This just-in-time healthcare model depends on cutting costs at every corner in order to improve the bottom line. The fact that we may run out of protective equipment for hospital staff and ventilators for sick patients is part of how the system operates. As Maggie Koerth from fivethirtyeight.com recently noted, "We have this healthcare system that is operating with no real margin for extra beds and extra supplies."

Consequently, when we think about risk for COVID 19 a big part of the story that must not be ignored is the role that our market-based healthcare system has played in producing vulnerability.