Patrick McKenzie — Money laundering, big tech censorship, SBF & Japan

**Dwarkesh Patel** (0:00)
Today, I'm chatting with Patrick McKenzie. He is known for many things. On the internet, he's known as Patio11.
Most recently, he ran VaccinateCA, which probably saved on the order of high four-figure number of lives during COVID. He also writes an excellent newsletter called Bits About Money. Patrick, welcome to the podcast.

**Patrick McKenzie** (0:18)
Thanks very much for having me.

**Dwarkesh Patel** (0:19)
So what was VaccinateCA?

**Patrick McKenzie** (0:21)
In early 2021, we were quite concerned that people were making 20, 40, 60 phone calls to try to find a pharmacy that actually had a dose of the COVID vaccine in stock and could successfully deliver it to them.
I tweeted out randomly, you know, it's insane that every person or every caregiver is attempting to contact every medical provider in the state of California to find doses of the vaccine. California clearly has at least one person capable of building a website where we can centralize that information and send everybody to the website. If you build that website, I'll pay for the server bill or whatever. And Carl Yang took up the gauntlet and invited 10 of his best friends and said, basically, all right, get in, guys. We're going to open source the availability of the vaccine in California by tomorrow morning. This is at like 10 p.m. at night California time. And so I lurked on into the Discord where, of course, all medical infrastructure is built and gave a few pointers on making scaled calling operations. And then one thing led to another and ended up becoming the CEO of this initiative. At the start, it was just like this hackathon project of a bunch of random tech people who thought, hey, we can build a website, make some phone calls, maybe help some people find the vaccine at the margin.
And it grew a little bit from there. We ended up becoming essentially the public-private partnership, which was the clearinghouse for vaccine location information for the United States of America. That felt a little weird at the time and continues to.

**Dwarkesh Patel** (1:37)
Okay, so the obvious question is, why was this something that people randomly picked up on a Discord server? Why wasn't this an initiative either by an entity delegated by the government or by the White House or the pharmacies have a website where you can just sign up for an appointment?

**Patrick McKenzie** (1:56)
Oh, there are so many reasons and a whole lot of finger pointing going on. One of the things was that there were almost no actors anywhere in the system who said, yes, this is definitely my responsibility. Various parts of our nation's institutions, county level public health departments, governor's offices, the presidency, two presidencies over this interval, which will become relevant.
They all said, well, I have a narrow part to play in this, but someone else has to do the hard yards of actually putting shots in people's arms. And someone else is clearly dealing with the logistics problem, right? And the ball was just dropped comprehensively, and no one at the time really had a plan for picking it up or didn't feel like it was incentive compatible for them specifically to pick it up right now. It would be great if someone could do this, but just not me.

**Dwarkesh Patel** (2:45)
Okay, so to explain the context and how important it was that people get vaccines at the time and how much these delays mattered, you can account for it obviously in the amount of lives saved. You can even look at it in terms of when vaccine news was announced, how much the stock market moved.
It was clear it was worth trillions of dollars to the economy that the vaccine be delivered on time. And so it should be priority number one that people know where the vaccine is. A sort of meta question is why are I kind of heard about this problem for the first time when I read your article about this?
Why is this there's a bunch of controversy after COVID about people pointing fingers about masks or different kind of protocols. Why was this not people are getting called in front of Congress? Why were we not able to deliver the one thing that was needed to arrest the pandemic as fast as possible?

**Patrick McKenzie** (3:35)
Well, if folks want to read 27,000 words on this, my article in Works in Progress called The Story of Vaccinate CA goes into some of the nitty-gritty, broadly, I think a matter of incentives more than matter of people choosing to do evil things, although I will say we did choose to do evil things and we can probe on that if you want to. But if you look at the federal government specifically, the federal government institutionally learned one, I believe wrong, lesson, which has terrible consequences from the healthcare.gov rollout a number of years ago when Obamacare was first debuting.