Category Archives: Accountability

The White House said it was following health experts’ advice. Then we learned it isn’t approving a key CDC document.

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Diseases & Conditions | CDC

White House press secretary Kayleigh McEnany made a point at the start of Wednesday’s news briefing to emphasize that President Trump is following health experts’ advice as we enter what Trump has labeled the “next stage” of the coronavirus response — reopening the economy.

“As you are well aware, President Trump has consistently sided with the experts and always prioritized the health and safety of the American people,” McEnany said.

Several hours later, we got another example of the White House resisting what those health experts are advising.

The Associated Press reported around midnight that the White House had shelved planned guidelines from the Centers for Disease Control and Prevention. The document, which was due nearly a week ago, was aimed at providing local authorities with step-by-step guidance on how to reopen:

The 17-page report by a Centers for Disease Control and Prevention team, titled “Guidance for Implementing the Opening Up America Again Framework,” was researched and written to help faith leaders, business owners, educators and state and local officials as they begin to reopen.
It was supposed to be published last Friday, but agency scientists were told the guidance “would never see the light of day,” according to a CDC official. The official was not authorized to talk to reporters and spoke to The Associated Press on the condition of anonymity.

A coronavirus task force official told The Washington Post that the document has not been completely shelved but was in the process of being revised because it was “overly specific.” The official also indicated that it was felt the document was too broad, as “guidance in rural Tennessee shouldn’t be the same guidance for urban New York City.”

The denial, though, reinforces that the White House is reluctant to submit to the CDC’s more detailed prescriptions for reopening the economy. And it’s difficult to divorce the delay in this document’s publication from Trump’s anxiety to reopen the economy — and the tension that has created with past guidelines.

The administration in mid-April issued phased advice on when areas should start to reopen places such as restaurants and other nonessential businesses. But many states have moved forward with certain elements of reopening without actually satisfying those guidelines. Most notably, they have begun to reopen without meeting the Phase One guideline that they should see a decrease in confirmed coronavirus cases over a 14-day period.

As The Post’s Philip Bump reported, some states that have pushed forward with reopening have also seen an increase in cases — which would prevent them from satisfying the requirement for moving into Phase Two. That requirement is that the decline should continue for another 14 days after Phase One begins.

Issuing a detailed document would seemingly complicate further reopenings, because it would again restrict what states and local authorities are supposed to do.

The Washington Post’s Lena H. Sun and Josh Dawsey previewed what the document was set to look like last week. And they also obtained a draft of the document. The new guidelines were to go beyond the initial ones in prescribing specific actions that could be taken in each phase of the reopening. Advocates for reopening have worried that strict guidance could make it difficult for businesses, churches, child-care centers and other facilities to actually function.

Trump, who has long signaled a desire to begin reopening that economy sooner rather than later, has doubled down on that rhetoric in recent days. Despite a steady national death rate that approached previous highs on Tuesday and Wednesday, and even though cases continue to increase outside the major U.S. hotbed of New York City, Trump on Tuesday signaled that we are entering the “next stage” of reopening the economy.

“Thanks to the profound commitment of our citizens, we’ve flattened the curve, and countless American lives have been saved,” Trump said. “Our country is now in the next stage of the battle: a very safe phased and gradual reopening. So, reopening of our country — who would have ever thought we were going to be saying that? A reopening. Reopening.”

Trump has been resistant to the advice of the health officials around him, from the early days of the outbreak when he continuously downplayed the severity of the situation. On several occasions, this tension has boiled over.

We’re also hearing from those officials less and less. The CDC long ago ceased holding briefings on the coronavirus outbreak, and the White House coronavirus task force briefings, which often featured health experts Anthony S. Fauci and Deborah Birx, have now been halted in favor of less-frequent and less-coronavirus-focused briefings from McEnany. Fauci has also been prevented from testifying to the Democratic-controlled House, although he is still slated to testify in the GOP-controlled Senate and has continued doing some interviews. The cumulative effect is that these health experts aren’t on the record as much as the effort to reopen the economy begins in earnest.

In the place of those public comments, the CDC guidelines were to provide firm and detailed advice from those officials for the new stage. But for reasons that seem pretty conspicuous, we still don’t have them.

 

 

 

Home of the Brave

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Trump Moves to Replace Watchdog Who Identified Critical Medical Shortages

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Trump Moves to Replace Watchdog Who Identified Critical Medical ...

The president announced the nomination of an inspector general for the Department of Health and Human Services, who, if confirmed, would replace an acting official whose report embarrassed Mr. Trump.

President Trump moved on Friday night to replace a top official at the Department of Health and Human Services who angered him with a report last month highlighting supply shortages and testing delays at hospitals during the coronavirus pandemic.

The White House waited until after business hours to announce the nomination of a new inspector general for the department who, if confirmed, would take over for Christi A. Grimm, the principal deputy inspector general who was publicly assailed by the president at a news briefing three weeks ago.

The nomination was the latest effort by Mr. Trump against watchdog offices around his administration that have defied him. In recent weeks, he fired an inspector general involved in the inquiry that led to the president’s impeachment, nominated a White House aide to another key inspector general post overseeing virus relief spending and moved to block still another inspector general from taking over as chairman of a pandemic spending oversight panel.

Mr. Trump has sought to assert more authority over his administration and clear out officials deemed insufficiently loyal in the three months since his Senate impeachment trial on charges of abuse of power and obstruction of Congress ended in acquittal largely along party lines. While inspectors general are appointed by the president, they are meant to be semiautonomous watchdogs ferreting out waste, fraud and corruption in executive agencies.

The purge has continued unabated even during the coronavirus pandemic that has claimed about 65,000 lives in the United States. Ms. Grimm’s case in effect merged the conflict over Mr. Trump’s response to the outbreak with his determination to sweep out those he perceives to be speaking out against him.

Her report, released last month and based on extensive interviews with hospitals around the country, identified critical shortages of supplies, revealing that hundreds of medical centers were struggling to obtain test kits, protective gear for staff members and ventilators. Mr. Trump was embarrassed by the report at a time he was already under fire for playing down the threat of the virus and not acting quickly enough to ramp up testing and provide equipment to doctors and nurses.

“It’s just wrong,” the president said when asked about the report on April 6. “Did I hear the word ‘inspector general’? Really? It’s wrong. And they’ll talk to you about it. It’s wrong.” He then sought to find out who wrote the report. “Where did he come from, the inspector general? What’s his name? No, what’s his name? What’s his name?”

When the reporter did not know, Mr. Trump insisted. “Well, find me his name,” the president said. “Let me know.” He expressed no interest in the report’s findings except to categorically reject them sight unseen.

After learning that Ms. Grimm had worked during President Barack Obama’s administration, Mr. Trump asserted that the report was politically biased. In fact, Ms. Grimm is not a political appointee but a career official who began working in the inspector general office late in President Bill Clinton’s administration and served under President George W. Bush as well as Mr. Obama. She took over the office in an acting capacity when the previous inspector general stepped down.

Mr. Trump was undaunted and attacked her on Twitter. “Why didn’t the I.G., who spent 8 years with the Obama Administration (Did she Report on the failed H1N1 Swine Flu debacle where 17,000 people died?), want to talk to the Admirals, Generals, V.P. & others in charge, before doing her report,” he wrote, mischaracterizing the government’s generally praised response the 2009 epidemic that actually killed about 12,000 in the United States. “Another Fake Dossier!”

To take over as inspector general, Mr. Trump on Friday night named Jason C. Weida, an assistant United States attorney in Boston. The White House said in its announcement that he had “overseen numerous complex investigations in health care and other sectors.” He must be confirmed by the Senate before assuming the position.

Among several other nominations announced on Friday was the president’s choice for a new ambassador to Ukraine, filling a position last occupied by Marie L. Yovanovitch.

Ms. Yovanovitch was ousted a year ago because she was seen as an obstacle by the president’s advisers as they tried to pressure the government in Kyiv to incriminate Mr. Trump’s Democratic rivals. That effort to solicit political benefit from Ukraine, while withholding security aid, led to Mr. Trump’s impeachment largely along party lines in December.

Mr. Trump selected Lt. Gen. Keith W. Dayton, a retired 40-year Army officer now serving as the director of the George C. Marshall European Center for Security Studies in Germany. Mr. Dayton speaks Russian and served as defense attaché in Moscow. More recently, he served as a senior United States defense adviser in Ukraine appointed by Jim Mattis, Mr. Trump’s first defense secretary.

 

 

 

The U.S. plans to lend $500 billion to large companies. It won’t require them to preserve jobs or limit executive pay.

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DownWithTyranny!: April 2020

The Fed’s coronavirus aid program lacks restrictions Congress placed on companies seeking financial help under other programs.

A Federal Reserve program expected to begin within weeks will provide hundreds of billions in emergency aid to large American corporations without requiring them to save jobs or limit payments to executives and shareholders.

Under the program, the central bank will buy up to $500 billion in bonds issued by large companies. The companies will use the influx of cash as a financial lifeline but are required to pay it back with interest.

Unlike other portions of the relief for American businesses, however, this aid will be exempt from rules passed by Congress requiring recipients to limit dividends, executive compensation and stock buybacks and does not direct the companies to maintain certain employment levels.

Critics say the program could allow large companies that take the federal help to reward shareholders and executives without saving any jobs. The program was set up jointly by the Federal Reserve and the Treasury Department.

“I am struck that the administration is relying on the good will of the companies receiving this assistance,” said Eswar Prasad, a former official at the International Monetary Fund and economist at Cornell University. “A few months down the road, after the government purchases its debt, the company can turn around and issue a bunch of dividends to shareholders or fire its workers, and there’s no clear path to get it back.”

Treasury Secretary Steven Mnuchin defended the corporate aid program, saying that the lack of restrictions on recipients had been discussed and agreed to by Congress. “This was highly discussed on a bipartisan basis. This was thought through carefully,” he said in an interview with The Washington Post. “What we agreed upon was direct loans would carry the restrictions, and the capital markets transactions would not carry the restrictions.”

Democrats asked for restrictions on how companies can use the money from the central bank’s bond purchases but were rebuffed by the administration during negotiations about the Cares Act, said a spokesman for Senate Minority Leader Charles E. Schumer (D-N.Y.). The spokesman said Democrats won meaningful concessions from the administration on reporting transparency in the final agreement. (Transparency requirements do not apply to the small-business loans, the biggest business aid program rolled out to date.)

Mnuchin also said the program had already bolstered investor confidence in U.S. capital markets, which in turn helped firms raise capital they used to avoid layoffs.

“The mere announcement of these facilities, quite frankly, led to a reopening of a lot of these capital markets,” Mnuchin said in an interview. “Even before these facilities are up and running, they’ve had their desired impact of having stability in the markets. Stability in the markets allows companies to function, and raise money and allows them to keep and retain workers and get back to work.”

The corporate debt purchases by the Fed stand in stark contrast with other portions of the federal aid for U.S. businesses that come with requirements to protect jobs or limit spending.

The Paycheck Protection Program, which offers $659 billion for small businesses, requires companies to certify that the money will be used to “retain workers and maintain payroll or make mortgage payments, lease payments, and utility payments.”

The “Main Street” program offering up to $600 billion to “midsize” businesses — with 500 to 10,000 employees — forbids companies from issuing dividends and places limits on executive compensation, according to a term sheet issued by the Fed. Those restrictions are in effect until 12 months after the loan is no longer outstanding. The companies must also “make reasonable efforts” to maintain payroll and retain employees.

Likewise, the $46 billion program for airlines, air cargo companies and national security forbids dividends and limits executive pay. Its requirement on retaining employment is more rigorous, however. Companies are supposed retain at least 90 percent of their employees.

The first version of the Fed program to buy bonds from large companies, known as the Primary Market Corporate Credit Facility, probably would have compelled recipients of the aid to limit executive pay and dividends. That version of the program, described in a March 23 term sheet issued by the Fed, offered direct loans and bond purchases to companies. Under the Cares Act, the federal programs offering direct loans must set restrictions on company dividends and CEO pay; those that buy only corporate bonds do not. Both are forms of lending, although bonds are more easily resold.

But on April 9, the Fed altered the design of the program to exclude direct corporate lending. The Fed program will still essentially lend money to large companies — by buying their bonds — but the Fed will not be compelled by the Cares Act to ensure that companies abide by the divided and CEO pay rules.

“The change to the term sheet between March and April is the smoking gun on the Fed’s own culpability here,” said Gregg Gelzinis, a senior policy analyst at the Center for American Progress, a left-leaning think tank. “The basic principle of the Cares Act was that if we’re going to provide taxpayer funding to private industry, we need conditions to make sure it is in the public interest. This violates that principle.”

Bharat Ramamurti, an aide to Sen. Elizabeth Warren (D-Mass.) who was appointed to the board overseeing the bailout, said in a statement: “Big corporations have shown time and again that they will put their shareholders and executives ahead of their workers if given the choice. That’s why I’m so concerned that the Treasury and the Fed have chosen to direct hundreds of billions of dollars to big companies with no strings attached.”

A spokesman for the Federal Reserve declined to comment. The Fed’s board of governors unanimously approved the new bond purchasing program on March 22. The Fed has said it will purchase only the bonds of firms above a certain grade. The issuer of the bond also must meet the conflicts-of-interest requirements in the Cares Act, which preclude federal lawmakers or their relatives from benefiting financially from the government bailout.

In the interview, Mnuchin also said many companies are ceasing stock buybacks and are likely to use the additional capital to retain workers.

“A lot of companies have stopped their share buybacks and slashed their dividends, because they need that capital to invest in their business. Even though these restrictions don’t necessarily apply, that’s already happening,” he said.

Some experts disputed that assertion. “Some companies have ceased buybacks and dividends and some haven’t. We shouldn’t have to keep our fingers crossed,” Gelzinis said.

It is unknown what the terms will be for the Fed lending under the program, or how favorable they will be for recipients. The term sheet says only that they will depend on the company and be “informed” by market conditions.

Companies selling their bonds to the central bank are expected to be primarily investment grade, publicly traded firms and therefore subject to more disclosure and oversight than those that are privately held. Patricia C. Mosser, a former senior official at the Federal Reserve Bank of New York, said these corporations are scrutinized by the U.S. Securities and Exchange Commission, private investors and the credit rating agencies.

“It’s true that there’s nothing stopping these companies from continuing to pay stock dividends. You may not like that, and I have sympathy for that position,” said Mosser, now a professor at Columbia University. “But it’s easier to unmask bad behavior in public companies. Large companies certainly don’t do everything right, but they have to admit publicly how they pay top executives, where their profits go and how they use them. That history of disclosure and oversight means the risk of not being repaid is lower.”

The weaker restrictions on recipients of the Fed’s lending program may be partly justified, said Nathan Tankus, research director at the Modern Money Network, which studies monetary policy. The corporate bonds that the Fed is purchasing from companies can be resold, whereas direct loans establish an agreement between the company and the government that makes the asset less valuable to the central bank, he said.

“Purchases of debt are a slightly more arm’s-length transaction than the loan, which is forming a bilateral relationship,” Tankus said. “But this is really just the fig leaf the Fed can use to justify lifting the restrictions.”

 

 

 

Large, Troubled Companies Got Bailout Money in Small-Business Loan Program

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Large, Troubled Companies Got Bailout Money in Small-Business Loan ...

Companies with accounting problems or in trouble with the government received millions in federal loans.

A company in Georgia paid $6.5 million to resolve a Justice Department investigation — and, two weeks later, received a $10 million federally backed loan to help it survive the coronavirus crisis.

Another company, AutoWeb, disclosed last week that it had paid its chief executive $1.7 million in 2019 — a week after it received $1.4 million from the same loan program.

And Intellinetics, a software company in Ohio, got $838,700 from the government program — and then agreed, the following week, to spend at least $300,000 to purchase a rival firm.

The vast economic rescue package that President Trump signed into law last month included $349 billion in low-interest loans for small businesses. The so-called Paycheck Protection Program was supposed to help prevent small companies — generally those with fewer than 500 employees in the United States — from capsizing as the economy sinks into what looks like a severe recession.

The loan program was meant for companies that could no longer finance themselves through traditional means, like raising money in the markets or borrowing from banks under existing credit lines. The law required that the federal money — which comes at a low 1 percent interest rate and in some cases doesn’t need to be paid back — be spent on things like payroll or rent.

But the program has been riddled with problems. Within days of its start, its money ran out, prompting Congress to approve an additional $310 billion in funding that will open for applications on Monday. Countless small businesses were shut out, even as a number of large companies received millions of dollars in aid.

Some, including restaurant chains like Ruth’s Chris and Shake Shack, agreed to return their loans after a public outcry. But dozens of large but lower-profile companies with financial or legal problems have also received large payouts under the program, according to an analysis of the more than 200 publicly traded companies that have disclosed receiving a total of more than $750 million in bailout loans.

Another dozen or so collected money even though they have recently reported being able to raise large sums through private means. Several others have recently showered top executives with seven-figure pay packages.

The government isn’t disclosing who receives aid, leaving it up to individual companies to decide whether to disclose that they obtained loans. That makes a full accounting of the loan program impossible.

“It’s outrageous,” said Amanda Ballantyne, the executive director of Main Street Alliance, an advocacy group for small businesses. She added that there were countless small business owners “who have laid off all their staff, are trying to file for unemployment and will go bankrupt because of the problems with the way this Paycheck Protection Program was designed.”

Applicants for loans do not need to provide evidence that they have been harmed by the pandemic. They simply need to certify that “current economic uncertainty makes this loan request necessary” to support their operations.

Instead of having the Small Business Administration, which is guaranteeing the loans, decide which companies get funding, the process was essentially outsourced to banks. The banks collect fees for each loan they make but don’t have to monitor whether the recipients use the money appropriately.

For small business owners shut out of the program, watching big companies collect loans while their applications languish has been infuriating.

“It has been beyond frustrating,” said Diane Burgio, a single mother who runs a design business in New York City that employs four people. She was one of more than 280,000 applicants who sought, and did not get, a loan from JPMorgan Chase.

The New York Times identified roughly a dozen publicly traded companies that had recently boasted about their access to ample capital — and then applied for and received millions of dollars in the federal loans.

Legacy Housing, a Texas company that manufactures premade homes, announced on April 1 that it had access to a new $25 million credit line. Curtis D. Hodgson, Legacy’s executive chairman, told investors that he expected any damage from the coronavirus to be short-lived. “Our order book is still strong, and we are well-positioned once the situation begins to normalize,” he said.

Less than two weeks later, on April 10, the company announced that a local lender, Peoples Bank, had approved it for $6.5 million under the S.B.A. loan program.

In an interview on Sunday, Mr. Hodgson said that an inquiry from The Times led the company to decide to give back the money it borrowed, though he defended seeking the loan in the first place. “Legacy is a highly leveraged company without cash on hand,” he said. “Here was a way to get a cash infusion.”

Escalade Sports, which makes things like table tennis tables and basketball hoops, already had a $50 million credit line from JPMorgan Chase. The company’s chief executive, Dave Fetherman, told investors this month that the company, based in Evansville, Ind., had “a strong balance sheet” and was seeing rising demand for its products, with so many Americans cooped up in their homes.

Days earlier, Escalade got a $5.6 million federally backed loan. A spokesman for Escalade said the company “fully met all required conditions at the time we applied for the P.P.P. loan.”

Executives at some companies said applying for the loans made clear business sense. The loans are essentially free money: They have rock-bottom interest rates and can be forgiven if, among other things, the borrower maintains the size of its work force. In some cases, executives said, their bankers encouraged them to apply for the loans.

At least seven companies that received a total of $45 million in loans under the federal government’s program have recently had serious scrapes with the federal government.

MiMedx Group, a biopharmaceutical company in Marietta, Ga., got a $10 million loan on April 21. On April 6, the company had agreed to pay the Justice Department $6.5 million to resolve allegations that it violated federal law by knowingly overcharging the Department of Veterans Affairs for medical supplies.

MiMedx, which makes and sells human tissue grafts, also ran into problems with the Securities and Exchange Commission. Last year, the agency sued MiMedx, accusing the company of exaggerating its revenue to investors over several years. MiMedx agreed to settle the case for $1.5 million, without admitting wrongdoing. Two of its former top executives were indicted last year by federal prosecutors in Manhattan on charges of accounting fraud.

A MiMedx spokeswoman, Hilary Dixon, said the company was trying to move past its accounting scandal. “We don’t have the option of raising capital in the public markets owing to our financial restatement process,” she said.

Another company, US Auto Parts Network, which received a $4.1 million loan through the program, has been in a heated dispute in recent years with Customs and Border Protection. The agency has seized some of the company’s imported products, claiming they are counterfeit.

US Auto Parts Network didn’t respond to requests for comment.

At least two companies that received federally backed loans have previously borrowed heavily from their own executives or others close to the firms — meaning that the new loans could help the companies repay their insiders.

Infinite Group, a cybersecurity firm in Pittsford, N.Y., had been borrowing hundreds of thousands of dollars from its board members and the brother of a top executive at annual interest rates as high as 7.5 percent. This month, Infinite secured a nearly $1 million federally backed loan whose 1 percent interest rate could allow the company to dramatically lower its funding costs. Company officials didn’t respond to requests for comment.

Intellinetics, the company that announced that it was buying a rival days after it received its emergency loan of $838,700, borrowed nearly $400,000 last fall from two brothers who run a small New York brokerage firm, Taglich Brothers. If the money isn’t repaid by May 15, Intellinetics will need to give the brothers stock in the company or start paying a steep 12 percent interest rate. (Some of that debt has already been converted into stock.)

“Securing the PPP funding gives us extra confidence and ability to restart and hit the ground running,” James F. DeSocio, the company’s chief executive, said in a news release.

Infinite Group and Intellinetics have not said precisely how they intend to use the loan proceeds.

A number of other companies have had serious accounting problems. The chief financial officer of CPI Aerostructures, an aerospace manufacturer that got a $4.8 million loan, resigned in February after the company disclosed major problems with how it reported revenue.

And several firms have been paying their top executives millions of dollars despite financial problems that predate the coronavirus crisis.

For example, AutoWeb’s chief executive, Jared Rowe, got $4.7 million in total compensation over the past two years — including $1.7 million in 2019 — even as its stock price plummeted more than 70 percent. The company declined to comment.

And Manning & Napier, an investment firm in Fairport, N.Y., that has about $20 billion in assets under management, disclosed in March that its chief executive, Marc O. Mayer, earned nearly $5 million last year. On April 19, the company was approved for $6.7 million in the paycheck protection loans — even as the company said it would pay out a quarterly dividend to its shareholders.

Last week, amid mounting public anger toward large recipients of the rescue loans, Manning & Napier said it had decided not to take the money.

While the federal loan program is supposed to help companies avoid layoffs, some of the large recipients of loans have already dramatically reduced their workforces — and not always because of the coronavirus.

Harvard Bioscience, based in Holliston, Mass., has been trying since last year to pacify an activist investor that is pressuring management to boost the company’s stock price. The company closed facilities in North Carolina and Connecticut and said in February, before the coronavirus upended the economy, that it was laying off about 10 percent of its work force.

This month, Harvard Bioscience received a $6.1 million loan through the paycheck protection program. In a securities filing disclosing the loan, the company didn’t say why it sought the money or how it would use it. A spokesman didn’t respond to requests for comment.

A number of relatively large companies with connections to Mr. Trump also received millions of dollars in loans.

Phunware, a data-collection company that received a $2.9 million loan this month, counts Mr. Trump’s re-election campaign and Fox News as two of its biggest clients.

Continental Materials, a heating and air conditioning and construction material supplier based in Chicago, got a $5.5 million loan. The firm’s chief executive, James Gidwitz, is a major Trump donor, and his brother Ronald was appointed ambassador to Brussels by Mr. Trump after serving as Illinois campaign finance chairman for the 2016 Trump campaign.

It isn’t clear whether political considerations helped Phunware and Continental Materials get their loans approved. Neither company responded to requests for comment.

 

 

 

 

Trump, Head of Government, Leans Into Antigovernment Message

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Trump, Head of Government, Leans Into Antigovernment Message

With his poll numbers fading after a rally-around-the-leader bump, the president is stoking protests against stay-at-home orders.

First he was the self-described “wartime president.” Then he trumpeted the “total” authority of the federal government. But in the past few days, President Trump has nurtured protests against state-issued stay-at-home orders aimed at curtailing the spread of the coronavirus.

Hurtling from one position to another is consistent with Mr. Trump’s approach to the presidency over the past three years. Even when external pressures and stresses appear to change the dynamics that the country is facing, Mr. Trump remains unbowed, altering his approach for a day or two, only to return to nursing grievances.

Not even the president’s re-election campaign can harness him: His team is often reactive to his moods and whims, trying but not always succeeding in steering him in a particular direction. Now, with Mr. Trump’s poll numbers falling after a rally-around-the-leader bump, he is road-testing a new turn on a familiar theme — veering into messages aimed at appealing to Americans whose lives have been disrupted by the legally enforceable stay-at-home orders.

Whether his latest theme will be effective for him is an open question: In an NBC/Wall Street Journal poll released on Sunday, just 36 percent of voters said they generally trusted what Mr. Trump says about the coronavirus.

But the president, who ran as an insurgent in 2016, is most comfortable raging against the machine of government, even when he is the one running the country. And while the coronavirus is in every state in the union, it is heavily affecting minority and low-income communities.

So when Mr. Trump on Friday tweeted “LIBERATE,” his all-capitalized exhortations against strict orders in specific states — including Michigan — were in keeping with how he ran in 2016: saying things that seem contradictory, like pledging to work with governors and then urging people to “liberate” their states, and leaving it to his audiences to hear what they want to hear in his words.

For instance, Mr. Trump did not take the opportunity to more forcefully encourage the protesters when he spoke with reporters on Friday.

“These are people expressing their views,” Mr. Trump said. “They seem to be very responsible people to me.” But he said he thought the protesters had been treated “rough.”

In a webcast with Students for Trump on Friday, a conservative activist and Trump ally, Charlie Kirk, echoed the message, encouraging a “peaceful rebellion against governors” in states like Michigan, according to ABC News.

On Fox News, where many of the opinion hosts are aligned with Mr. Trump and which he watches closely, there have also been discussions of such protests. And Mr. Trump has heard from conservative allies who have said they think he is straying from his base of supporters in recent weeks.

So far, the protests have been relatively small and scattershot, organized by conservative-leaning groups with some organic attendance. It remains to be seen if they will be durable.

But Mr. Trump’s show of affinity for such actions is in keeping with his fomenting of voter anger at the establishment in 2016, a key to his success then — and his fallback position during uncertain moments ever since.

In the case of the state-issued orders, Mr. Trump’s advisers say his criticism of certain places is appropriate.

Stephen Moore, a former adviser to Mr. Trump and an economist with FreedomWorks, an organization that promotes limited government, said he thought protesters ought to be wearing masks and protecting themselves. But, he added, “the people who are doing the protest, for the most part, these are the ‘deplorables,’ they’re largely Trump supporters, but not only Trump supporters.”

On Sunday, Mr. Trump again praised the protesters. “I have never seen so many American flags,” he said.

But Mr. Trump’s advisers are divided about the wisdom of encouraging the protests. At some of them, Gov. Gretchen Whitmer of Michigan, a Democrat, has been compared to Adolf Hitler. At least one protester had a sign featuring a swastika.

One adviser said privately that if someone were to be injured at the protests — or if anyone contracted the coronavirus at large events where people were not wearing masks — there would be potential political risk for the president.

But two other people close to the president, who asked for anonymity in order to speak candidly, said they thought the protests could be politically helpful to Mr. Trump, while acknowledging there might be public health risks.

One of those people said that in much of the country, where the numbers of coronavirus cases and deaths are not as high as in places like New York, New Jersey, California and Washington State, anger is growing over the economic losses that have come with the stringent social-distancing restrictions.

And some states are already preparing to restart their economies. Ohio, where Gov. Mike DeWine, a Republican, took early actions against the spread of the virus, is planning a staged reopening beginning on May 1.

Still, as Mr. Trump did throughout 2016, as when he said “torture works” and then walked back that statement a short time later, or when he advocated bombing the Middle East while denouncing lengthy foreign engagements, he has long taken various sides of the same issue.

Mobilizing anger and mistrust toward the government was a crucial factor for Mr. Trump in the last presidential election. And for many months he has been looking for ways to contrast himself with former Vice President Joseph R. Biden Jr., the presumptive Democratic presidential nominee and a Washington lifer.

The problem? Mr. Trump is now president, and disowning responsibility for his administration’s slow and problem-plagued response to the coronavirus could prove difficult. And protests can be an unpredictable factor, particularly at a moment of economic unrest.

Vice President Mike Pence, asked on NBC’s “Meet the Press” about the president’s tweets urging people to “liberate” states, demurred.

“The American people know that no one in America wants to reopen this country more than President Donald Trump,” Mr. Pence said, “and on Thursday the president directed us to lay out guidelines for when and how states could responsibly do that.”

“And in the president’s tweets and public statements, I can assure you, he’s going to continue to encourage governors to find ways to safely and responsibly let America go back to work,” he said.

With the political campaign halted, Mr. Trump’s advisers have seen an advantage in the frozen-in-time state of the race. Mr. Biden has struggled to fund-raise or even to get daily attention in the news cycle.

But Mr. Trump himself has seemed at sea, according to people close to him, uncertain of how to proceed. His approval numbers in his campaign polling have settled back to a level consistent with before the coronavirus, according to multiple people familiar with the data.

His campaign polling has shown that focusing on criticizing China, in contrast with Mr. Biden, moves voters toward Mr. Trump, according to a Republican who has seen it.

“Trump finally fired the first shot” with his more aggressive stance toward the Chinese government and its leader, Xi Jinping, said Stephen K. Bannon, Mr. Trump’s former chief strategist. “Xi is put on notice that the death, economic carnage and agony is his and his alone,” Mr. Bannon said. “Only question now: What is America’s president prepared to do about it?”

Mr. Trump’s campaign manager, Brad Parscale, has advocated messages that contrast Mr. Trump with Mr. Biden on a number of fronts, including China.

But inside and outside the White House, other advisers to Mr. Trump see an advantage in focusing attention on the presidency.

Kellyanne Conway, the White House counselor, has argued in West Wing discussions that there is a time to focus on China, but that for now, the president should embrace commander-in-chief moments amid the crisis.

Chris Christie, the former governor of New Jersey and a friend of Mr. Trump’s, said on ABC’s “This Week” that he did not think ads criticizing Mr. Biden on China were the right approach for now.

Ultimately, Mr. Trump’s advisers said, most of his team is aware that it can try to drive down Mr. Biden’s poll numbers, but that no matter what tactics it deploys now, the president’s future will most likely depend on whether the economy is improving in the fall and whether the virus’s spread has been mitigated. Those things will remain unknown for months.

“This is going to be a referendum,” Mr. Christie said, “on whether people think, when we get to October, whether or not he handled this crisis in a way that helped the American people, protected lives and moved us forward.”

 

 

 

 

The Huge Coronavirus Gamble

Posted on by • Posted in 2020 Election Issues, Accountability, Coronavirus, Health Policy, Infection Control, Infectious Virus, Leadership, Mortality, Pandemic, Public Health, Public Safety, Shortsightedness • Leave a comment

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President Trump is eager to ease off of stringent coronavirus mitigation steps “soon,” he said yesterday, but that would have a calamitous impact on Americans’ health — and it’s not clear how much it would help the economy, either.

Why it matters: For now, the only way to avoid large numbers of deaths is to keep people away from each other to stop the virus’ spread. And as long as the coronavirus is spreading, it’s likely to hurt the economy.

Driving the news: “This is a medical problem. We are not going to let it turn into a long-lasting financial problem,” Trump said in a press conference yesterday.

Between the lines: Missing from Trump’s rhetoric is any real acknowledgement that the situation is going to get worse in the near term.

“A policy of returning people to work too soon should be called the ‘let old people die already’ policy,“ a former Trump administration official told me.

  • If Trump decides to release the brakes in a week — and if states follow suit — the number of coronavirus cases would likely skyrocket far beyond anything the health care system can handle.

The big picture: The number of confirmed U.S. cases is still rising at an alarming rate — and that’s not counting the thousands who have it but are unable to get tested.

  • That number is expected to continue to rise.

Reality check: The choice between saving lives and saving the economy may not even be a real one.

  • If the virus’ continued spread causes people to still be concerned for their health, and they don’t start spending money again in droves, then service workers may be putting their health back on the line for weak demand and a lackluster rebound.

 

 

 

 

Trust issues plague the relationship between Ascension St. Joe’s and the community it serves

Posted on by • Posted in Accountability, Agreements, Commitment, Community Benefit, Community Benefits Agreement (CBA), Health Policy, Health System, Hospital, Hospital Closure, Hospital Industry, Leadership Commitment, Trust • Leave a comment

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Three empty chairs at a community meeting epitomized the mistrust between the leaders of Ascension Wisconsin and the St. Joe’s Accountability Coalition.

The coalition, composed primarily of community leaders from Milwaukee’s north side, invited Ascension Wisconsin to that Oct. 1 meeting to press the health system to sign a legal contract binding it to a list of commitments. The commitments included keeping Ascension St. Joseph hospital open and providing an urgent care clinic, affordable housing assistance, local hiring, more employee training and living wages for all employees.

Ascension didn’t show.

For one, Ascension Wisconsin officials said they were told they would not be allowed to speak at the event. For another, they said signing a contract was unnecessary because they have promised to keep the hospital open, already hire locally and provide employee training.

The hospital, which employs about 800 people, is one of the neighborhood’s largest employers.

The coalition wants the hospital to sign a community benefits agreement, known as a CBA, which is a contract between community groups and real estate developers or government entities.

Reggie Newson, Ascension Wisconsin’s vice president of government and community services, said the health system is proving its commitment to the community by expanding and adding services to St. Joseph.

For example, two certified nurse-midwives were just hired for the hospital’s new midwifery clinic and a third is being recruited. The hospital is also planning to hire a cardiac nurse practitioner and cardiologist.

But members of the coalition aren’t convinced, because they say there is no legal penalty if Ascension fails to follow through on its promises.

Nate Gilliam, an organizer with the Wisconsin Federation of Nurses & Health Professionals, advisory board member of the University of Wisconsin Population Health Institute and coalition spokesman, said the coalition just wants accountability.

“It’s good that they’re saying all these great things on paper and to the media,” he said. “But if they are going to do that, they shouldn’t have a problem with signing a CBA.”

Future bright despite history of mistrust, Ascension says

The lack of trust between the coalition and Ascension Wisconsin started 18 months ago, when hospital administrators — citing losses of roughly $30 million a year — proposed cutting some of Ascension St. Joseph’s surgical and medical units and other services, such as cardiology support.

The hospital, at 5000 W. Chambers St., serves a majority African American population on the city’s north side, an area facing steep socioeconomic disadvantages. Decades of limited access to health care have contributed to higher rates of chronic disease. Higher rates of poverty means many residents rely on Medicaid for health insurance.

Residents interpreted Ascension’s proposal as a precursor to closing the hospital and — in an area where transportation is scarce — feared they would have to go farther for health care.

The proposal was criticized by Mayor Tom Barrett, several aldermen and community leaders, including George Hinton, CEO of the Social Development Commission and former president of Aurora Sinai Medical Center, who wrote an op-ed in opposition.

Ascension dropped the proposal.

But that was 18 months ago.

Since then, Newson said the hospital surveyed more than 1,000 people by telephone and held five community listening sessions. The information was used to develop priorities for the hospital and corresponding programs, such as the midwifery program and heart and vascular community care center.

Similarly, members of the coalition conducted their own survey, knocking on hundreds of doors and collecting 584 detailed responses.

When surveyed on non-clinical services, over 40% of residents said housing assistance, local hiring and living wages were their top priorities. From the coalition’s survey on clinical services, 61.6% said access to urgent care was most important to them.

Kevin Kluesner, Ascension St. Joseph’s chief administrative officer, said he and others are well aware of the health disparities and disadvantages within the community they serve.

He said Ascension Wisconsin’s push to expand services is proof the hospital isn’t going anywhere.

That commitment is despite the hospital’s having lost roughly $150 million since the 2012 fiscal year. In the 2018 fiscal year, the most recent for which information is available, Ascension St. Joseph lost $31.6 million.

By comparison, Froedtert Hospital reported $134 million in profits for the 2018 fiscal year, according to information filed with the Wisconsin Hospital Association. Aurora St. Luke’s Medical Center reported $166 million in profits in 2018.

Gilliam said that since the hospital is a non-profit venture, lost profits shouldn’t matter. He also said that Ascension Wisconsin has more profitable locations across the state, that can offset the losses at St. Joseph.

Coalition wants accountability

The results from the coalition’s survey mirrored what residents at the Oct. 1 community meeting described.

Charles Hawkins said he likes his primary care physicians, but said they keep leaving.

Another resident who lives blocks away from the hospital, Arkesia Jackson, said when her brother-in-law experienced a flare-up of his COPD, or chronic obstructive pulmonary disease, she was thankful a community hospital was nearby.

“He ran inside the emergency and collapsed, car running,” she said. “He is a patient at St. Joe’s. They had all his records, they knew who he was, they knew what he was suffering from.”

Newson said the goal is to provide consistent, quality care for all patients.

Gilliam acknowledged that details of what the coalition is asking for, such as racially equitable health care and helping with housing assistance, are somewhat vague. However, that’s because its members said they want to sit down with Ascension and hammer out an agreement — as long as Ascension commits to signing one.

Coalition members argue that other hospitals have worked with community groups on similar initiatives.

Robert Silverman, a professor in the Department of Urban and Regional Planning at the University of Buffalo, said there are some rare examples of CBAs being used in the health care field.

For example, Yale University signed a CBA with the Community Organized for Responsible Development group in 2006 regarding the construction of a new cancer center.

It still remains unlikely that Ascension, a national organization, would willingly set such a precedent for its hospitals.

Gilliam said he thinks it’s important for hospitals to be accountable to the community.

“I don’t see why they see a community benefits agreement as adversarial off the top,” Gilliam said. “Whenever they’re ready to come to the table in earnest, we’ll be there. That’s it.”

But with the addition and expansion of several new programs, Kluesner said he’s not sure what else hospital officials can do to prove they are serious about being a reliable anchor institution on the city’s north side.

“We’ve signed 11 new providers. That’s the best proof we could give of our commitment to growing services here at St. Joseph. If people are wondering what are we doing at Ascension St. Joseph, I think that actions speak louder than words,” he said.