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Tuesday, August 11, 2020

COVID19 CALIFORNIA--Kamala Harris & Quest Diagnostics-- TEST LAB VENDETTA

     "...this historic settlement affirms that Medi-Cal exists to help the state's neediest families rather than to illicitly line private pockets.." (Atty Gen Harris, 2011)
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     INCLINE VILLAGE (EOC)-- If life were a movie and gangsters were in charge of laboratories, then the recent episode coming out of Sacramento might hint at why the director of the State Health Department resigned, reported by KCRA News today,
      "...the problem began with a computer server outage July 25 and was compounded by the state’s failure to renew a 2-year-old certificate for an intermediary for one of the nation’s largest commercial labs, meaning the state did not receive updates for five days from Quest Diagnostics." (1)
That failure to upgrade the test lab subscription cost the state 300,000 cases that went unreported right in a critical time with school just around the corner and expiration of the CARES Act supplemental unemployment income for jobless workers at the end of the month.(2)


     As in baseball, when an umpire doesn't like the way a pitcher buzzes a batter, the result is "history" between the two. In the case of Quest, the pitcher, and Medi-Cal, the umpire, that history began ten years ago in a False Claims Act settlement that netted the California health agency more than $240 million in back pay. The attorney general at the time was none other than Kamala Harris, chosen today by Democratic candidate for the White House, Joe Biden, to be his running mate; 
     "In a time of shrinking budgets, this historic settlement affirms that Medi-Cal exists to help the state's neediest families rather than to illicitly line private pockets,' said Attorney General Harris. 'Medi-Cal providers and others who try to cheat the state through false claims and illegal kickbacks should know that my office is watching and will prosecute.' " (3)
     In the case of last week's computer glitch, the governor promised to "hold people to account" according to that KCRA report from above. Without further explanation, the first to be fitted with cement shoes for a short trip to Folsom Lake was Sonia Angell, M.D., the state health director. (4) In spite of the well wishes from the governor on her departure, the entire affair stinks from the top down! For Quest Diagnostics, The Sacramento Bee reported in 2011 regarding the settlement itself, in a column by Mark Glover;
     " 'Our laboratory testing services were priced appropriately, and we deny all allegations in the complaint.' said Michael Prevoznik, Quest senior vice president and and general counsel." (5)


     Not so according to AG Harris who, in a 2011 formal press release at the attorney general's office noted Quest charged  Medi-Cal $8.59 for one test and charged others just under $1.50 for the same test. As swiftly as  conspiracy theory speculation sweeps across social media, it may be no different with the current status quo surrounding pandemic testing. That may be the reason for Quest, a vital link in the chain of command necessary for the governor's office to make life saving decisions, not to send up a red flare to Governor Newsom alerting him to the upcoming expiring subscription. Blackmail, extortion, scandal, all the ingredients of a cheap gangster flick. And what about Kamala? Anything more there that can be sensationalized over the scandal? 
     At the time, Quest wasn't the only one scalping the state health agency, Labcorp was squeezed in 2011 by the AG's office in another settlement just under $50 million for similar medical malpractice.
     Fast forward to the current pandemic testing shortage, news reports are now surfacing of a different story entirely in the effort to stay current with positivity. Bulletins by Matt Voltz and Phil Galewitz originating at the KHN health news website indicate the inability of Quest to keep up with demand;
     "Montana said Wednesday that it is dropping Quest Diagnostics, one of the nation’s largest diagnostic testing companies...it (Quest) told state officials last week that it was at capacity and would be unable to accommodate more tests for two or three weeks." (7)  Naturally it would be far more convenient to take advantage of a computer glitch at the California state level and allow the electronic certificate to expire rather than have the syndicate admit it can't handle its territory. But according to the certificate expiration imbroglio in the Luna-Shalby-Mozingo article in the LA Times last week;
     " 'Simultaneously, we discovered that we were not receiving data from one of our largest commercial labs for a period of five days,' (Dr. Mark) Ghaly said. 'This was due to a certificate that the state neglected to renew timely. This resulted in data not being able to transmit to the state.' Ghaly identified the lab as Quest Diagnostics and said the company had been unable to send test results to the state from July 31 through Aug. 4." (8)
     For a company that just a few years prior was hit with a whopping Kamala Harris fine combined with the fact it was falling behind and needed the invoice to cover costs, Ghaly might be overlooking some suspect details as to how the document conveniently expired and went unnoticed for a week. The legislative analysts office has reported that the Coronavirus Relief Fund (CRF) would release over $15 billion to the state for use other than state revenue loss. (9) With expiration of  the federal unemployment addon and the new White House directive for the state to cover 25 percent of the new package, the governor sees no solution to the deficit. (10) A great deal of that money is earmarked for testing and has become a proposed slush fund to cover other costs.


     Certainly no one could have foreseen something that Democratic VP nominee Kamala Harris did almost ten years ago might have a devastating affect on the dire straits the state finds itself in today. Back in 2011 the biggest concern was a blood count test and which doctors were getting a cut rate, petty thievery at best. Suddenly the testing monopoly by lab syndicates such as Quest and Labcorp are thrust into the spotlight and facing an old foe. No longer a nickel-dime numbers racket run by neighborhood dons, it involves billions of dollars of federal pandemic relief money.


Cited:
(5) Settlement, Sacramento Bee, 20 May 2011, Page B6.
(6) Labcorp, Visalia Times-Delta, 31 Aug 2011, Page 14

Atty Gen Harris image, The Sacramento Bee, 04 Jan 2011, Page A3

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Monday, August 10, 2020

COVID19 CALCULUS--White House Quadratic Equation-- {dx/dt} SOLUTION

     "...it is a stretch of the imagination to believe that anybody at all was 'actively seeking work.' " 

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      INCLINE VILLAGE (EOC)-- Any number of responses to the president's four point emergency relief policy executed this week might be evaluated as either noteworthy or meaningless;


     "Ohio Gov. Mike DeWine praised Trump for issuing the order. 'He’s trying to do something. He’s trying to move the ball forward,' DeWine said. Still, he was noncommittal about whether Ohio would participate. 'We’re looking at it right now to see whether we can do this,' he said. " (1)
     The governor has the authority to make a contribution in the equation by working with the White House. On the other hand, former presidential candidate, Hillary Clinton, had no positive comments about the equation; 
      “ 'It’s a stunt,' Mr Trump’s former presidential rival told MSNBC. 'There’s no doubt about it, it’s most likely, as even Republican senators have said, unconstitutional, bypassing the Congress, trying to spend money that he has no authority to direct.' " (2)
Former candidate Clinton would certainly know about "no authority" as she hasn't any herself other than to appear on talk shows and news programs and attempt to undermine the White House effort.  The article written by Andrew Naughtie for The Independent follows under the headline, "Hillary Clinton attacks..." As reported today in the Times Union by Emilio Munson, the governor  of New York, Mario Cuomo's reaction was; 
     "With the state already facing a $13 billion deficit this year — which is expected to nearly triple over the next four years — Cuomo likened the executive order to 'handing a drowning man an anchor.' He also blasted the change as 'unrealistic' and possibly illegal." (3)
The White House emergency executive order would cost the state an additional $4 billion. The same article cites Governor Andy Beshear of Kentucky as also being cash strapped. The governor added that his unemployment system is 20 years old and unable to adjust to the new demands."
The governor's comment about the updated system appears to contradict what White House economic adviser Larry Kudlow said in a CBS staff report today; 
      "I don't think there will be a huge delay. Labor Department has been working with the states. The states are the ones that process the federal benefits before. So, I don't see any reason why it would be all that difficult," (4)
That appeared to be in reaction to Senator Schumer's (D-NY) comment that "Most states will take months to implement it, because it's brand new. It's sort of put together with spit and paste."   
With regard to that frail state-to-state unemployment benefit system, the original CARES Act called for those who qualified for the additional $600 perk above and beyond their normal unemployment benefit, Section 2107 stipulated an "Actively Seeking Work" clause; 



     "(A) IN GENERAL.—Subject to subparagraph (C), for purposes of paragraph (2)(D), the term 'actively seeking work' means, with respect to any individual, that such individual— (i) is registered for employment services in such a manner and to such extent as prescribed by the State agency; (ii) has engaged in an active search for employment that is appropriate in light of the employment available in the labor market, the individual’s skills and capabilities, and includes a number of employer contacts that is consistent with the standards communicated to the individual by the State; (iii) has maintained a record of such work search, including employers contacted, method of contact, and date contacted; and (iv) when requested, has provided such work search record to the State agency." (5)
     If the state unemployment systems are in shambles as the governor of Kentucky so apologetically emphasizes, it would not be possible to keep track of the efforts of the individual seeking work in the labor market. In addition, with innumerable reports of sunbathers flooding the beaches from Florida to California this summer, it is a stretch of the imagination to believe that anybody at all was "actively seeking work." That, of course, is speculation. Yet another example of the possible breakdown of state information tech systems, the California Health Director, Dr. Sonia Angell, resigned over what may have been related to the recent crash of the test reporting system. (6)
    Not all differential equations have a complete solution. It is then necessary to find which parts of the equation are workable and which ones will need to undergo transformation and substitution in order to be solved. No one way back at the beginning of summer could have seen the Levitt surge-mitigation projection (7) go from a rather innocuous log bell curve to a parabolic explosion of confirmed cases. It was the result of rapid improvement in testing that gave a much clearer picture of the dilemma, especially the part of the failed CARES Act solution that ended the weekly unemployment bonus at the end of July. To what degree other shortcomings of the initial stimulus package begin to appear remains to be seen. 
     The president has attempted a bit of intuitive calculus, a bit of analytics in opposition to the rather straightforward inductive process of Congress where every coefficient and unknown variable needed to be carefully scrutinized, qualified and quantified  before proceeding. In a pandemic of unprecedented modern day proportions, that process failed.

Mnuchin says new federal jobless aid will be available from states within 2 weeks

Treasury Secretary Steven Mnuchin on Monday said that states will be able to "execute" new weekly federal unemployment benefits of up to $400 within two weeks, after the Trump administration repeatedly declined to offer a timeline for the new benefits announced by President Donald Trump over the weekend, following the collapse of coronavirus relief negotiations with Democrats.

 
UPDATE: (08/11/20/0930PDT) --Unemployment data for each state can be found at the Department of Labor website. (8) That data notes an interesting trend. Taking California as an example, claims by the end of February, 2020 showed 161 thousand. By the end of March, when the statewide lockdown was ordered, the claims jumped to 1.65 million. By May, the level was at 2.35 million claims. but by the end of May it dropped to around 1 million. There is no indication as to whether the dramatic drop in May was attributed to benefits running our or an increase in the workforce, which may have been the reason given. 
     If the former is true, it shows that benefits did not last very long. Why would someone go back to work if they made more money with the extra $600 weekly from the CARES Act than they would by working? For May, weeks claimed shows 13 million with compensated roughly the same. That means, on average, the claims were good for 13 weeks per worker, a little over four months. According to an article by Richard Harroch reporting in Forbes (9), the total number of weeks for California are 26 with an additional provided by the CARES Act. That is in conflict with the Labor Department stats where only 13 weeks were used on average. It may be related to how many weeks the claimant qualified for and not the maximum number available. 
     Depending on the persistence of the virus in the population and its affect on an increase in joblessness, the overall benefit extension would only be necessary ideally until the winter holidays. There would be a limit of diminishing returns when unemployment benefits across the board for each state would not only be exhausted, but claims would eventually drop off. 





Cited




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