Bill Gates slams 'shocking' U.S. response to Covid-19 pandemic
I appreciate a lot of Gates&#x27; statements here, since they are substantive and not just posturing. The issue is that the US medical system is rotten to the core. There are hundreds of thousands of wonderful individual practitioners and even thousands of excellent teams, but the system as a whole is broken.<p>His idea that no one should be paid for a test result if it takes more than 24 hours to result is not bad, but the existing system is not set up for it. Decades of regulation of all aspects of the US medical system, from billing codes even to electronic health records, would prevent that kind of change from being adopted overnight. If we adopted this change, you&#x27;d very likely see almost no one running any COVID tests at all - the risk and infrastructure investment would be too high, for too little payout. (Recouping the cost of lab tests is generally hard as is, since the costs of running a medical lab are almost entirely fixed, both in terms of labor and capital. Routine maintenance must be performed, the lab must have a certain contingent on duty to handle stat tests, etc.)<p>I&#x27;m not sure the US system can be improved unless we have some practitioners who want to make a clean break from the existing regime, and they get some cover from the government to actually innovate. I&#x27;m not holding my breath.