They set rules for everything from how many hospitals can be owned by a single entity, to what sorts of qualifications are required for hospital administrators, to what types of medical orders are allowed to be given to patients. Their explicit charter is to ensure Medicare and medicaid patients are cared for and their health is looked after. From that lens, requiring a vaccination that reduces the likelihood that one of those patients is infected with a potentially deadly disease (particularly deadly for those on Medicare, given the demo), is eminently reasonable.

And the administrator is confirmed by congress. If this regulation was about almost anything else, this would be a nothingburger

Congress often delegates their power to other agencies. It’s an important regulatory function that allows agencies to adapt to a changing world even in a gridlocked legislature.

Note that while the position is appointed by POTUS, it is a Senate confirmed position - she was approved with a vote of 55-44 [0] (with five R votes).

[0] https://www.senate.gov/legislative/LIS/roll_call_lists/roll_...

I'm from a country (UK) where parliament has absolute power, but also where the populace largely trusts the civil service. Health decisions, prosecution decisions, and so on are explicitly devolved from the government so that they don't become politicized. To me, that seems better, rather than asking politicians to intercede in what should essentially be decisions for experts to make.

If the CMS does it, it is a public health decision. Doing it in Congress makes it a political decision.

IMO, the better route is that the CMS issues the mandate, but that Congress ratifies it. Ie, they have to provide a clear reason why the public health decision should be overruled.

Do you mean like "Efficacy of Pfizer/BioNTech Covid vaccine slips to 84% after six months, data show" (https://www.statnews.com/2021/07/28/efficacy-of-pfizer-biont...) or "Covid-19 Vaccine Efficacy: What Do the Numbers Really Mean?" (https://www.wsj.com/articles/covid-19-vaccine-efficacy-what-...)? Or did you have something else in mind?

I thought this was pretty well-discussed as VRBPAC/ACIP began to review the data guiding their third dose/booster recommendations but maybe I've misunderstood.

Strongly agree. Tangentially, I felt this way about net neutrality. It should have been law passed by Congress. Instead, everyone cheered when an unelected executive board passed a net neutrality bill that the public wasn't allowed to read.

And then, everyone had the audacity to be surprised when the FTC undid net neutrality as fast as it did it. There is a reason we have a legislature and not just an executive branch that can do anything it wants.

This is not true at all. Media has been talking openly about "waning immunity" and "declining effectiveness" all along.

It didn’t pan out because of Delta, a way more infectious variant that became common well after the 95% figure was determined.

And it’s fully accurate to say that despite Delta, the vaccines are effective at preventing severe disease, hospitalization, and death. I think that’s a very good thing!

CMS is one of the largest government agencies (by budget, >$1T annually).

Even that might not be quite the best end result to be looking for (unless you own the jab patents).

Shouldn't we be looking at clinical outcomes of covid patients, or counts of severe covid cases instead?

If we optimized for marriage rate in the world we might end up with a whole lot of unhappy couples and/or broken homes.

Jacobson v. Massachusetts[1] established that it is within the State's power to mandate vaccinations, so shouldn't this be up to individual states? I'm also pro- nationwide mandatory vaccinations, but Congress also doesn't seem to be the right way to do it.

1: https://supreme.justia.com/cases/federal/us/197/11/

Odd, the fact that you have never heard about the CMS has no bearing on whether it has the authority to issue a vaccine mandate

Are you aware that Federal regulatory agencies are a result of Congress delegating their power, mostly to the executive branch? Congress has already delegated their authority…

There’s a reason, for example, why we don’t let the market or public opinion dictate the efficiency or safety of drugs.

I remember that too, and I think its needed context.

Which is it?

Maybe social utilitarianism is all there is?

Maybe the rest is just being left alone. Formal demands by churches their flock act as social missionaries and stewards to save others souls being LARPed in a secular world.

Why do I have to care about inside these machines and not just the machines (organic or synthetic)?

There are separate needs due to physics that we cannot let our imaginations of unfettered freedom disabuse us of.

That will lead to mistrust; if moral relativism is fine for anti-vaxxers, why not open hostility? My biology cannot control itself in all situations.

We don’t let a chainsaw wielding psycho live in his own world. That’s based on real world observation of the outcomes.

How is viral transmission that can be measured physically, even though it requires some specific tools, be considered any less violent towards others than a chainsaw wielding knob? Our evidence comes from the same observable space as our evidence a chainsaw wielding knob is unsafe.

Philosophical wankery does not change the physical truth.

That's a facile statement. I'd have to bait an HN into playing devil's advocate just to get an opposing view.

What are the "Zig and Rust" of protecting democracy in a time of crisis? Or maybe more realistically-- if we want a "Zig and Rust" for making democracy "memory safe," what are the sources to start with? (Note: I'll filter any citations that rely on invisible hands or, "let's start by decentralizing all the thingies")

Better to wait for the updated booster before forcing more people to take it.

In other words most healthcare workers share the same demographics as those who currently have low uptake on the vaccine.

https://www.kff.org/other/state-indicator/flu-vaccine-requir...

Even without vaccines, that means nearly half of Americans already have natural immunity which is vastly superior to vaccine immunity.

https://www.cdc.gov/coronavirus/2019-ncov/cases-updates/burd...

in her words no one really knows how the lipid nanoparticles actually work, and it is much too soon to be forcing this onto the public, and thats just the delivery mechanism. so you have a novel mRNA vaccine, with a novel delivery mechanism, and very little long term safety data. she does not feel like these have been tested to the same standard as other vaccines, we are at the point where if this is mandated for our children we will probably move somewhere they are not.

https://www.ama-assn.org/press-center/press-releases/ama-sur...

Just because someone works in Medicine doesn't mean they are intelligent.

In many parts of Asia and Sub-Saharan Africa, hesitancy, misinformation on social media, and lack of adequate institutions is now more of a hindrance than getting shipments.

https://www.nytimes.com/2021/12/01/world/africa/coranavirus-...

These people were considered heroes last year (and overwhelmingly exposed to this virus while everyone else stayed at home). Now their judgment is in question because they won't follow the herd, with all of their medical experience/expertise being rejected or discredited. The inconsistency is a work of art.

Everyone should read this: https://www.amazon.com/Rape-Mind-Psychology-Menticide-Brainw... — you will find an alarming number of parallels to our current situation.

For thousands of years, privileged citizens of empires have gotten more rights and better treatment than non-citizens and foreigners. Some humans are just born into a position where they don't need to fear for their life or fight to survive. This is true even in the US; all over the country, in the same square mile, you will find people starving, and people throwing away good food; people rejecting a vaccine just to exercise their personal power, and people waiting 8 hours outside in freezing cold to get one. Our societies seem destined for injustice.

The vast majority of doctors get themselves vaccinated, whereas a large portion of nurses only get vaccinated as needed legally.

Are these people performing treatments on patients that they do not believe work?

The mind boggles.

https://news.ycombinator.com/newsguidelines.html

Also, the virus does care about the things you mention, insofar as they affect infection vectors i.e. If you don't have the power to avoid situations that put you at risk.

And what about other choices that impact emergency care? Obesity related illness and injuries, smoking and other cancer-inducing habits, dangerous activities such as motor sports and rock climbing, workplace injuries without appropriate PPE, auto accidents without helmets and seat belts, etc.

And who is it that gets to be the moral arbiter of what is acceptable? To me, it seems like whoever is in power. What happens when “the other side” from your perspective wins an election cycle?

Or, for that matter, to other groups of people with an "illness that could have been prevented by a widely and freely available measure"?

A few spring to mind immediately – obesity first and foremost.

In broad terms, I agree with your approach: incentives at the personal level. Bottom-up. But in many countries (mine included, in EU), "health insurance" is really just a tax. There's no connection between your health & behaviour, and the "insurance" cost or fulfillment. So what you propose would essentially amount to privatizing health care, or at least turning it from an income tax into real insurance.

I don't do personal attacks but in your case I'll make an exception: you are a fucking psychopath if you think it's ok to tell people to get a jag for something that is killing literally no one right now!

We're at around 100 deaths per day right now in the UK [0] and those stats don't actually tell you if they died FROM covid or merely had covid 28 days earlier when they died (massive difference!)... completely hides the real data.

In addition, there are on average 450 deaths per day from cancer [1] so where is the big gov. push to eradicate that?

Here are the overall death stats in the UK [2]. COVID is a tiny fraction of it.

[0] - https://coronavirus.data.gov.uk/details/deaths?areaType=over... [1] - https://www.cancerresearchuk.org/health-professional/cancer-... [2] - https://www.ons.gov.uk/peoplepopulationandcommunity/birthsde...

So condoms, another life-saving invention, should also be mandated? Should you lose your job if you don't wear your seat belt? (Wearing a seat belt does save others by preventing you from becoming an out-of-control projectile and hitting others.) Should people be prevented from buying unpasteurized milk if they want it? Should smokers be forced to quit with the threat of losing their job or fines or jail time, especially since their smoke affects others?

> Did people forget that we eradicated Polio, Tetanus, Hepatitis etc?

Those are sterilizing vaccines that survived longer scrutiny than the COVID ones, and the COVID ones are not sterilizing.

To be honest, the lies around the COVID vaccines have me now questioning those supposedly safe vaccines.

> Where does this sudden influx of people come from that are opposed to this absolute incredible work of science?

If they are anything like me, they came because of the lies we were told. Once we figured out they were lies, it was a natural thing to question other things.

And the vaccines are not an incredible work of "science." They are an engineering effort. That sounds a lot like Fauci claiming that people who criticize him are criticizing science, as though he defines what science is.

Spoiler alert, he does not.

Is... that meant to be a bad thing? Yes, judicial branch should not be directly accountable to voters. In fact, as a Canadian, I find the idea of electing judges to be so thoroughly strange that it almost defies belief. Why the hell would you want your judicial branch to be "democratic", as in directly and immediately beholden to the whims of the mob? It should be behind layers of indirection, only generally accountable to the voters, and with a long lag to boot.

Also, they explicitly said that Congress should do it, as our elected representatives. That's basically putting the authority where it belongs, if it exists. That's not about preventing government from doing anything.

And what's wrong with dismantling the administrative state? Many industries are already over-regulated because there are so many agencies, so many rules, and often, those rules conflict. The administrative state is a hindrance to progress and innovation because it keeps new players from entering the field.

Why do you think that "dismantling" it will lead to ruin?

We have unelected officials who are making decisions against the will of the people. The entire system is too large for any person to affect change. That is why we see “crises;” they allow people to focus the group onto a crisis. In normal times, the entire industry reverts to how can they increase their size..

Not sure what you’re complaining about. You seem to both want more and less democracy at the same time. Just because the president is elected doesn’t make him a king, and doesn’t make anything he does democratic.

I don’t think that’s what you intended, but thank you!

If you don't like the law, get Congress to change it.