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‘You can’t have that time back’: How the U.S. lost Plan A against COVID-19

Dr. Larry Brilliant
REUTERS/Carlos Barria
Dr. Larry Brilliant is known, among other things, for his work with the World Health Organization in the 1970s, helping to successfully eradicate smallpox in India.

By many measures (like the most cases and the most deaths), the United States has the biggest and worst coronavirus outbreak in the world. Our numbers are the worst, and I suppose you could dispute such a strong statement, but no one who cared about honesty based on factual accuracy could dispute that, although we are on the opposite side of the planet from where the virus originated, and although we are a rich, scientifically advanced country, we are the hardest hit or among the hardest hit.

Why?

I can think of lots of possible contributing factors. But after listening to the most recent episode of the Al Franken Podcast, in which he interviewed a brilliant epidemiologist (who happens to be named Brilliant), I’m going to pass along his view of the why, which is fundamentally about the passage of time, specifically the month or more that the United States government, led by its president, spent denying that we had a very serious potential problem, during which the virus spread, almost certainly carried by people who were infected but didn’t know it and moved around the country.

During that month or six weeks, the epidemic spread far, deep and wide. After that period, although you could argue about other things that may have been done right or wrong, it become exponentially (remember that word) harder to defeat or contain the spread.

And, yes, that was the month or more, from late January to early March, that Donald Trump spent downplaying the seriousness of the threat, promising that it would go away by itself when the weather warmed up.

The numbers for doing such comparisons are complicated and problematic. And my negative attitude toward President Trump is a challenge, to which I confess. But it appears that Trump’s unwillingness to acknowledge the seriousness of the COVID menace for six weeks or so after it reached our shores is a big, and perhaps the biggest, reason it got so much bigger here than in many, many other places.

Dr. Larry Brilliant, the epidemiologist whom Franken interviewed last week, is known, among other things, for his work with the World Health Organization in the 1970s, helping to successfully eradicate smallpox in India, which might be a pretty relevant credential for speaking about how to defeat a pandemic. Brilliant currently serves as the chairman of the board of an organization called (amazingly enough) Ending Pandemics. The full interview with Franken is accessible here.

But in case you don’t listen to the whole thing, I’ll just highlight the portion where Franken asked Brilliant about how smallpox was eradicated in India by, as Franken put it, having “lots and lots of people going from village to village, door to door, finding every case of smallpox, [until] you found the last case of smallpox.”

While that is surely an oversimplification, it does seem to get to the essence of what worked in India with smallpox. But the key to its success, and the key to why it’s now too late to do the same thing for COVID in the United States, is that it’s too late to contain the disease once it has spread so far and wide. I’m not suggesting the pandemic will never end; rather that it is too late to contain its spread.

Brilliant seemed less interested than Franken in making the contrast about what worked in India and the failure under Trump to contain or eradicate COVID. For example, Brilliant acknowledged to Franken that the approach that worked with smallpox in India in the ’70s was easier in some ways “because you can see the disease [smallpox] right on their face when you see someone who has contracted it.” Also, unlike COVID, a vaccine existed for treating smallpox. Those are big differences, and I appreciate that kind of intellectual honesty.

But the contrast that Brilliant drew, which at least implied a devastating critique of the Trump administration’s efforts on COVID, was to emphasize the importance, in fighting a highly communicable disease, of acting early, while the number of carriers is small and in a limited area, and then focusing laser-like on locating everyone with whom those infected have had contact, making them likely to develop and/or spread the disease.

That piece of controlling an epidemic is much easier in the age of cellphones, compared to the situation his team faced in India in the mid-1970s where, he said: “It’s harder because it’s India. It was harder because we didn’t even have mimeograph  machines, let alone iPhones.”

The sharpest direct criticism Brilliant had with Trump’s excuses on COVID was about Trump’s insistence on minimizing the problem when it was small, which prevented much of America from taking it seriously until it had already spread so far and wide across the United States that it could not be surrounded or contained by isolating those who had been infected or had had contact with carriers.

The best strategy, in both instances, smallpox in India or COVID in America, would be basically the same, he said.

You find every single case, then you do epidemiology. You do backward tracing to find out where they’d been and whom they’ve been in contact with. You do forward tracing, to find who has been in contact with them, who might have caught the disease and have gone to some other place.

You find them and [use the tools that] you have. We had a vaccine then; now we have quarantines. And it works. It was Plan A. It’s what we should have done when the first cases came to the United States in January, which they did, even though the only case that’s been reported that early was February 5 — but that was a death, which means the cases began in January.

That’s what we should have done. But the federal government failed us. We had no testing. They dismissed the threat, constantly saying it would disappear in April. … And the CDC failed us, my beloved CDC. …

(He’s referring to the test, developed by the Centers for Disease Control, which turned out not to work.)

It’s not just, Al, that they failed in that first test. It’s that they then failed to do Plan B, which would have been to bring in the test that the Germans did, that the South Koreans used and China used. … If you’re trying to get rid of a disease and you need to test everybody, and you’ve geared up to make a test and it’s contaminated and it doesn’t work, you get a test from some other place — if you really believe that it’s a serious enough problem, you kind of swallow your pride and you take what you can get.

OK, you’ve heard some of that before. But perhaps we haven’t emphasized enough the consequences of the screw-up in the U.S.-made test and the failure to bring in one that worked.

But the key is what that screw-up cost. It cost time, time that the virus used to spread, as highly contagious viruses do.

This is the key point he made, in explaining why the United States turned into the hottest COVID spot in the world: It was the long delay that enabled the virus to spread beyond the point the contact-tracing epidemiological approach could solve:

When you’re dealing with a virus that … spreads exponentially and the exponent is two or five, you don’t want to give that virus a seven-week, six-week head start. … You can have a billion cases before you know it. It’s really hundreds of millions. …

(This is why I suggested you keep in mind the word “exponential” above. If everyone who catches the virus infects four or five others, the numbers explode pretty fast and far.)

And you can’t have that time back. You can’t historically revision it. You can’t pretend that it didn’t happen.

But what we’ve done is we’ve gone from Plan A, which would have been you find every case, you put a ring of quarantine around it, to Plan Z, which is you close everything.

And we’ve done that because of desperation. We had no choice. Once that virus was out of the bag and it was in every single county, every state, you can’t go back. You then have to change your plan.

The only plan that was available to the United States then was a plan that has totally knocked out our economy, … and there is a linear direct relationship between [everything that was done then] and what we’ve had to endure, what is it, six weeks.

As I mentioned above, Franken was more interested in emphasizing Trump’s role in these errors, but Brilliant cut him off:

Let’s leave aside the president. We do not have a plan in place today. We should have a two-year or three-year or four-year or six year plan….

Here’s one more link to the full Franken-Brilliant podcast/interview.

Comments (49)

  1. Submitted by Dennis Wagner on 05/11/2020 - 10:13 am.

    Well you brought up a Trump and minion weak point, calculus, time and rate of change (acceleration and velocity) calculating the area (infectious people) under the curve. Better to believe in fake conspiracy theories and blame others to rally the troops then in actual facts and science where you have to do something to address the problem, in a timely manner! .

  2. Submitted by Jim Tingsdale on 05/11/2020 - 10:37 am.

    I’m looking forward to observing the change in talking points from the left in a couple months when people really start suffering from the economic meltdown that is underway.

    The WHO is not going to have a canned response to the likely millions of people that lose their houses. The Democratic party is going to have to wing it. Should be quite interesting.

    • Submitted by Pat Terry on 05/11/2020 - 11:09 am.

      Yup, the Trump economic disaster is going to be rough. Who would have figured that a man who was a complete and utter failure at business would run the economy into the ground as president.

    • Submitted by RB Holbrook on 05/11/2020 - 11:19 am.

      I, for one, am not looking forward to an economic meltdown, nor do I anticipate with apparent glee any facet of such a meltdown.

    • Submitted by Brian Simon on 05/11/2020 - 11:21 am.

      Clearly conservatives & liberals answer the question differently as to what’s more valuable: money, or life?

      • Submitted by Charles Holtman on 05/12/2020 - 09:03 pm.

        As Neal Rovick notes cogently below, that’s a false dichotomy. Through its complete lack of leadership and competence (and that is stating it in the most charitable way possible – I might, for example, have included the word “malevolence”), the Trump administration has ensured both far more mortality/morbidity, and far deeper economic consequences, then we might have sustained. As Steve Schmidt (Republican talking head) stated recently, the economic damage is not the result of the pandemic, it’s the result of the response to the pandemic.

    • Submitted by Jon Kingstad on 05/11/2020 - 11:30 am.

      Change in talking points? The “left”?

      Evidently, Trump supporters seem to believe that anyone who finds President “Very Stable Genius” to be incompetent, as well as corrupt, racist and, well, repulsive, comprise “the left.” Informed views of experts like Dr. Brilliant that reveals the incompetence of the Very Stable Genius in addressing and dealing with the greatest health crisis in 100 years are dismissed as merely “talking points.”

      Three months ago, the only “talking points” that Trump’s supporters could muster against the overwhelming evidence of his corruption and racism was how great the stock market was and how this would almost guaranty Trump’s re-election. That’s gone now and with the passage of time, the evidence is there for all to see that the “Very Stable Genius” screwed up big time in dealing with this health crisis.

      Trump fired the government’s pandemic response team a couple of years ago on purely partisan political grounds and then never replaced them. He could have ordered test kits from Germany or South Korea of elsewhere as soon as the CDC tests were found to have failed. If the country is in a recession or, Heaven forbid, a depression in November, it will be on Trump in failing to recognize and take decisive measures to contain the pandemic. The only interesting and frightening question is whether the American voting public is astute enough to see through the inevitable avalanche of propaganda blaming everyone but Trump for his incompetence and monumental failure of leadership.

    • Submitted by Marc Post on 05/11/2020 - 11:36 am.

      Indeed, Connor.

      I’m also interested in the right’s response to the death toll. The push to re-open was predicated on projected 60,000 deaths. The WH guidelines have been ignored by the POTUS himself as he and the right push for re-opening. The projected body count is now 137,000. So much winning!

      It will be interesting to see if the so-called evangelical Christians can stomach so many body bags. All this from the pro-life party. What a joke.

      Maybe if we called them “Covid Abortions”, the right might see it differently.

    • Submitted by Edward Blaise on 05/11/2020 - 11:40 am.

      What will even be more interesting will be the data that shows the US economic impact is severe and proportional to the onslaught of the epidemic.

      Look at the data for South Korea: a good reaction to the onslaught equated to a better result on economic impact. Even Italy is looking better than us.

      Trump’s inability to get in front of the virus early on to slow its’ spread is on him. When our economy suffers an economic meltdown more than most other nations it is also on him: his failure to respond and take things seriously on the front edge is what has brought us to this point.

      As he told us:

      “Leaders, true leaders, take responsibility for the success of the team and understand that they must also take responsibility for the failure.”

      • Submitted by Paul Brandon on 05/11/2020 - 06:44 pm.

        The 1918 Spanish Flu pandemic showed that states which shut down more thoroughly were in better economic shape when the pandemic ended.

    • Submitted by Michael Friedman on 05/11/2020 - 01:48 pm.

      Painfully obvious political stunt to suggest that Democrats shut down the economy which otherwise would have sailed. No, the worldwide impact of the pandemic was and remains devastating to the economy. Democratic and Republican governors issued shut down measures, which were consistent with Trump’s executive branch guidance and our relative lack of medical infrastructure compared to other places in the world. The economy would not have sunk as much if we had more capacity to keep workers healthy and consumers confident, but it would have sunk. It will stay sunk while reopen absent consumer confidence to spend in public places, exacerbated by mixed messaging for phony political point scoring. The harping on blame is not helping the debate about what to do now. Time for Eric to let it go until we’re past it, and not let the absurd responses interfere with promotion of how to stay appropriately safe going forward.

    • Submitted by ian wade on 05/11/2020 - 03:44 pm.

      You’re right, Jim. If everyone would just chug bleach, the country could get back to normal in no time.

    • Submitted by Eric Snyder on 05/11/2020 - 07:56 pm.

      “Real suffering” is already taking place, and was well before the pandemic. But the brunt of responsibility for this needless economic stress during the pandemic falls on the shoulders of the GOP, which refuses to take any number of obvious steps to lessen the economic blows. The Democrats are not free of blame here either.

      “The left,” which only barely has a toehold in Congress, is already calling for measures like the following:

      -Rent and mortgage freezes.
      -Cancellation of back rent.
      -Moratoriums on evictions.
      -$2000+/month assistance until the virus is minimized.
      -Expanded and much more easily accessible unemployment compensation.
      -Federally mandated paid sick leave and hazard pay.
      -Funding and coordination of food banks.

      And if we had the least bit of intelligence in this country we’d raise revenue with a massive tax hike on the wealthy and on Wall Street. We’d be slashing the military budget.

      What is the response of Republicans in power? It’s irrational and ethically deplorable:

      -Ignore or minimize public health and science considerations and put people back to work, in particular in places that are ideal petri dishes for transmission like fitness clubs. Open up public places like beaches.
      -As with Mitch McConnell, refuse to budge on needed legislation until corporate America is effectively indemnified against criminal endangerment of workers. McConnell effectively wants to give a green light to coercive and reckless corporate behavior that will end up costing lives.

      THIS is the conservative response–a treacherous game of scientific illiteracy, magical thinking, moral indifference and vicious political calculation with eyes on November 2020.

    • Submitted by Tom Christensen on 05/11/2020 - 11:28 pm.

      This would all be going better if Trump had any leadership skills, he has none. The public is being whiplashed from one bit of Trump nonsense to the next. How do we know who and what to believe? The Trump administration doesn’t have any credibility, from top to bottom. I’m looking forward to November when the voters will clean Trump out along with all the GOP political cowards that have chosen to cede their Constitutionally given power to Trump, because they are afraid of him. That’s not leadership that is cowardice.

  3. Submitted by Brian Scholin on 05/11/2020 - 11:22 am.

    You mention Diamond twice. Is that just because he’s Brilliant? Or someone else?

  4. Submitted by Ann Frisch on 05/11/2020 - 11:39 am.

    We will survive the corona virus. But nuclear weapons: there is no emergency plan, no recovery, no muddling through. A “small!” (“tactical”) weapon could set off the ever-ready missiles before anyone can stay “let’s think this through” as we can do with the virus. With 14,000 nuclear weapons (many of them pointed at Russia and US) as few as 100 launched could drop the climate below the temperature needed to grow crops, and scatter highly radioactive material everywhere. Think about that when you plant your garden!

  5. Submitted by David LaPorte on 05/11/2020 - 11:47 am.

    For anyone who’s wondering whether a prompt response from the Trump administration would have made a difference, take a look at Hong Kong and Taiwan. They got on top of COVID-19 quickly and their deaths were in the single digits as of April. They also have unemployment rates in the range of 3 – 4%.

    In stark contrast, Trump was in denial from January until mid-March and now he’s trying to pass the buck to the states, even as FEMA confiscates their essential medical supplies. Our deaths have passed 80,000, our unemployment rate is 14.6% and Secretary of the Treasury Steven Mnuchin is expecting it to surpass 20%.

    We lost a couple of months because Trump was too obsessed with the Dow Jones Average (which he conflates with the economy) and now we’re paying the price. And that price could get much steeper if he is successful in his pressure campaign to get the governors to reopen the economy too quickly.

  6. Submitted by Mike Chrun on 05/11/2020 - 12:24 pm.

    Hopefully, people will remember those first two months and the constant downplaying of the threat by Trump come November. We’ll see the usual distortions of, “But Trump didn’t let the cruise ship dock,” and, “But Trump banned travel from China early on,” as the cult tries to convince people that their great leader was on it from the beginning. But we have all those quotes on video about how we really don’t have any worries.

    It’s futile to number the distortion campaigns of this administration because there are so many, but we’re certainly in the midst of another one now. This virus isn’t really that large a threat. The left is inflating the death count for political purposes more and more. Along with that is the constant drumbeat of, “It’s not that big a threat to us. “After all, just about all of the people who have died are being carried out of nursing homes.” Quite the position for the party of No Death Panels and Sanctity of Life.

    Without a doubt, we are going to have to do things to get the economy going again. And, as someone in the vulnerable age category, I am going to have to gague how much of a risk I want to take when things get back to “normal.” But this crises is being managed by a group of sycophants to a person without any sense of empathy and absolutely no inclination to tell the truth or to unite the nation in saving lives.

    • Submitted by Frank Phelan on 05/13/2020 - 12:10 pm.

      Bone Spurs banned travel from China AFTER the airlines did.

      GOP presidents know better than to order corporations around. They know the tail doesn’t wag the dog.

      • Submitted by RB Holbrook on 05/14/2020 - 11:05 am.

        As Gail Collins pointed out today, the Great Helmsman issued his travel ban after a lot of countries, such as the Marshall Islands.

        He probably was busy. Fox & Friends isn’t going to watch itself.

  7. Submitted by BK Anderson on 05/11/2020 - 01:36 pm.

    So Ignoramus Maximus in DC thoroughly botched Plan A, and is now telling all and sundry to give up on Plan Z! In other words, the Stable Genius is really quite tired of this little Covid-19 problem and he’d liked to wash his hands of it. And since the CDC’s earlier “guidance” (social distancing, etc) is (apparently) inoperative, there is now no federal plan to speak of.

    Actually that’s wrong. The new Trumpian plan is to see this as a WAR against an INVISIBLE ENEMY, whip Warrior Nation into a frenzy, have us storm the Covid-19 hill with assault weapons blazing, leap into the evil virus’s trenches and…um,….what? Seriously, this is now what “conservatives” are reduced to? The heroic Nation of Warriors(tm) who happily make any sacrifice, no matter how futile!

    Unfortunately, a better way of understanding Trump’s “Plan Warrior USA” is that it’s asking the non-elite elements of the US populace (and they know who they are) to become Covid cannon fodder and die for 2 for 1 beer nite and fast food “dining rooms”. In other words, just another “conservative” cult of death from the Party of Life[sic]. Bonsai!

  8. Submitted by Connie Sullivan on 05/11/2020 - 04:36 pm.

    On can only hope that all those voters out there who are over fifty years of age realize that Donald Trump has decided to throw them under the bus, to benefit his re-election. He does not care about that demographic at all–despite the fact that he’s in that demographic and is now absolutely terrified of the corona virus,which is in the White House, floating around in the air there.

    Trump is cool about several hundred thousand Americans dying of this pandemic disease. Or not: His team’s recent tactic is to deny the tallied numbers of the infected and, especially, the number of us who have been dying. “Warriors” on the front line, unwillingly, we are supposed to die off in silence, to protect Donald Trump.

    He forgets, too, that so far, 20% of the more than 80,000 Covid-19 dead, or about 16,000 souls, are NOT over fifty years old.

    On one point, I disagree with Dr. Brilliant: We don’t just need to look for solutions to the health crisis and ignore Trump.

    We can, indeed, hold two concepts or goals simultaneously in our minds. One, that we need to find ways to survive this pandemic in literal terms (may we all be so lucky!). And two, we need to hold Donald Trump and his abysmal administration to account for this disaster, which did not have to happen the awful way it is happening.

  9. Submitted by joe smith on 05/11/2020 - 04:40 pm.

    What you can never get back is the whole United States of America shutting down because of New York City’s horrendous handling of this virus. We went “one size fits all” off of how NYC was doing and that was a terrible decision for the majority of Americans. Keeping the subways open and packed with homeless is bad policy, along with mandating long care facilities take in COViD 19 patients from hospitals while still contagious was a death sentence for the elderly in NYC. States that didn’t close down have the same or better results as the lockdown states. I have stated before it takes no leadership to close down a State, it takes tremendous leadership and courage to keep your State open and working. Georgia was supposed to be the State that shows going back to work will prove deadly, is not happening.
    Fear mongering has so many Americans hiding in their basement with little to no chance of dying from COViD 19, Minnesotans included. With all the testing it is becoming clear that up to 80% of the people that tested positive to the virus had little to no symptoms. Florida, with the highest rate of seniors in the country, took early action to protect them and it worked. We won’t get back the months of total panic, lost lives, lost wages, lost businesses, lost houses and all the stress that puts on everyone…… Shame on us free people for being herded like cattle to our basements. In America you have the right to make decisions for yourself, or at least we used to.

    • Submitted by Edward Blaise on 05/12/2020 - 11:41 am.

      So much misinformation, so little time…

      “What you can never get back is the whole United States of America shutting down because of New York City’s horrendous handling of this virus.”

      The data shows that while NYC has flattened the curve, the brave Governors of Trump states like GA, IA and NE are in a big mess.

      ” I have stated before it takes no leadership to close down a State, it takes tremendous leadership and courage to keep your State open and working.”

      And as we all recall, Trump definitively said that he calls the shots on closing and reopening, so, looking for courage? What do you see at 1600 Pennsylvania Ave? Why did he not follow through on his ultimate authority to reopen as he saw fit?

      “Georgia was supposed to be the State that shows going back to work will prove deadly, is not happening.”

      Take a closer look at NE GA and new cases.

      “Florida, with the highest rate of seniors in the country, took early action to protect them and it worked.”

      Well:
      “The DeSantis administration is struggling to contain the spread of the coronavirus among the elderly, even as it moves to allow more businesses and parks to reopen to the public.”

      Just because FOX and Trump team up to declare “Mission Accomplished” on anything it does help to make sure the data agrees.

      “Shame on us free people for being herded like cattle to our basements. In America you have the right to make decisions for yourself, or at least we used to.”

      Tell that to the folks in the West Wing hot spot….

    • Submitted by Pat Terry on 05/13/2020 - 10:42 am.

      Yup, Trump has sure made a mess. It should be no surprise that a guy who was a complete failure at business was a complete failure at running the American economy. He inherited a fortune from his father and squandered it. Then he inherited a good economy from his Democratic predecessor and led us into the worst economic crisis since the Great Depression.

      Trump’s disastrous economic legacy will be remembered for decades, if not centuries. Trump will be synonymous with economic failure.

  10. Submitted by Ray Schoch on 05/11/2020 - 04:44 pm.

    Does anyone remember “The Peter Principle” from the 1970s? What we’ve had over the past couple months (and really, over the past 3+ years) is a public demonstration of people who know what they’re doing being put in a position wherein their bosses are elected officials and political appointees who are themselves walking, talking exemplars of that Peter Principle. The social, psychological and economic consequences of this widely-demonstrated incompetence, not to mention moral and ethical bankruptcy, on the part of far too many alleged “leaders” will take a very long time to correct.

    Many of the followers of these alleged “leaders” have abandoned the use of reason. They’ve retreated to the kind of magical thinking that characterized the Medieval, and preceded the development of the scientific method – a period during which humanity suffered centuries of misery, disease and death at the hands of people with religious or cultural authority, but who knew, by modern standards, almost nothing. Alas, those kinds of people are still around.

  11. Submitted by Jim Tingsdale on 05/11/2020 - 06:06 pm.

    Several states have re-opened their economies. It will be very instructive to measure their response to the states that continue their lock downs until the economy stops struggling…apples to apples, so to speak.

  12. Submitted by Charles Thompson on 05/12/2020 - 09:16 am.

    Joe- You’ve gone retro! Pre 9/11! Big bad NYC is back. Hotbed of the homeless, the Wall Street cabal, and don’t forget breeding ground for our hero.

  13. Submitted by Neal Rovick on 05/12/2020 - 11:51 am.

    Sadly, the “re-open now” people miss the point.

    The lock down was not supposed to be until the virus was eradicated with a vaccine–there is no-one out there that advocated for that. I challenge any of you to find anyone responsible of any party who said lock down for a year or more.

    Wasted time.

    Wasted time in January, February and March to fly teams to our allies (are they still there?) in Asia and Europe to learn as much about the challenges of this virus.

    Wasted time in January, February and March to build up stockpiles and sources of domestically manufactured PPE, equipment and drugs.

    Wasted time in January, February and March to build up a testing and tracing program to find out the rates and locations of infection.

    Wasted time in March and April to build up support for common-sense distancing and mask wearing–two things that are proven to reduce infections.

    Wasted time in April with an astounding week where the ‘reopening committees’ were named on a Tuesday, surprised members of the committees had phone meeting with the White House on Wednesday, guidelines were issued on Thursday, and on Friday the president denigrated the findings, tweeting “Liberate”.

    Division, delay, denying, obstructing.

    With friends like that who needs enemies?

    Think, if it had been considered a serious matter, handled by serious and competent people, we COULD be in a position to open safely now–like a lot of other countries in the world.

    But no, we’re not.

    We’ve wasted almost half a year to get nowhere safe.

    And we wasted the costs of the lock-down with massive stupidity.

    Don’t be surprised if we end up having to do it all again.

  14. Submitted by William Hunter Duncan on 05/13/2020 - 08:48 am.

    TRUMP TRUMP TRUMP

    Yeah, he deserves to take much responsibility for this.

    But what about a health care industry that has been much taken over by private equity vultures plundering the system, which long preceded Trump (which of course he has done nothing to call out – much like the media and most people generally)?

    Health Care in America has largely become a racketeering exercise, separating people from their money on much false pretense and not a little coercion, which has been a process building since the 80’s, no matter who has been president.

    The list is long, on both sides of the isle, the leadership of America, the media too, dismissing this as just a passing thing, in February and early March. It was not just Trump. Of course, Trump is president and he sets the tone…but had he been more serious about it early, would he have been taken seriously?

    The virus has run loose in America because America has screwed up, backwards priorities with money as the central pole around which all things revolve…Trump is merely a symptom of that illness.

    • Submitted by Edward Blaise on 05/13/2020 - 09:09 am.

      “Vulture capital is a type of venture capitalism. Venture capitalists take the risk of investing in startup companies, with the hope that they will earn significant returns when the companies become a success.. … A vulture capitalist disposes of some of a company’s assets in order to give its investors better returns.”

      Can you give us any examples of the large scale intervention of “Vulture Capitalism” in our healthcare industry as you claim.

      I am no fan of the likes of United Health Group, but they do not fit the definition. Just throwing around baseless claims not backed up by the data does give us insight into your reluctance to distance your self from Trumpism which should also be known as Putinism.

      You seem to long for a 1930s Soviet economic system. It did not work out then and will not work now.

      • Submitted by William Hunter Duncan on 05/13/2020 - 02:23 pm.

        Here is a list of private equity groups “investing” in health care – way back in 2018. The list you might imagine is a lot longer and deeper in 2020.

        https://www.beckershospitalreview.com/hospital-transactions-and-valuation/9-private-equity-firms-gobbling-up-healthcare-businesses.html

        Here is a New Yorker take on it:

        https://www.newyorker.com/business/currency/how-private-equity-firms-squeeze-hospital-patients-for-profits

        Here is an even less sympathetic take on it, from NakedCapitalism:

        https://www.nakedcapitalism.com/2020/03/firing-of-whistleblowing-emergency-room-doctor-ming-lin-by-blackstone-owned-teamhealth-demonstrates-outsized-role-of-private-equity-in-hospital-staffing.html

        A simple search for ‘private equity hospitals’ will reveal an abundance of information about private equity and health care. Some of it is about how GREAT that is for Health Care, some of it is more honest about how private equity effectively bleeds the health care system.

        So maybe a simple search is more honest than a default direct accusation of “baseless claims not backed up by the data”? And speaking of baseless claims, isn’t it so very Trumpian to call someone a communist just because they criticize billionaire and corporate control of society?

        • Submitted by Edward Blaise on 05/13/2020 - 03:52 pm.

          Your private equity gobblers gobbled up about .4% per your example.

          Why would you consider being labeled a Communist derogatory? It’s not 1952 anymore. You have repeatedly said we should essentially eliminate billionaires. We know our social democratic friends in Norway and Sweden still have lots of billionaires enabled by capitalistic governments. It seems you are not a US style Democrat or Republican, not a European style Democratic Socialist. The options seem to be narrowing and what you have long espoused on these pages more closely resembles Communism than anything else. And that’s OK, it’s a free country…

          • Submitted by William Hunter Duncan on 05/14/2020 - 07:44 am.

            I have never said get rid of billionaires. I have suggested instead, acting like we will all starve and descend into barbarism if we do not give billionaires, banks and corporations every thing they want, is servile and un-American. I have been arguing for a capitalism/free market that empowers people and takes care of the earth, rather than practicing ecocide and finding ever more creative ways to bleed people of their money and reduce compensation and benefits for everyone who isn’t invested in the stock market.

            As for your 0.4% statement, if that is your takeaway then you didn’t read the links or bother to do your own research. What we know is, private equity has spent at least $340 billion just the last several years, buying up hospitals, nursing homes etc. That is more like 10% market share, but my guess is it is much higher. Even the venerable Dr Fauci is concerned about it, so it is not like private equity being part of the reason Health Care costs increase far faster than inflation or wages is some kind of secret or “conspiracy theory”.

            • Submitted by Edward Blaise on 05/14/2020 - 02:32 pm.

              Ahh William,

              As much as I enjoy debating with you, I am not that far off from your views.

              I look at what we had for a healthcare system in my 1950s-60s childhood and see how badly we have messed it up.

              Back then:

              Doctors as successful small business people, running their own clinics.

              Hospitals as civic amenities owned by communities, educational institutions and religious and fraternal orders.

              Insurance companies who sold policies and did not control the 2 items above.

              That was a very good system and new “for profit providers” have not enhanced it in the intervening years. And I also believe simple state control of all these things would also not solve our problems.

              And I maybe part of the problem too: over the years I have worked with lots of companies to build better pacemakers, property functioning heart valves, reliable and lasting artificial joints. And I did this for profit, as did the clients I worked with.

              AS MUCH PROFIT AS I COULD REASONABLY ATTAIN!

              So, are we OK with capitalistic Medtronic using innovation to maximize their returns, but if a private nursing home does the same it should not enjoy the same free market as medical device companies?

              And pharmaceuticals are even a bigger quandary.

              These are not easily answered questions. And just making the guys who invest money in these ideas as the bad guys is too simple.

              Jeff Bezos was a guy with an idea in his basement 25 years ago. His is an American success story like Bill Gates, Steve Jobs, Elon Musk and Michael Bloomberg.

              When they were just starting almost everyone admired them as the best of our country: “The American Entrepreneur”. Some where along the way they became villains. I would bet if they were asked what changed they would agree on:

              “In the beginning I was just chasing what I thought was a good idea and that good idea led to another and another and another and the next thing you know I’m a billionaire”.

              And I’ll also bet they were more interested in their ideas and where they could lead than some master plan to be a financial titan.

              And if we are to fix all of the problems we see in our system of government I think it will happen like these now big organizations did and continue to do it:

              Have an idea, implement it, see what it does and make it better.

              Rinse and repeat….

              And that is why I think we build on the ACA to fix healthcare, get a fix to mend social security, get at least 2 years of post secondary school available to anyone who wants it, get private financial interests out of school loans. These are all main stream Democratic party things. They do not advance because of some deficiency or evil intent of the D office holders. They are opposed by Republicans who see things differently. 8 Months of a 60 vote Senate, a D majority in congress and a D President in the last 60 years got us the ACA just under the wire before Scott Brown cut it to 59 D Senators. No time to make it much better. 8 Months out of 60 years!

              You want progress towards:

              “I have been arguing for a capitalism/free market that empowers people and takes care of the earth”

              Donald Trump is not going to get you there. Nobody is going to get you there as quickly as you want.

              The best, most practical bet you can make right now is elect Biden, get House and Senate majorities, work towards 60 in the Senate. And then if the progress is not there, get an ACO type as Speaker of the house, get a similarly progressive people as Senate leader and President.

              The demographic deck is stacked against the Republicans and they know it. They know their ever narrowing path requires tricks like voter suppression. These tricks will run out of gas and continually more progressive candidates and office holders will get us to the many things (well maybe some) we agree on.

              • Submitted by William Hunter Duncan on 05/15/2020 - 08:16 am.

                Well said, Edward.

                I don’t know how we take the corporatized and financialized Health Care system from an increasing exercise in racketeering, back to the focus on human health and welfare, but maybe a pandemic will help?

                I’ve long said, it is very much like a quiet conspiracy in this country, much of the the work we do and the food we have available making us ill over time. Others grow wealthy off our labor, others grow wealthy off our illness. That we poison the earth and devastate ecosystems to grow our food is emblematic of that pathology that industrial Health Care has become. Maybe there is some awareness of that in the progressive wing, there seems to be none among Dem elite, and of course most Republicans are totally hopeless in that regard.

                Anyway, I am growing as much food as I can, and trying to articulate a vision of a healthier economy for everyone and everything. You can see pictures of our garden here:

                https://www.foodforestfarmrestaurant.org/blog/may-2020-garden-update

                • Submitted by William Hunter Duncan on 05/15/2020 - 08:36 am.

                  I would add, Edward, regarding the ACA as an attempt to fix Health Care, one of the greatest, most unacknowledged impediments to real, healthy structural change in Health Care, is a liberal elite who’s retirement investments are at least somewhat dependent on the gross over-inflatement of Health Care as 20% of GDP. The status quo has been very lucrative. But the more profits realized in Health Care, the less access for regular working people.

                • Submitted by William Hunter Duncan on 05/15/2020 - 08:57 am.

                  And here is some thinking on ethics in health and welfare for people and the earth. it is a well reasoned article, the title is clickbait (but more or less accurate)…

                  https://www.nakedcapitalism.com/2020/05/americas-chilling-experiment-in-human-sacrifice.html

                • Submitted by Edward Blaise on 05/15/2020 - 08:21 pm.

                  Nice link on the garden. I am not a golfer so I have no issues with turning Hiawatha Golf Course into a food forest. We do have a lot of golf courses and very few food forests. Agreement found!

                  “I don’t know how we take the corporatized and financialized Health Care system from an increasing exercise in racketeering”

                  Begin by solving the malpractice and medical records issues that prevent Dr.s from being entrepreneurs again as partner owners in local clinics. Talk to most Docs who work in the Allina / Park Nicollet / Health Partners sphere as a family practice Doc and they aren’t happy. Way too much:

                  “You saw 3.72 patients per hour last week your target is 4.34 patients per hour”

                  Conveyed, of course, by bureaucrats.

                  Despite the fact that United Health is a locally based national company with lots of local jobs, every time I drive buy 62 and Shady Oak Road I see a big monument to medical overhead. How can that add efficiency to the system?

                  Big campaign money certainly drives the bus for both parties; but there are gaps in the Ds that should give hope. And if given the chance they would do something to limit its’ influence. No chance as long as we have Mitch McConnell and the R Senate…

                  Our current dilemma in Washington is that even things with 70% popular support have zero chance of progressing through our legislative process. And for our conservative friends, tell us a single R supported bill that has 70% support and is being shutdown by the Ds? I give you common sense gun laws, basic election security and many provisions in the ACA that are continually under fire by the Rs despite strong public approval.

                  As I said:

                  The best, most practical bet you can make right now is elect Biden, get House and Senate majorities, work towards 60 in the Senate. And then if the progress is not there, get an ACO type as Speaker of the house, get a similarly progressive people as Senate leader and President.

          • Submitted by William Hunter Duncan on 05/14/2020 - 09:28 am.

            Matt Taibbi at Rolling Stone says it more clearly than I can in these comments, about how we bail-out the wealthiest players again and again, guaranteeing profits for elite, while the rest of us not tied to the stock market are treated as expendable:

            “The $2.3 trillion CARES Act, the Donald Trump-led rescue package signed into law on March 27th, is a radical rethink of American capitalism. It retains all the cruelties of the free market for those who live and work in the real world, but turns the paper economy into a state protectorate, surrounded by a kind of Trumpian Money Wall that is designed to keep the investor class safe from fear of loss.

            “This financial economy is a fantasy casino, where the winnings are real but free chips cover the losses. For a rarefied segment of society, failure is being written out of the capitalist bargain.”

            https://www.rollingstone.com/politics/politics-features/taibbi-covid-19-bailout-wall-street-997342/

        • Submitted by Edward Blaise on 05/13/2020 - 04:07 pm.

          Your private equity gobblers gobbled up about .4% per your example.

          Why would you consider being labeled a Communist derogatory? It’s not 1952 anymore.

          You have repeatedly said we should essentially eliminate billionaires. We know our social democratic friends in Norway and Sweden still have lots of billionaires enabled by capitalistic governments. It seems you are not a US style Democrat or Republican, not a European style Democratic Socialist.

          The options seem to be narrowing and what you have long espoused on these pages more closely resembles Communism than anything else. And that’s OK, it’s a free country…

    • Submitted by Dennis Wagner on 05/13/2020 - 09:27 am.

      Suppose the alternate solution is what? We aren’t where we are by accident.

      • Submitted by William Hunter Duncan on 05/13/2020 - 02:35 pm.

        Right. It is working out (Covid aside/speaking mainly about economics) exactly as it is meant to. More more more and never ever enough for a very few – austerity for the vast majority. (As example in this pandemic bailout, already 6+ trillion dedicated to an elite few, maybe a trillion or two for the many.)

        An “alternate” solution might be educated people being more thoughtful about essentials, priorities, foundations and the general health and welfare of America and the land and waters, with a focus on local economic resilience?

        • Submitted by Dennis Wagner on 05/17/2020 - 10:48 am.

          ““alternate” solution might be educated people being more thoughtful about essentials, priorities, foundations and the general health and welfare of America and the land and waters, with a focus on local economic resilience? ”

          Its the same discussion, we aren’t here by accident, What is going to change things? It appears as a nation we are getting more uneducated by the day

          I think BKA nailed it: Take special note of the word “ungovernable”

          When you have the President of the US promoting rebellion in the states, an AG destroying the rule of law, governance by conspiracy theory, they are pulling in the opposite direction you are looking for; a haircut is now more important than the health and safety of neighbors and family members, and on and on and on…..

          “It is not a surprise that the Trump regime (as the latest iteration of the conservative movement) has successfully divided the nation and made it now quite ungovernable.”

  15. Submitted by BK Anderson on 05/13/2020 - 11:42 am.

    Trump and the rightwing Noise Machine can congratulate themselves on moving significant numbers of Repub voters against the (global!) public health community’s pretty unanimous advice and toward the politicization of the pandemic in America. Now even a public health crisis needs become a partisan issue, with increasing lawbreaking bubbling up across the Red portions of states, such as the numerous (illegal) bar and restaurant openings across TrumpLand. The Freedom to be Typhoid Mary, as one clever EB Inker wrote recently.

    It appears that Gov. Evers in WI has essentially capitulated to the anti-science frenzy in anticipation of the far right WI supreme court’s ruling that shelter at home violates one or another made up “right”. For “conservatives” the Constitution apparently IS a suicide pact, at least for higher risk citizens.

    It is not a surprise that the Trump regime (as the latest iteration of the conservative movement) has successfully divided the nation and made it now quite ungovernable. That was where this disaster was headed all along and became inevitable after Nov 2016. Nevertheless, it is worth at least recognizing the fact.

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