Archive for the ‘Leadership’ Category

This Is Madness

Friday, November 13th, 2020

Let’s start with the numbers.

Global Cases

Global COVID-19 cases are rising and the rise is accelerating, as documented by the Johns Hopkins Coronavirus Resource Center. There have been nearly 53 million cases around the world, 660 thousand yesterday. There have now been about 1.25 million deaths, and the death rate is also rising.

U.S. Cases

According to the New York Times Latest Map and Case Count, America’s case rate is surging faster than at any time in the pandemic.

Consider these four points from the above chart:

Since the beginning of COVID-19 in the U.S., the health care community has made tremendous gains in treating the disease, that is, in preventing deaths. However, no one yet knows the extent of long-term complications due to contracting the virus. Although COVID-19 primarily affects the lungs, it can damage many other organs as well. This organ damage may increase the risk of long-term health problems. Regardless, deaths are once again rising.

With respect to keeping safe, absolutely nothing has changed since the beginning of the pandemic. Hand washing/sanitizing, social distancing, mask wearing, and testing are, to this day, the only things we can do to control the disease. At some point in the future, perhaps by mid-spring, the vaccine cavalry will come charging over the hill. But until then, we’re on our own. COVID-19 is the enemy, the opposition, and we have to outlast it. Everyone needs to put on the moral cloak of responsibility.

It would be nice if that moral cloak were to become moral leadership from the White House, but the Trump Administration, obscenely obsessed with fighting the will of the majority, has gone AWOL, once again leaving the states to fight the disease by themselves, and most are now fully engaged.

Consider Ohio, where Republican Governor Mike DeWine is doing everything he and his team can to drive home the need for masks, hand washing and social distancing. Case in point: His Department of Health created a compelling video to illustrate the value of social distancing.

One of the most tragic things I have ever observed is going on right now across America. Millions of people have been persuaded the washing, wearing and distancing things are lies meant to steal the soul of the nation in a socialistic, Mephistophelean conspiracy. They believe government is trampling on their “rights.” Meanwhile, many of them get sick, some of them die, and they bring great harm to their neighbors who are trying to do the right thing. This is madness.

Can We Ever Learn From History?

Tuesday, November 10th, 2020

Yesterday was the 82nd anniversary of Kristallnacht, Germany’s Night of Broken Glass.

Two days prior to Kristallnacht, Herschel Grynszpan, a 17-year-old Polish Jew, had assassinated Ernst vom Rath, a young diplomat at the German embassy in Paris, shooting him five times at close range. This gave Hitler and his Minister of Propaganda*, Joseph Goebbels, the excuse they needed to organize a pogrom against Jews in Germany and parts of Austria and Czechoslovakia.

Goebbels told an assembly of National Socialists, “The Führer has decided that … demonstrations should not be prepared or organized by the (Nazi) Party, but insofar as they erupt spontaneously, they are not to be hampered.”

And so, on 9 November 1938, thousands of Nazis and Hitler Youth erupted “spontaneously,” attacking Jewish homes, schools, synagogues and businesses, smashing windows and destroying property. They put everything Jewish to the torch. Firefighters were told to let the fires burn themselves out. Goebbels instructed police to round up as many Jewish young men as possible and cram them into jails.

As far back as 1925 when he wrote his autobiographical Mein Kampf (My Struggle) from jail, Adolph Hitler had made known his anti Semitic intentions. And by 1933 the people of the UK and America knew also, because in that year Mein Kampf was translated into English. Nobody paid attention.

Kristallnacht was Hitler’s first, large scale, organized and overt attack on Jews. Consequently, many historians consider 9 November 1938 the beginning of the Holocaust.

Immediately following the close of the Second World War, social scientists and historians began trying to figure out why so many Germans had, lemminglike, followed, even embraced, hate-filled Hitlerism. The answers are complicated.

Following the First World War, the victors had punished Germany in monumental fashion, both economically and politically. Germans resented this with seething anger. Hitler capitalized on this.

Then there was the Great Depression of the early 1930s, which plunged Germany into even more profound economic chaos. Hitler took advantage of this, also, calling on Germans to throw off the yoke of humiliation. He gave fiery speeches, observed by American and British diplomats, which should have alerted governments to what was coming, but did not.

Hitler  instilled in the German people an us-against-them world view, or Weltanshauung. They would have followed him anywhere, and they did.

A week ago today, more than 70 million Americans voted for Donald Trump. That’s four million more than voted for him in 2016. Although I’m sure perhaps half of them voted out of economic self interest – they like his policies enough to stomach his lies and boorishness – what about the other half, the cheering cult, his own lemminglike followers at his rallies and beyond? As Hitler before him, Trump has sold them the us-against-them Kool Aid, and they have swallowed without questioning and without caring if whatever comes out of their Leader’s mouth is true or not.

As far as I can see, Joe Biden won the presidency and the republican party won the election. Not a single state legislature flipped. Republicans gained seats in the House, and are on the verge of holding on to the Senate. The last time we had a democrat elected president and a republican senate was 1885, 135 years ago, with the presidency of Grover Cleveland.

Donald Trump will eventually leave the White House, but he’s not going away, and neither are his followers or Trumpism. He gets tremendous satisfaction from his Rallies. Can you see him abandoning them? No, he will continue to stoke fear and hatred, just as a certain Austrian wannabe artist did long ago.

If you think 2020 was bad politically, just wait until you get to experience 2021.

Good luck to us all.

* Originally, Goebbels opposed the word propaganda, because in the public usage of the day it connoted – wait for it – Lies!

Shameful Leaders Play Chicken With The Economy Hanging In The Balance

Monday, November 9th, 2020

Today, the Bureau of Labor Statistics announced productivity, output and earnings data for Q3, 2020. This follows its announcement three days ago that the nation’s unemployment rate in October had fallen to 6.9%, the 6th consecutive month it has dropped.

While the drop in the unemployment rate is certainly good news, the long-term unemployed (those jobless for 27 weeks or more) increased by 1.2 million to 3.6 million, accounting for 32.5 percent of the total unemployed. Further, the country has seen only half of the 22 million people who lost jobs due to the pandemic return to the workforce.

Regarding today’s announcement, while productivity and output rose 43.5% and 38.6%, respectively, real earnings, a very important number, dropped 9.1% in Q3.

Most of the relief bills passed earlier in the pandemic have expired, including the $2.2 trillion CARES Act, which provided for additional unemployment benefits of up to $600 a week for many individuals.

The Federal Reserve, led by Chairman Jerome Powell, as well as the nation’s leading economists, have been arguing for months that we need a second relief package. Powell maintains that businesses, cities and states, and the unemployed are in dire need of help. On 6 October, in a speech to the National Association for Business Economics, he said the unemployment rate would be closer to 11% were it not for misclassification of idle workers and for people leaving the workforce. He warned the group that without additional support, the economy could slip into a downward spiral “as weakness feeds on weakness.”

Powell and his colleagues at the Federal Reserve say we need a new relief package NOW, and we need it to be BIG. Personally, I am not optimistic about that. I’m no economist, but I have friends who are, and they are not optimistic, either, at least not in the short term. And, although the 74 million (and increasing) Americans who voted for Joe Biden are happy Donald Trump has been handed his walking papers, we remain a house divided now more than ever. Some of us are euphoric, some in denial, others in despair, still others angry beyond words. It will take time and a lot of compassion for healing to even begin. But time is something many of our neighbors in horrific economic difficulties through no fault of their own simply don’t have.

In the next few days and weeks we’ll discover if our elected leaders can get out of the way of their ego-driven lust for power and display enough moral fiber, presuming they have some, to help the businesses, cities, states, and millions of our fellow citizens who hang by their fingertips over the edge of an economic abyss.

 

One Day More

Monday, November 2nd, 2020

Music is built on mathematics. Together they form humanity’s only universal language. With that in mind, here’s One Day More, the greatest Act One Finale in the history of theatre. Just to set the tone and get your blood moving.

“Tomorrow we’ll discover what our God in heaven has in store.”

No gloom and doom today. Just a thank you to all who have voted and who will vote. We’ll probably wind up with the largest vote count in the history of the country in both raw numbers and as a percentage of population. If Donald Trump has done nothing else, and he sure has done a lot, he’s brought out the vote.

After the dust settles, we’ll get more into that “done a lot” thing.

Stay safe.

The Attic Door Is Opening

Friday, October 16th, 2020

Today is the 166th birthday of the controversial, but brilliant Irishman and playright Oscar Fingal O’Flahertie Wills Wilde. In his day, the wittiest man in Dublin, or anywhere else for that matter. And it’s the 129th anniversary of the publication of his only novel, The Picture of Dorian Gray. We’ll come back to that in a bit.

Moving to the present, we have 18 days to go, and I know you know what I mean. Eighteen unpredictable, but grueling days until 3 November, the official election day, although the election is well underway with more than 17 million votes already cast across 44 states and the District of Columbia. Democrats have voted early at four times the rate of republicans, most of whom plan on voting in person on the 3rd.

I confess for me it’s hard to focus on anything else, workers’ compensation, for instance. I’ve tried, but I keep getting sucked back into the political black hole.

Because not all states treat early balloting the same, it is highly unlikely we will know the result on the night of the 3rd, but we will certainly know at some point. To get to that point, the parties will face off in a fight to the death. Neither of them will bring a knife to that gunfight. The Supreme Court may step in à la Bush v. Gore. Given recent shenanigans, won’t that be interesting?

Last night during Joe Biden’s Town Hall in Philadelphia, George Stephanopoulos asked the former Vice President what he’d do if he lost. Biden said he’d probably go back to teaching and working at The Biden Institute within the Biden School of Public Policy and Administration at the University of Delaware (he taught constitutional law from 1991 to 2008 – bet you didn’t know that). He said he’d also continue working on the causes he’s advocating during the campaign.

Samantha Guthrie asked the same question of President Trump at his simultaneous, split screen Town Hall in Miami, but couldn’t get a similar rational response that he’d go quietly into that good night. I have the feeling that if the President loses we’re in for Hellzapoppin’.

During his presidency, Donald Trump, who, during the 2016 campaign famously said, “I could stand in the middle of Fifth Avenue and shoot somebody, and I wouldn’t lose any voters, OK?”, has been more teflon-coated than any of your expensive kitchenware. Fiascos that would annihilate Paul Bunyan just bounce off. But since mid-way through the pandemic, things seem to have changed. Recent polling from Reuters/Ipsos shows 59% of likely voters believe he has managed our healthcare horrendoma poorly. And in the last few weeks it’s been one thing after another tarnishing his image. While his followers remain religiously devoted, the rest of the nation seems to be turning on him. At last night’s Town Halls, Biden was calm, thoughtful and engaging with his questioners, going so far as to ask one young man to stay after the Town Hall so they could talk some more. Trump, on the other hand, was, well, Trump, on defense, but in fighting mode, nonetheless.

All of which brings us back to Oscar Wilde and The Picture of Dorian Gray. In the novel, Dorian Gray, a handsome and hedonistic young man, sells his soul à la Faust, but with a twist. A famous artist paints his portrait, which Dorian puts in the attic of his home. Over the years, the young man in the portrait in the attic ages in a gruesome, hideous way, but not Dorian himself, who lives a life of debauchery and cruelty. Finally, in a fit of remorse, he slashes the painting. Servants below hear agonizing cries, rush to the attic and break down the door, only to find an unrecognizable and very dead old man lying in front of the painting, restored to its original beauty.

Donald Trump’s attic door is beginning to crack open.

Like BBs In A Boxcar

Monday, October 12th, 2020
Turning and turning in the widening gyre   
The falcon cannot hear the falconer;
Things fall apart; the centre cannot hold;
Mere anarchy is loosed upon the world….
The best lack all conviction, while the worst   
Are full of passionate intensity.
          The Second Coming, by William Butler Yeats

 

One thing COVID-19 has certainly done is to expose many of the foundational flaws in America’s healthcare house that Jack built, the house that “cannot hold.” From the Trump administration’s helter-skelter response, to the unequal treatment of Blacks and Latinos, to the near total reliance on China for PPE, to the exacerbating plight of rural hospitals, to jaw-dropping surprise bills, to something as granular as the price of insulin, and the list goes on.

To illuminate the dire situation even more, the Kaiser Family Foundation last week published its annual Employer Health Benefits Survey, which showed the average annual premium for a family of four has grown 4% over the last year, more than doubling the rate of inflation, and has now reached $21,342, with worker contributions averaging $5,588. Add in the average deductible of $4,000, along with copays of $40, and employees get their hair-raising, once-a-year healthcare sticker shock.

In 2020, the U.S. is spending 18% of GDP on healthcare, according the Office of the Actuary within the CMS. For years, I’ve been quoting Herb Stein’s Law: “If something cannot go on forever, it will stop.” And for years, I’ve been wrong. This cannot be sustainable, but so far it has been.

A distant second-most-costly-country-in-the-world is Switzerland, at 12.1% (which is what the U.S. spent 30 years ago in 1990). The Swiss, as do many other OECD countries, have a decentralized system similar to ours, a blend of public and private-pay healthcare, with two important differences: First, since 1996, government, wanting to spread the pool, has required the Swiss people to purchase healthcare insurance, similar to the Affordable Care Act’s individual mandate (which Congress eliminated when it passed the Tax Cuts and Jobs Act of 2017, effective 1 January 2019). The result is for more than 20 years the Swiss have nearly 100% participation, but not the U.S.; our rate of the uninsured is going up, not down, made worse, much worse, by job, and consequently health insurance, losses due to the pandemic. Second, government plays a large role in establishing prices, especially for pharmaceuticals.

I think we can say with total certainty that, regardless of what you hear or read, nobody knows what healthcare in America will look like a year from now. If Trump wins reelection and republicans hold the senate, the ACA, or what’s left of it, could find itself buried deep beside Davy Jones’s locker at the bottom of the ocean, and what would come after that? Back to square one. People, our fellow citizens, our friends and relatives with chronic conditions, would once again find themselves walking down the edge of an economic razor blade.

There are four possible outcomes:

  1. Trump wins and republicans hold the senate, as above;
  2. Trump wins and democrats take the senate, resulting in stalemate, but the Trump reality show continues;
  3. Biden wins and democrats take the senate, in which case big changes are coming; and,
  4. Biden wins and republicans hold the senate, resulting in stalemate, but we’re saved from Trump’s histrionics (one hopes).

Options three and four spare us the president’s governing style, which is to say, chaos. For four years we have been subjected to his whipsawing and dangerous administration. His policies, personality and pronouncements seem to bounce around like BBs in a boxcar. Never more so than in the last few weeks. Things change by the hour. Nothing is predictable, except unpredictability.

We are moving inexorably into the winter of our continuing discontent. God help us all.

When This Is Over, We Must Do Better!

Thursday, August 6th, 2020

For decades, we have swept our health care problems under the rug for posterity to trip over.    And right now, posterity is flat on its face.

Let me ask you this: Whether you believe high quality health care is a basic human right or just a privilege to be earned (I argued the former here), what do you think about 5.4 million Americans losing health insurance in the middle of the worst health care crisis in more than 100 years, because they lost their jobs?

One of the many terrible things COVID-19 has done is to expose our health care foundational flaws for all the world to see. For example, if there is ever a time not to lose health insurance it is during a pandemic. Another deep and open wound suddenly exposed to bright light is the abominable, even obscene, way in which COVID-19 has been allowed to impact the African American, Native American and LatinX communities. Health care is neither universal nor applied equally throughout the country.

As far back as 2008, I, along with others, documented the many ways our health care system, if you can call it that, lags behind the rest of the developed world*, in some case far behind. This, despite costing twice as much as the average of the other 36 member countries in the Organization for Economic Cooperation and Development (OECD), 25 of whom are members of the European Union. Since then, except for the passage of the Affordable Care Act (ACA), things have only gotten worse, and the ACA has been flayed, gutted and nearly beaten to death more than once. It should not, but it does to many, come as any surprise that the EU countries are performing significantly better in the battle against COVID-19 than we are, despite having a total population that is 27% greater than America’s. These two charts prove the point:

First, Population – From the World Bank:

Second, COVID-19 cases – from Johns Hopkins University and Statista as of 30 July, seven days ago:

What more does one need to see to conclude America’s response to COVID-19 has been tragically woeful?

Yesterday, I was speaking with a friend, a pulmonologist who has been on COVID-19’s front lines in Massachusetts since March. He and his patients, a number of whom are no longer with us, have been through a lot. His biggest complaint? The lack of “consistent, cohesive and comprehensive leadership from the federal government.” He said, “I’m a God-fearing man, but right now my God is science.”

The rug under which we swept our problems has been pulled up, and bad things have crept out into the light of day. But COVID-19, for all its horror and misery, has presented us with an opportunity. When this is over, and someday it will be, we will have an opportunity, nay, an imperative, to build a better American health care program, less fragmented, less costly, less complicated, and universally provided to every person within the confines of our nation’s borders. If the leaders we elect have even a modicum of courage, if they have entered public service to actually serve the public – all of it – we and they may be able to take the iniquity of this virus and leverage it to the point where health care in this nation, rather than having to be earned as a privilege, available only to people who can afford it, becomes a basic human right for all of us.

* The link is to the conclusion of a 5-part series. For the first four parts, enter “The best health care in the world” in the search box on the right sidebar

 

Racial Justice: If Not Now, When?

Monday, June 8th, 2020

Since the nonchalant murder of George Floyd our nation has galvanized behind the cause of equal justice for all. We have moved past the chaos of the first day or two to a too-loud-to-be-ignored-any-longer chorus peacefully demanding systemic changes in race relations. Now, the question of the moment is: What will come of this? After all, we’ve had demonstrations and protests when abominations like this have happened before. And afterwards, after the thoughts and prayers stuff, life goes on. Is this going to be any different? Personally, I think it will be.

Why? Let me tell you a story.

It is 31 January 1968. In Vietnam, it’s the most important holiday of the year, the Tet Lunar New Year. In years past, this seven to nine day holiday has been the occasion for an informal cease fire between North and South warring forces. But not this year. Since the previous autumn, the North Vietnamese military commander General Vo Nguyen Giap has been secretly caching weapons, ammunition and Viet Cong troops throughout the country. In late autumn 1967, in a brilliant move of military misdirection, Giap has North Vietnamese regular army regiments attack U.S. strategically placed Firebases in the highlands of central Vietnam. The ferocious  battle of Khe Sang is an example. As U.S. commanders concentrate on repulsing these attacks, Giap prepares to spring the Tet trap.

And in the early morning hours of 31 January, 70,000 Viet Cong troops attack all over the country.

The Tet Offensive takes South Vietnamese and American commanders and politicians completely by surprise, shocks the U.S. public and begins the slow erosion of public support for the war. The fiercest fighting happens in the city of Hue, the ancient capital of Vietnam. The Viet Cong capture Hue and hold it until they are finally driven out on 24 February by American forces. During the time they hold the city, the Viet Cong exact a terrible price. They go house to house arresting all people thought to be South Vietnamese sympathizers, including a convent full of Catholic Nuns. They massacre them all and throw them into mass graves. Five thousand people.

In three to four weeks, Giap’s forces are resoundingly defeated. He has spread them too thin. The Tet Offensive will prove to be a military disaster for the North, but, more important, it will become its biggest strategic victory. American and South Vietnamese politicians now realize the contest will be longer and much more deadly than they have anticipated, the mood of the American people begins to shift, and U.S. army Killed In Action increases to 500 per week.

And then, twenty days after the recapture of Hue, comes the most horrific and gruesome stain on America’s character during the entire war: The My Lai Massacre.

It is 16 March, and at the village of My Lai an American nerve-frayed platoon of the Americal Division under the command of 1st Lieutenant William Calley massacres hundreds of innocent civilians – men, women and children – as they run from their huts. Then they round up the rest of the village, line them up along a large ditch and shoot them all. According to Vietnamese records, they slaughter 547 people that day (the U.S. admits to only 304).

Calley had been ordered by his Company Commander, Captain Ernest Medina, to enter My Lai and kill the Viet Cong that Army Intelligence thought were hiding there among the civilian population. But there are no Viet Cong at My Lai that day. The Platoon troops don’t care. They kill everyone. And Calley, their commanding officer, stands by and watches. He does nothing to stop it.

Afterwards, Calley’s commanders in the Americal’s 11th Infantry Brigade will cover up the massacre by simply saying there wasn’t one. But the truth eventually comes out when American reporter Seymour Hersh breaks the story a year later (for which he will win a Pulitzer Prize). Calley is court-martialled, found guilty and sentenced to life in prison. President Nixon will reduce the sentence to three years and allow Calley to serve it by house arrest at Fort Benning, Georgia. The army also charges fourteen other people up and down the chain of command. All either have their charges dismissed or are acquitted at trial. Everyone seems to live happily ever after, even Calley, who doesn’t publicly admit any regret until 41 years later.

Why am I writing this? For two reasons. First, because the quality of leadership matters. All the leadership, top to bottom,  surrounding the My Lai massacre was horridly bad leadership, and, in the eyes of the public, leadership in many of America’s police departments is of a similar calibre. It is seen as suspect, at best, and despotic, at worst. Second, because the Tet Offensive and the My Lai massacre galvanized the American public into creating a movement that eventually became too powerful for politicians to resist and led to the end of the Vietnam war, a war that killed more than 50,000 Americans and millions of Vietnamese.

Today, we are in a similar situation of urgent morality. For hundreds of years, black children have been raised to fear whites, especially white police. “Don’t talk back, keep your hands on the steering wheel at all times, and never ever reach for anything.” Driving While Black is not fake news. The selection and training of police recruits continues to perpetuate this fundamental character flaw in the soul of America.

At the very least, what will reduce the worst in policing and increase the best is a thoroughly reimagined system of selecting and training new police officers. “Protect and serve” begins with empathy, actually seeing the people one is sworn to serve; actually listening to better understand them and their needs.

After My Lai, the army rebuilt its officer training programs. The Code of Military Justice and the Geneva Convention were given more attention. As we moved to an All-Volunteer Army, the selection criteria were rethought and enhanced. We have seen the benefit of that in our military’s improved conduct in Iraq and Afganistan. That kind of retooled selection and training has not happened in police academies. What has happened is more training in crowd control, more buying of military quality weaponry and a perpetuation of an us versus them mentality. These have been on stark display since the killing of George Floyd.

To change this will require sustained, dedicated and empathic leadership, which I’m guessing will not be coming from 1600 Pennsylvania Avenue, at least not in the immediate future. But the growing and forceful muilticultural demands for equal justice as vividly  demonstrated recently on the streets of America is a start, a start that urgently needs a finish.

More COVID 19 Quick Takes

Tuesday, April 7th, 2020

Offered without comment. None needed.

“The notion of the federal stockpile was it’s supposed to be our stockpile, It’s not supposed to be state stockpiles that they then use.” – Jared Kushner, the president’s son-in-law and adviser, at a White House briefing last Thursday, 2 April.

The federal stockpile of you know what.

I know, I know. You’re saying, “What? Another piece on the federal government’s inept performance to get masks and ventilators to the states?”

Yup. Some seemingly dead horses need new beatings when new facts emerge, and, as John Adams said 250 years ago when defending British soldiers on trial for their roles in the Boston Massacre, “Facts are stubborn things.”

But first, a word about the Associated Press (bet you didn’t see that one coming).

The AP, founded 173 years ago, is a cooperativeunincorporated association. Its members are U.S. newspapers and broadcasters. Its 3,200 employees operate out of 263 bureaus in 106 countries. It’s won 53 Pulitzer Prizes since the prize was created in 1917, and its AP Stylebook is the gold standard for reporters. Although everyone makes mistakes, and the AP is no exception, it exemplifies what news reporting ought to be.

Yesterday, the AP reported on its investigation into federal purchasing contracts for COVID 19 Personal Protective Equipment (PPE) and Ventilators. The investigation showed that:

As the first alarms sounded in early January that an outbreak of a novel coronavirus in China might ignite a global pandemic, the Trump administration squandered nearly two months that could have been used to bolster the federal stockpile of critically needed medical supplies and equipment.

A review of federal purchasing contracts by The Associated Press shows federal agencies largely waited until mid-March to begin placing bulk orders of N95 respirator masks, mechanical ventilators and other equipment needed by front-line healthcare workers.

By that time, hospitals in several states were treating thousands of infected patients without adequate equipment and were pleading for shipments from the Strategic National Stockpile.

The President has said repeatedly that the states should be purchasing the PPE they need to confront the virus and that the stockpile is a last resort (see the Jared Kushner quote, above). On 19 March Trump said of the federal government, “We’re not a shipping clerk.” Trouble is, we now have a situation where:

  • The stockpile is nearly empty, because Trump, under constant criticism from the governors, was forced to distribute much of it;
  • The federal government is now buying all the PPE and ventilators it can find all over the world;
  • The states continue to try to buy, scrounge, or borrow PPE and ventilators wherever they can; and,
  • Everybody’s competing with each other for the stuff, driving up prices, creating a seller’s market (think price gouging as an art form).

What’s going on in the Situation Room?

CNN is reporting a “heated disagreement” over the weekend in the Situation Room about the efficacy of the anti-malaria drug hydroxychloroquine. Multiple sources told the network Donald Trump’s top trade adviser Peter Navarro, recommending widespread use of the drug,”feuded with other officials over the drug’s unproven effectiveness to treat coronavirus.” In particular, Navarro took great exception to Dr. Anthony Fauci, Director of NIH’s National Institute for Allergy and Infectious Diseases, a post he’s held since 1984, telling him there was no data to indicate hydroxychloroquine is in any way effective, let alone safe, for treating COVID 19. CNN reports Navarro came to the meeting armed with documents he said proved his point, but which Dr. Fauci called anecdotes, and anecdotes are not data. Apparently, Dr Fauci saying to Navarro, who is not a member of the White House Task Force, “What are you talking about?” was particularly upsetting to the Trade Advisor.

Asked about the exchange today on CNN’s “New Day” Monday morning, Navarro claimed he is qualified to disagree with Dr. Fauci about COVID 19, despite not working in the health care field, because he has a PH.D. and is a Social Scientist. According to Merriam-Webster, Social Science is “a branch of science that deals with the institutions and functioning of human society and with the interpersonal relationships of individuals as members of society.” Surely that qualifies Dr. Navarro to recommend unproven medical treatments for the hundreds of thousands of current and projected victims of COVID 19 and to hijack the Task Force’s valuable time in the Situation Room. Split hairs are thicker than Navarro’s logic.

On the other hand.

This morning, Maggie Haberman, of the New York Times reported that Navarro warned the administration late in January that the “coronavirus crisis could cost the United States trillions of dollars and put millions of Americans at risk of illness or death.” Navarro wrote in a memo that a “lack of protection elevates the risk of the coronavirus evolving into a full-blown pandemic, imperiling the lives of millions of Americans.”

Too bad Navarro couldn’t prevail in that discussion back in January. We give him points for trying.

And what about those masks?

China is the world’s leading producer of surgical masks, turning out 50 to 60 million of them per day. When COVID 19 happened, China increased production to – get ready for this – 200 million per day. But because the pandemic originated in China, most of those masks stayed there. When the pandemic eased in China, masks once again began flowing, albeit more slowly and at greater cost, to the rest of the world, which, by that time, was already in the throes of the pandemic. Masks became the new gold.

Yesterday, NPR’s Mary Louise Kelly interviewed Mike Bowen, Co-Owner and Executive Vice President of Prestige Ameritech, located in North Richmond Hills, Texas. Mr. Bowen’s firm is the largest domestic maker of healthcare masks in this country. Governments, the healthcare industry, and companies from all over the world are asking him and the other American mask makers to supply them with masks, given the Chinese have turned down the spigot. During the interview, Bowen was discouraged and discouraging about his firm’s success prospects in picking up the Chinese slack to produce more masks. According to Health and Human Services Secretary Alex Azar, as of 10 March, the U.S only had about 1% of the 3.5 billion masks it needs to combat this pandemic. Bowen said every day he gets more than 400 emails asking for masks. But he can’t provide what he doesn’t have. He said, “It’s not like flipping a switch.” Machines have to be built, employees hired and trained. And when this is over, what does he do with the new machines and the new workers when demand has dropped off?

Bowen told Kelly he has been here before, during H1N1, when he built new machines, hired and trained workers and, after the scare was over, nearly went bankrupt. He had to lay off 150 people and moth-ball his machines. He’s afraid that’s what will happen again, as are all the other mask manufacturers.

And why is that? Bowen says because his masks are made in America, they are more expensive than masks made in Mexico and China. Consequently, until COVID 19, his firm had, in his words, “zero masks” going to federal agencies. Prestige has repeatedly bid on federal contracts for masks with HHS and DOD, but has never succeeded, because of cost.

Even going all out, 24/7, Bowen claims there is no way on God’s Green Earth he, and all the other mask-making companies, will ever be able to get all the masks COVID 19 requires to American health care workers. Sobering, indeed.

On that happy note, I leave you until next time.

 

 

 

It Is Time

Monday, November 5th, 2018

This is not a piece about insurance or health care. It won’t make the cut for Health Wonk Review and it will probably cost us readers (Well, 15 years has been a pretty good run). What this piece is is one that addresses the health of our nation.

Today, the Bureau of Labor Statistics (BLS) released a chart showing gains in productivity and hourly wages from Q3 2017 to Q3 2018. It looks remarkably similar to the chart BLS released at the end of Q2. Impressive Productivity and Output gains in both quarters. And, if you didn’t know better, you’d think Hourly Compensation is rising pretty well, too.

However, look to the far right of both charts to see the change in Real Hourly Wages, which are wages after inflation is factored in. The Trump administration and most of the press have trumpeted (pun intended) the nominal wage increase of 2.8% for Nonfarm Business and 2.2% for Manufacturing in Q3, 3.2% and 2.5%, respectively, in Q2, without saying a thing about the negligible, and in some cases decreasing, Real Wages.

Real Wages for Nonfarm Business during this one-year period (Q3 to Q3) are up a measly 0.1%, after rising an anemic 0.5% in Q2; Manufacturing Real Wages in Q3 are actually down 0.4% after being down 0.2% in Q2. And this is not a new phenomenon. In the 40 years since 1979, Real Wages for hourly and non-supervisory workers have increased by a total of only 4.5%. During that same period, the CPI has risen 247.7%.

These are not “alternative facts.”

Since the day Donald Trump and his cronies got the keys to the kingdom, Real Wages per week have risen from $349 to $351 in constant 1982-1984 dollars. Two bucks! For the mathematically inclined among you, that’s an increase of 0.005%. During the same period, the Dow Jones average has grown 20.9%, and that counts the recent decline. I like the stock market as well as the next guy, but barely one-third of families in the bottom 50% of earners own stocks, according to the Federal Reserve. The fact is, lower-income Americans don’t have extra money to put into stocks, and a third of workers don’t have access to a 401(k) or another retirement plan, according to Pew.

The facts make clear that since Republicans took control of everything, the economic gains  have gone to the top earners. Folks in the middle and lower end have, to a large degree, been left by the wayside. Inequality reigns supreme. It is beyond baffling that these people who continue to get the smelly end of the stick resolutely remain, seemingly unperturbed, in the center of Mr. Trump’s base. Look at the enthused, smiling faces at his rallies. Sociologists have written about this, but I have yet to see anything that explains it fully.

Regardless, tomorrow is Election Day. Many of us have already voted. Many more will exercise the option tomorrow. Predictions call for a large turnout, large being defined, God help us, as perhaps a little more than half. I’m now in my eighth decade, and I cannot recall a more consequential election.

Many Americans (as well as some of my friends) are highly satisfied with the tax law changes, the rise in the stock market and the new makeup of the Supreme Court. In exchange for those they allow, without condemnation, the bullying behavior, the constant hyperbole, the ad hominem attacks and the non-stop lying.

It is time for the better angels of our nature to rise to the challenge. It is time to demand decency, and it is time to reject the abject vulgarity that oozes from the awesome edifice where John Adams, Thomas Jefferson and Abraham Lincoln once lived and guided the nation. It is time to raise up America to its true potential. It is time for America to become once again the world’s beacon of hope. Maybe tomorrow America will say, “It is time.” To quote John Milton, “Hope springs eternal.”

Perhaps it is fitting to end this non-insurance piece with the words John Adams wrote to his wife Abigail at the end of his first day residing in the yet-to-be-completed new White House in 1800. Franklin Roosevelt had the words engraved onto the mantel of the White House State Dining Room in 1945. Adams wrote, “May none but honest and wise men ever rule under this roof.” I wonder if the current occupant has ever seen those words.