% 13.3
2061 Years til % of GDP 50% 41.4
2078 Years til % of GDP 75% 57.8
2089 Years til % of GDP 100% 69.4

Note that it is no longer 4 or 5 years to reach 25% of US GDP, it takes more like 13 years. It takes 40 years to reach about 50% of GDP.

When you consider that the US spends 4 times what the rest of the world spends on healthcare (about $10k) and more than twice what the typical developed country spends… For outcomes that are no better… Some place in here we need to rethink.

Hall and Knab (2012) outlined 10 other items besides healthcare costs that were non-sustainable trends/practices that appeared to have compounding and accelerating forces at play. The (US) Federal deficit is one. Each of those scenarios loom as large or larger today than back in 2012.

#scenario #healthcare #gdp #compounding #ipzine #patents #intellectualproperty

References

Hall, E., & Knab, E.F. (2012, July). Social irresponsibility provides opportunity for the win-win-win of Sustainable Leadership. In C. A. Lentz (Ed.), The Refractive Thinker: Vol. 7. Social responsibility (pp. 197-220). Las Vegas, NV: The Lentz Leadership Institute. (Available from www.RefractiveThinker.com, ISBN: 978-0-9840054-2-0)

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