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One Size Does Not Fit the Virus

The attempt to protect everyone left the most vulnerable nakedly exposed

The nation and Connecticut are reopening fitfully and unevenly from a shutdown that many think should not have happened – many including Pulitzer-Prize-winning columnist Thomas Friedman of the left-leaning New York Times and Dr. David L. Katz, a Connecticut MD and an expert with a public health degree from Yale.

Our “one-size-fits-all” shutdown policy is strange in the face of a virus which afflicts different population segments in such wildly different ways. For those over age 65, who comprise only 16 percent of the country’s population, the virus has been devastating. This age group has sustained about 80 percent of nationwide deaths – 94 percent of Connecticut fatalities have hit people over 60.

Additionally, it is just plain common sense that people with serious prior conditions would be at greater risk, and that transmission would be greatest in densely populated urban areas and in communal residential settings for seniors. An estimated one-third of national fatalities occurred in nursing homes, and almost 70 percent of Connecticut deaths occurred in nursing homes and assisted living communities.

To have imposed a uniform stay-home-shutdown policy was like a shoe store selling only size-8 shoes.

Before the U.S. shutdown began, data out of China and Italy were unambiguous that the virus attacked the elderly and spared those younger. Moreover, the first U.S. outbreak occurred at a nursing home in Washington State.

Tragically, the attempt to protect everyone left the most vulnerable nakedly exposed. A central precept of medicine in the context of scarce resources is triage. God knows, we had scarce resources as the pandemic broke out. When everyone can’t be saved, triage means focusing policy, effort and resources in a manner designed to maximize survivors – in the case of this virus, that means protecting those most clearly vulnerable.

Instead, nursing homes were overlooked at best, and, even worse, in New York and some states, governors forced them to admit infected seniors. Will these governors be held to account?

From the start, many saw a targeted approach without a total economic shutdown as a better approach. Unfortunately, partisanship has developed, with most Democrats supporting the universal stay-home-shutdown policy and many Republicans the targeted alternative. So, looking at the targeted alternative through the eyes of Thomas Friedman may help.

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It’s Not Stimulus, if the Economy Remains Closed

It is not “stimulus” if there’s nothing to stimulate. Most states have been under stay-home-shutdown orders for almost seven weeks, and only a few plan to reopen before mid-May, so the “stimulus” bills are really just “bridge” bills – constituting a combined $2.7 trillion bridge to an uncertain future date when 30 million newly unemployed Americans can go back to work and businesses can re-open.

Moreover, the bridge isn’t even fully built. Many citizens have not received their $1,200 “stimulus” checks, and many small businesses haven’t received Payroll Protection Program loan funds intended to cover eight weeks of payroll. Many never will, because the program is oversubscribed.

So a bridge designed to span an eight-week gulf isn’t complete, even as the gulf is extending to ten weeks and more. So, "stimulus” is a cruel misnomer. Many workers and businesses will not survive or be able to revive. States that prolong the shutdown based upon “an abundance of caution” are creating an overload of tragedy and danger instead.

For some areas, an extended shutdown may make sense, most obviously the immediate New York City area. In other areas, particularly rural areas where social distancing is inherent, it probably does not.

We should remember that the objective of the extraordinary stay-home-shutdown measures was to flatten the curve, not eliminate it.

Even in hard-hit New York, Governor Cuomo has acknowledged that the curve has flattened. The US Comfort hospital ship sent to New York City never reached capacity and has departed.

The spread of the virus has been slowed and kept within hospital and medical capacity, so flattening has been achieved, and extreme measures should be lifted – and soon.

We should reopen the same way we shut down, namely here and there, based on conditions on the ground, except, of course, in reverse sequence, starting where conditions are the best. Dr. Anthony Fauci, Director of NIAID, and U.S. Surgeon General Jerome Adams have said as much in White House briefings.

However logical, this may not be easy. As the crisis has unfolded, a natural and admirable spirit of unity has developed. However, unity should not be translated into uniformity. The nation is not uniform, nor are individual states.

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Time for CT State Employees to Give Back

Republican American, CT Examiner, Journal Inquirer - April 4-6 ... For the second time in roughly a decade, over 100,000 private sector workers in Connecticut have lost their jobs, while not a single state employee has been laid off in either nstance. For almost the entire decade, state workers have enjoyed contractual no-layoff guarantees, presently extending to 2021.

Not only that, following the Great Recession, state workers got three 3 percent annual pay raises, and, now, they are to get a 3.5% wage hike in just three months – on the heels of a 3.5% pay raise last July 1st.

That’s unfair, almost cruelly so in face of the unfolding economic ravages of COVID-19.

Union leaders talk about “sacrifices” by state workers. That's shameless disinformation.

Governor Lamont should place a call immediately to Daniel Livingston, the chief negotiator for the State Employee bargaining Alliance Coalition (SEBAC) representing unionized state workers, and demand that workers forgo the July 1st pay raise and that retired state workers give up cost of living increases for the next decade at least.

The issue of fairness and social justice does not involve only the element of shared sacrifice in times of hardship. For
almost two decades, Connecticut state employees have enjoyed amongst the highest pay and benefits among state workers nationwide.

Their compensation has been
significantly higher than that of state’s private sector workers in all years – good and bad. In 2010, the state’s Commission on Agency Options looked at 2008
compensation data and found average state worker wages of $65,746 and benefits of $39,752 versus average private sector wages of $59,313 and benefits of
$14,861 – for a staggering compensation premium of more than $31,000, or 42%.

In 2014, scholars at the American Enterprise Institute (AEI), Andrew Biggs and Jason Richwine, looked at 2009-2012 data and found that very same premium of 42%, which was the highest of the 50 states. The next highest premiums were 35%, 34% and 26% for Pennsylvania, New York and Illinois, respectively.

In 2019, AEI’s Biggs compared private sector compensation to public compensation at all levels of government in all 50 states. From 1998 to 2017, private sector worker compensation grew only 38%, lagging compensation for federal workers, state and local workers, and teachers which grew 67%, 44% and 40%, respectively.

Biggs found that Connecticut state and municipal workers’ compensation grew 77% over this period compared to a 6% increase in the state’s private sector. In 2017, Connecticut public sector workers enjoyed a whopping 51% compensation premium over the state’s private sector workers.

This is a gross social injustice, but it is more than that. Public sector compensation has overwhelmed the state budget
and economy.

Public sector workers should embrace this reality and realize that it imperils their own jobs, wages, and health care and retirement benefits.

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Balancing Virus Response With Its Economic And General Health Consequences


Connecticut is Not New York City, Where Strict Shutdown Policies Are Needed. CT Governor Lamont Should Issue and Follow Evidence-Based Connecticut-Specific Guidelines For Continuing His Schools and Business Shutdown and, Ultimately, For Lifting It.

CT Examiner, Republican American, CT Hearst newspapers - March 22 -26 ... The coronavirus is not the only threat we face. As I wrote in The Hill on last Thursday (3/19) and The Wall Street Journal editorialized last Friday, the 20th,, we may face a far greater threat from a collapsed economy, which would devastate everyone’s financial resources and their medical condition.

This should be of special concern in Connecticut which entered the current crisis already economically anemic and financially shaky.

While this may not be popular to say, we should rethink shutdown policies in Connecticut. Actually, it may not be unpopular. A new Pew Research
Center poll
shows that 70 percent of Americans see the virus as a major threat to the economy, while only 27 percent see it as a major threat to their own personal health.

It should be a priority to keep people working and return to work the tens of thousands suddenly being idled. The Connecticut Labor Department received 56,000 unemployment claims in the first four days this past week versus a weekly average of 2,500.

A deep recession or depression would bring an inevitable deterioration in public health along with economic pain. It would push us backward down the Preston Curve, which demonstrates that life expectancy varies directly with income level: wealthy societies are relatively healthy, poor ones less so.

We should balance the “incidence curve” with the Preston Curve, putting as much effort into moderating economic devastation as we put into flattening the incidence, or infection, curve to keep coronavirus hospitalizations below hospital capacity.

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Truck-Toll Revenue Would Be a Mirage: Truckers Would Dodge the Gantries


There Are Access Points on I-95 About Every Mile. Trucks Could Dodge a Gantry by "Going Local" for Only a Mile.

There’s a new game in Connecticut. It’s called dodge-a-gantry. Right now, it is only a virtual game being played on Google Maps.

Governor Lamont's latest toll plan – he’s had many – is to toll only tractor-trailer trucks at just 12 highway bridges in the state. So what are truckers doing? They are getting ready to game Lamont’s proposed system. They are researching the best toll evasion routes, i.e. the best local roads to use to bypass the intended highway gantry locations.

The governor and his advisers have failed to take into account a unique and fundamental obstacle to imposing tolls in Connecticut.

Almost all existing toll roads in other states are limited-access highways. Vehicles travel for several miles between entry-exit access points. To exit and re-enter these highways in order to evade tolls is an onerous proposition. Actually, in most instances, it is impossible, because every entry-exit access point has a gantry or toll booth, where vehicles are logged in and out and charged for the distance they have traveled.

In contrast, Connecticut’s highways are uniquely open-access with short distances between entry-exit points.

In neighboring Massachusetts, the Mass Pike (I-90) has 24 entry-exit points (and 24 toll locations) over the 141 miles from West Stockbridge to downtown Boston. Here in Connecticut, I-95 has 91 access points over the 105 miles from Greenwich to Stonington.

Erecting tolls at all 91 would be absurd and exorbitantly expensive. Alternatively, gantries spanning across traffic on I-95 would invite trucks to jump off just before a gantry and re-enter a few miles further along just past the gantry.

The proposed high toll rates for trucks would provide motivation to truckers to evade the gantries.

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An after-action report: Trump, Soleimani and Khameni


Donald Trump has been excoriated by critics for ordering the killing of the number one terrorist in the world, Qassem Soleimani. If he wasn’t number one, who was?

If Iran isn’t the very definition of an enemy and a threat to world peace, what nation is? Iran is a nation whose national slogan is “Death to America” and whose greatest aspiration is to wipe another nation off the map.

The president’s critics engage in some truly tortuous mental gymnastics to level their charges.

Take U.S. Senator Chris Murphy, Democrat from Connecticut. On New Year’s Eve, as Soleimani’s henchmen were ransacking parts of the U.S. embassy compound in Baghdad, he tweeted: “Trump has rendered America impotent in the Middle East.

Simultaneously, Iran’s Supreme Leader – and Top Tweeter, Ayatollah Khamenei challenged the president with a taunting tweet: “You can’t do anything.”

Surprise: dead wrong.

Both Murphy and the Ayatollah responded, the former challenging the president’s authority to kill “the second most powerful person in Iran,” and Khameni with an ineffectual rocket attack.

Here’s one citizen’s after-action report.

Execution: If ever there were a surgical strike, this was it. Perfect execution. Two bad guys and their aides were eliminated without any collateral damage.

Authorization / Consultation: Despite delegitimizing semantics terming the killing an “assassination” and repositioning Soleimani as an anodyne national leader or military commander, he was the leader of the Quds Force, which was designated a terrorist organization by the U.S. State Dept long ago in 2007.

Critics want proof that Soleimani was planning an imminent attack, as if the Quds Force leader wasn’t planning attacks every single day of his life.

Windows of opportunity for surgical strikes open rarely and close quickly. Delay for significant congressional involvement might have jeopardized the opportunity. Moreover, POTUS operates in a White House that leaks like a sieve. Anonymous op-ed writers rove the hallways alongside whistleblowers, who communicate constantly and coordinate closely with anti-Trump Democrats and media reporters, who lionize these moles.

Justification: If Soleimani’s decades of mischief and his terrorist designation weren’t enough, Soleimani had just orchestrated an attack on an American embassy, sovereign territory under international law.

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CT Hospital Tax Exploits Medicaid to Finance Irresponsible Spending


Hartford is exploiting an anomaly in the Medicaid program to extract billions from the U.S. Treasury, not to finance health care, but rather to finance otherwise unaffordable state spending, primarily state employee health care and retirement benefits.

This anomaly, or “shell game” (the term used in a U.S. Senate committee report) operates through the hospital tax. While all states impose this tax, no state imposes nearly as high a hospital tax rate. That’s what former Office of Policy and Management Director Ben Barnes told me in late 2017. He said Connecticut’s hospital tax scheme requires explicit federal approval, because the roughly 9% rate exceeds a 6% threshold that no other state exceeds.

The Medicaid program is a federal-state partnership providing medical care to poor citizens, with the federal government reimbursing states for about one-half to two-thirds of allowable fees and costs that hospitals and others charge Medicaid patients for medical care.  Under Obamacare, Connecticut and other states expanded Medicaid in return for much higher federal reimbursement percentages on the patients newly covered.

Apart from this straightforward reimbursement arrangement, states provide hospitals supplemental payments, with the federal government matching the payments, in order to achieve various policy objectives. The hospital tax exploits this supplemental payment mechanism in a manner which the General Accountability Office criticized strongly in a 2014 report.

Let’s start with some fundamental questions. Why is government taxing hospitals, which only serves to raise the cost of the nation’s primary providers of health care. Many are non-profit. Why tax non-profits? Many are for-profit and already pay corporate income taxes. Why levy a second tax? Hospital taxes are truly strange and wonderful.

Just before Christmas, the Connecticut General Assembly went into a special session, to approve unanimously a plan to extend the state’s stratospheric hospital tax for seven years. The plan will generate about $675 million annually, including $375 million in federal matching funds.


The plan requires the approval of the federal Centers for Medicare and Medicaid (CMS), which may not be forthcoming. In mid-2018, a U.S. Senate committee took a look at hospital taxes and issued a report calling hospital taxes “a shell game” and singling out Connecticut as a major perpetrator.

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  • here on The Red Line
  • CT Examiner - CT's Hospital Tax Exploits Medicaid To Finance Irresponsible State Spending, January 12, 2020
  • Republican American - State's Hospital Tax 'Shell Game' in Peril, January 15, 2020
  • The Endless Game of Whack-a-Toll-Mole

    Highway tolls in Connecticut have become a game of whack-a-mole. Gov. Ned Lamont’s toll mole has popped up again, just two weeks after having been whacked summarily by General Assembly leaders of his own party. The current mole is a variant of the governor’s original trucks-only campaign proposal. Things have gone full circle.

    The game started with candidate Lamont’s vague trucks-only plan. Once inaugurated, Lamont whacked his own proposal, saying that truck tolls alone wouldn’t raise enough money. He added cars, and presented a sketchy eight-page plan with a smothering network of as many as 80 gantry locations on interstate and state highways.

    Fierce public opposition and insufficient Democratic support whacked this proposal, but Lamont’s toll mole popped back up again as about 60 gantries in a system stripped of all state highways, except the Merritt Parkway.

    When this mole was whacked by continuing public opposition and Democratic intransigence, Lamont gave his own plan another good whack.


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    The surprising income equality in America

    This is a column about a column.

    On November 4, 2019, the Wall Street Journal published a column entitled “The Truth About Income Inequality,” by Phil Gramm, former U.S. Senator from Texas, and John Early, twice Assistant Commissioner of the U.S. Bureau of Labor Statistics.

    The column makes a convincing case that the U.S. enjoys remarkable income equality –  not inequality.

    This reality flies in the face of the almost universal belief that the U.S. suffers from gross income inequality, which notion serves as the foundation of all the extravagant proposals from one side of the political spectrum, ranging from free college and Medicare for All to the wealth tax that Elizabeth Warren and Bernie Sanders advocate.


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    There are better ways to cut traffic congestion than tolls

    Gov. Ned Lamont is poised to re-launch his highly unpopular tolls plan, revised to reduce tolling to a rumored 16 to 18 gantries located only on bridges in need of repair. So what happened to the governor’s concern with traffic congestion? Repairing bridges, however necessary, won’t relieve congestion.

    It could be that Lamont is holding a Tolls 2.0 plan at the ready, including the remainder of his original 59 gantries and his trademark congestion pricing scheme, ready to be sprung on the public once he’s established his 16-18 gantry beach head.

    In anticipation of Tolls 2.0, it’s worth reminding our wealthy governor of the obvious: Most people on congested rush hour roads are driving to work. So, tolls are effectively a payroll tax. Moreover, congestion pricing wouldn’t reduce congestion, because people can’t be late to work — they can’t wait for lower toll rates later on.

    Ironically, there’s a simple tax-free way to reduce congestion, and it is already in use across the state. School districts employ staggered “school bell times.” Preschools start at one time, elementary schools at another, and middle schools and high schools at yet other times. This avoids local traffic jams and optimizes bus utilization

    The state could follow the same approach, mandating that municipalities and major employers collaborate to devise staggered work days. In Hartford, Aetna could begin its day at 8:15 a.m., while CIGNA in neighboring Bloomfield could start at 9 a.m. and most state employees might be required to show up at 7:30 a.m.

    If local school boards can accomplish this kind of system planning, why can’t local governments and major employers?


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