Public Policy and Governance – Page 124

The Rest Of The Story

When I was much younger, a radio personality named Paul Harvey had a feature on his newscast (or whatever it was) called “The Rest of the Story.” He would begin with a report of some sort, there would be a commercial break, and he would then return and conclude with “The Rest of the Story.” Usually, it was something that shone a rather different light on what had gone before.

So what is the Rest of the Story behind Trump’s incessant hawking of hydroxychloroquine–his insistence that it represents a “cure,” and that people “have nothing to lose” by trying it?

The Guardian recently published a well-resourced explanation of the multiple flaws in the French study that Trump and others latched onto. Dr. Fauci–one of the few remaining competent persons in this bizarre administration–has repeatedly said there is no probative evidence that it works.

Worse, people ingesting it based on Trump’s representations have died, and people who do need it for auto-immune diseases are increasingly unable to get their prescriptions filled. For them, it’s lifesaving, so this is a huge problem.

It’s easy enough to chalk up Trump’s embrace of this fantasy to the mental illness that has characterized his performance for the past three years– his need to believe (and have others believe) that he is all-knowing, his need to convince his cult that he is in control and doing a good job–coupled with his abysmal ignorance.

But the rest of the story is in a report first published in the New York Times, and picked up by other outlets.

President Donald Trump has a “small financial interest” in the maker of an anti-malarial drug that he has been touting as a “game changer” in treating coronavirus, according to The New York Times. Over the past two weeks, Trump and his Fox News allies have aggressively promoted hydroxychloroquine as a potential cure, despite top infectious-disease expert Dr. Anthony Fauci and others urging caution and noting that there was not enough evidence of the drug’s efficacy.

The Times reports the president’s family trusts all have investments in a mutual fund whose largest holding is Sanofi, the manufacturer of Plaquenil, the brand-name version of hydroxychloroquine. Associates of the president, including Commerce Secretary Wilbur Ross, have also run funds that hold investments in the pharmaceutical firm.

Other reports have reminded us that right after the 2016 election, Novartis, another major manufacturer of the drug, paid Trump’s now-incarcerated former personal attorney Michael Cohen more than $1 million for “access” to Trump.

The Times article noted that Trump has hyped hydroxychloroquine “with all of the enthusiasm of a real estate developer,” repeatedly asking “What do you have to lose?”

Apologists for the administration have excused the enthusiastic promotion as an effort to “provide hope” at a difficult time; others have suggested that more scientifically-valid studies might yet show the drug’s usefulness. But as the Times reported,

The professional organization that published a positive French study cited by Mr. Trump’s allies changed its mind in recent days. The International Society of Antimicrobial Chemotherapy said, “The article does not meet the society’s expected standard.” Some hospitals in Sweden stopped providing hydroxychloroquine to treat the coronavirus after reports of adverse side effects, according to Swedish news media.

According to the Times, the Administration is continuing to push hydroxychloroquine, and to order large quantities of it, despite the absence of properly-conducted studies suggesting its effectiveness. Trump has been quoted as saying it would be wrong to wait for the kind of study Dr. Fauci wanted. “We don’t have time,” the president said. “We don’t have two hours because there are people dying right now.”

Evidently, the people dying as a result of the President’s misinformation are unimportant.

It would be bad enough if this misinformation was just added evidence of Trump’s manifest stupidity, but it certainly looks like the financial incentive is “the rest of the story.”

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We Need Reassurance And This Isn’t It….

A number of media outlets have recently reported that Jared Kushner has been “tasked” with oversight of the administration’s response to the Coronavirus pandemic.

That’s evidently in addition to his “task” of bringing peace to the Middle East, and Vice President Mike Pence’s “task” of heading up the dysfunctional White House pandemic Task Force. Two recent columns have addressed this latest assignment handed to Wonder Boy, both by New York Times columnists.

I usually find Maureen Dowd too self-consciously cute for my tastes, but her column on Trump, Kushner and the pandemic is dead-on. She spent the bulk of her column inches on Trump’s incompetence, but it was her description of Kushner that resonated with me.

At the Thursday briefing, the president brought out another wealthy, uninformed man-child who loves to play boss: Jared Kushner. Where’s our Mideast peace deal, dude? Surely Trump did not think giving Kushner a lead role would inspire confidence. This is the very same adviser who told his father-in-law early on that the virus was being overplayed by the press and also urged him to tout a Google website guiding people to testing sites that turned out to be, um, still under construction.

Now he is leading a group, mocked within the government as “the Slim Suit crowd,” that is providing one more layer of confusion — and inane consultant argot — to the laggardly, disorganized response.

From the lectern, Kushner drilled down on his role as the annoying, spoiled kid in every teen movie ever made. “And the notion of the federal stockpile was, it’s supposed to be our stockpile,” he said. “It’s not supposed to be the states’ stockpiles that they then use.”

There has been a predictable uproar over Kushner’s description of “our stockpile,” but it was precisely the sort of arrogant ignorance that we’ve come to expect from someone perfectly described as the “annoying spoiled kid in every teen movie ever made.”

Michelle Goldberg’s column was a more serious analysis of the insanity of Jared’s most recent “tasking.” Here’s her lede:

Reporting on the White House’s herky-jerky coronavirus response, Vanity Fair’s Gabriel Sherman has a quotation from Jared Kushner that should make all Americans, and particularly all New Yorkers, dizzy with terror.

According to Sherman, when New York’s governor, Andrew Cuomo, said that the state would need 30,000 ventilators at the apex of the coronavirus outbreak, Kushner decided that Cuomo was being alarmist. “I have all this data about I.C.U. capacity,” Kushner reportedly said. “I’m doing my own projections, and I’ve gotten a lot smarter about this. New York doesn’t need all the ventilators.” (Dr. Anthony Fauci, the country’s top expert on infectious diseases, has said he trusts Cuomo’s estimate.)

As Goldberg notes, Jared Kushner has had exactly three”successes” thus far in his life: being born to rich parents, marrying well, and influencing his father-in-law. Other endeavors —” his biggest real estate deal, his foray into newspaper ownership, his attempt to broker a peace deal between the Israelis and the Palestinians — have been failures.”

(No wonder he gets along so well with Trump–they have similar trajectories…and similar delusions of competence. But I digress.)

“Behind the scenes, Kushner takes charge of coronavirus response,” said a Politico headline on Wednesday. This is dilettantism raised to the level of sociopathy.

The author of a book about the Kushner family described Jared thusly: “he had supreme confidence in his own abilities and his own judgment even when he didn’t know what he was talking about.” Like his father-in-law. (In the quotable words of Rick Wilson, “Everything he touches dies.”)

His forays into the Israeli-Palestinian conflict — for which he boasted of reading a whole 25 books — have left the dream of a two-state solution on life support. Michael Koplow of the centrist Israel Policy Forum described Kushner’s plan for the Palestinian economy as “the Monty Python version of Israeli-Palestinian peace.”

Now, in our hour of existential horror, Kushner is making life-or-death decisions for all Americans, showing all the wisdom we’ve come to expect from him.

I have repeatedly described Trump’s White House as a cross between the Keystone Kops and the Mafia. To which I should add that all of them are walking, talking illustrations of the Dunning-Kruger Effect.

Gee–I wonder why I’m not reassured….?

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The South Isn’t Rising Again, And May Be Down For The Count

A set of maps published by the New York Times, showing the Coronavirus effort lagging most in America’s southern states triggered a Daily Kos post highlighting the failures of southern–mostly Republican–Goverrnors.

The list was hair-raising: Georgia Gov. Brian Kemp didn’t issue a stay-at-home order for weeks, because–I am not making this up, I checked it– Kemp claimed that he had “just learned” that people with COVID-19 can be asymptomatic, a fact that has been clear and widely publicized since January. (Most recently–despite his belated “education,” Kemp reopened Georgia’s beaches.)

Texas has long supplied the rest of the country with official stupidity, and Republican Gov. Greg Abbott has again lowered the bar; he has yet to provide any statewide guidance, and has left all such decisions to cities and counties.

In Alabama, Republican Gov. Kay Ivey pointed out that her state is “not California” (we’ve noticed) and declared that she’s not ready to take any action that might hurt the economy. (I guess lots of people dying doesn’t hurt the economy…)

In South Carolina, Republican Gov. Henry McMaster has been unwilling to do more than issue “recommendations” without any force of law.

And Arkansas now enjoys a position that may be unique in the nation: Not only has Republican Gov. Asa Hutchinson refused to set any level of suppression across the state, but there are also no city or county stay-at-home orders. Arkansas is open for business. And virus transmission.

And don’t even mention the idiot Governor of Florida….

Federalism clearly has its downsides.

The maps issued by the New York Times showed the degree to which compliance with social distancing had reduced travel times– reductions that have been greater in urban areas than in rural parts of the country. As Daily Kos pointed out, this disparity is at least partly because rural residents taking necessary trips–to the grocery, for example–require longer distances to get there. (One reason rural trips to the grocery require going a long distance, of course, is Walmart. In rural areas, big box retailers like Walmart long ago bankrupted and displaced local grocers.) In some rural counties, the distances recorded may reflect farming– people moving around their own properties.

But the second map in the Times set paints a blood-red swatch across the South, not in terms of their vote, but in terms of how far people are traveling on a raw miles basis. In much of the nation, even in the most rural portions of the North and West, the average distance traveled is less than two miles a day. In other counties, the distance traveled has fallen below two miles as social distancing has been implemented. But in most of the South—and not just the rural South—the average distance traveled is still above two miles. Americans in the South are getting out, getting in their cars, and traveling miles. Every day….

And that’s just the start of it. As The Atlantic makes clear, COVID-19 may have so far caused the greatest damage in the Northeast, but it’s unlikely to stay that way. Already, about a tenth of all deaths have come from the Gulf Coast states, and those states are still racing up the ramp of infection, even as states that have been under strict social distancing for days or weeks are beginning to bend the curve on local cases. The South, both cities and rural areas, looks set to be the next epicenter of the outbreak in America.

A Kaiser Family Foundation study suggests that the reason Southern states are–and are likely to remain–outliers is that more of their residents have the underlying conditions, such as diabetes and heart issues, that increase risk. Kaiser says the outbreaks currently expanding in the American South are unique— mainly because of how many younger people in their working prime are dying. They have poorer health to begin with thanks to less access to healthcare, less access to fresh produce, and higher consumption of fast foods. As the study also reports,

These differences are not innate to southerners; they are the result of policy. Health disparities tend to track both race and poverty, and the states in the old domain of Jim Crow have pursued policies that ensure those disparities endure.

The cited articles predict that much of the American South will experience “a disaster beyond imagining, and it’s one that won’t be neatly limited to those who partied on the beach or those who nod along when Rush Limbaugh calls COVID-19 ordinary flu.”

What you don’t know can definitely hurt you. What you refuse to know or admit (yes, Southern lawmakers, I’m looking at you) will hurt even worse.

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WTF?

Sorry for the inelegant headline, but…

We’ve all gotten used to hearing about the continued shenanigans of this corrupt administration: the purge of federal employees who earned Trump’s enmity by actually doing their jobs; the continued rollback of environmental protections; the cushy contracts with friends and supporters; etc.

We’d have had to be blind to have missed the central policy imperative motivating Trump–overturning anything and everything Obama ever did, no matter how sane, helpful or appropriate. That’s why one of the first things he did when he assumed office was dismantle the pandemic preparation task force Obama had established.

We’re also well aware of the incredible ineptitude of this administration. Governors and public health officials are pleading for coherent policies, for protective gear, for straight talk–none of which they are getting.

Okay. So we know he’s corrupt, insanely jealous of the black guy who preceded him, and totally ignorant of how government (and much else) works. But what explains this?

At Talking Points Memo, Josh Marshall reports

Let’s talk about these seizures of PPE goods by federal authorities. There are a number of instances of this and as I noted in the post below a number of reasons why it might be happening. There are numerous cases where orders placed by states or hospitals have been canceled after they have been outbid by federal authorities or federal authorities have ordered vendors to sell to the federal government. According to Kaiser Health News, those compelled sales appear to be pursuant to an executive order President Trump signed on March 18th under authorities granted by the Defense Production Act.

But what I’m more interested in are reports of federal authorities confiscating physical shipments en route to states, local governments or regional hospital systems. The most publicized case of this came at some point in March when, according to Massachusetts Gov. Charlie Baker (R), a shipment of 3 million masks ordered through BJ’s Wholesale was seized by federal authorities in the Port of New York. Baker did not say which agency confiscated the goods or under what authority. That incident was what led to the widely reported and successful effort to fly goods in from China using the New England Patriots jet.

Another case happened just yesterday when the top county official in Somerset County, New Jersey, Freeholder Director Shanel Robinson, announced that a shipment of 35,000 masks had been confiscated by federal officials. According to this report in the Franklin Reporter and Advocate, “As of early in the afternoon of April 3, Robinson said that the county was told the surgical face masks would be delivered that day, but that the federal government had taken the N-95 masks.

Evidently, there have been a number of other, similar incidents reported, including what Marshall says is a “reliable report of a major non-governmental entity in the western United States having a major shipment seized by federal authorities at an airport in California.”

This is inexplicable–and just nuts. (Hence the “headline” of this post.) Every time Trump holds one of his briefing-cum-political-rallies, he insists that the states are responsible for getting their own supplies and should only appeal to the federal government in emergencies. Why, then, would federal authorities be seizing shipments that states, local governments and major medical organizations have managed to locate and purchase?

As Marshall says,

In any case, we need to know more. States have been asking the federal government to take over the process of provisioning the country with these critical PPE goods. That at least would avoid states being forced to bid up prices by bidding against each other. After having FEMA swoop in and purchase ventilators that Colorado was in the process of buying, Gov. Jared Polis (D) said: “Either be in or out. [Either let] us know what we’re going to get and when we’re going to get them or stay out and let us buy them.” But these seizures of shipments are at best causing confusion for desperate states and hospitals. And they seem so haphazard that they are raising legitimate questions about whether they are being allocated to states in a preferential or politicized fashion.

If this was part of a legitimate FEMA effort to allocate supplies more equitably, the narcissist-in-chief would undoubtedly have bragged about it. So I repeat: WTF is going on?

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Corporatism On Display

I used to be persuaded by arguments from “big Pharma” that the enormous costs of research and development justified the sometimes staggering prices of new drugs.

That justification seemed eminently reasonable, until I learned some inconvenient facts. For example, the amounts drug companies spend on television advertising (“ask your doctor for the purple pill”) exceeds the amounts they spend on research and development. And for another example, significant percentages of those front-end R and D costs are paid for by citizens’ tax dollars, through government research and grants.

Those discoveries left me disgusted, but unsurprised, by recent reporting from Pro Publica.

Five years ago, the U.S. Department of Health and Human Services tried to plug a crucial hole in its preparations for a global pandemic, signing a $13.8 million contract with a Pennsylvania manufacturer to create a low-cost, portable, easy-to-use ventilator that could be stockpiled for emergencies.

This past September, with the design of the new Trilogy Evo Universal finally cleared by the Food and Drug Administration, HHS ordered 10,000 of the ventilators for the Strategic National Stockpile at a cost of $3,280 each.

But as the pandemic continues to spread across the globe, there is still not a single Trilogy Evo Universal in the stockpile.

Instead last summer, soon after the FDA’s approval, the Pennsylvania company that designed the device — a subsidiary of the Dutch appliance and technology giant Royal Philips N.V. — began selling two higher-priced commercial versions of the same ventilator around the world

When Trump belatedly invoked the Defense Production Act, forcing General Motors to begin mass-producing a different company’s ventilator (for which taxpayers will also pay), no one even mentioned the Trilogy Evo Universal.

Nor did HHS officials explain why they did not force Philips to accelerate delivery of these ventilators earlier this year, when it became clear that the virus was overwhelming medical facilities around the world.

An HHS spokeswoman told ProPublica that Philips had agreed to make the Trilogy Evo Universal ventilator “as soon as possible.” However, a Philips spokesman said the company has no plan to even begin production anytime this year.

Instead, Philips is negotiating with a White House team led by Trump’s son-in-law, Jared Kushner, to build 43,000 more complex and expensive hospital ventilators for Americans stricken by the virus.

It’s despicably corrupt to use a pandemic to–excuse my phrasing here–suck even more deeply at the public tit. But it is the foreseeable result of America’s thoughtless, decades-long embrace of “privatization” and “public-private partnerships,” which have all too often simply been a more sophisticated form of patronage. Old-style patronage–whatever its flaws– mostly benefitted working people; you helped to get out the vote and if your candidate won, you got a (usually low-level) job with the city. Now, you write a nice fat check to the candidate and your company gets a lucrative contract with the city. (And no one gets out the vote, which is a different problem..)

As Pro Publica reported,

The story of the Trilogy Evo Universal, described here for the first time, also raises questions about the government’s reliance on public-private partnerships that public health officials have used to piece together important parts of their disaster safety net.

“That’s the problem of leaving any kind of disaster preparedness up to the market and market forces — it will never work,” said Dr. John Hick, an emergency medicine specialist in Minnesota who has advised HHS on pandemic preparedness since 2002. “The market is not going to give priority to a relatively no-frills but dependable ventilator that’s not expensive.”

Reagan began what has since become a concerted attack on the very idea of government–an attack that has benefitted corporations and businesses in a position to profit, but has eroded (“hollowed out” in the words of one scholar) the capacity of government to act on behalf of the common good.

We are about to see what happens–and how many people needlessly die–when what is left of our hollowed-out governing institutions is incompetent and corrupt.

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