Category: Government

How does HIPAA interact with state governors’ demands for COVID-19 test results?

by philg

Today is National Pearl Harbor Remembrance Day, marking 79 years since we entered World War II in order to fight Totalitarianism.

Here in Massachusetts, as part of our governor’s more-than-50 orders, we are required to tell the government, via a web form, about any travels that we might have undertaken. And “Quarantine for 14 days or produce a negative COVID-19 test result that has been administered up to 72-hours prior to your arrival in Massachusetts.”

From mass.gov:

72-hour Testing Rule: The individual can produce, upon request, proof of a negative test result for COVID-19 from a test administered on a sample taken no longer than 72 hours before your arrival in Massachusetts.

So we’ve spent hundreds of $billions (software, time spent with forms) for our medical records to be protected by HIPAA (federal law), but the state can demand a portion of our record via a “request” (fine of $7,000 if one fails to comply with the “request”; see the governor’s 45th order).

Plainly the Shutdown Karens can say that this is quite reasonable. The governor has declared an emergency so the state government should have access to whatever is necessary to deal more effectively with that emergency (never mind that test and trace immediately fell apart, so this information is useless, or that the typical person is not contagious by the time a test has been scheduled and result received (NYT)). But, on the other hand, a governor can declare additional “emergencies” any time that he/she/ze/they wants to. Obesity kills far more Americans than COVID-19. Couldn’t a governor declare an obesity crisis and demand that people submit medical records related to obesity and diabetes? We’re already in an opioid crisis, right? Why shouldn’t the state have the right to “request” your prescription records to make sure that you haven’t been getting too many OxyContin pills? (and fine you $7,000 if you fail to comply with the request)

Very loosely related, a conversation with a 5-year-old after putting a e-collar on our golden retriever to prevent her from scratching at a scab:

  • Me: Mindy doesn’t like wearing this collar.
  • Child: Why not?
  • Me: Even a dog can tell when her liberty is taken away.
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Will millionaires pay up to live in New Jersey?

by philg

“Deal Reached in N.J. for ‘Millionaires Tax’ to Address Fiscal Crisis” (NYT):

Gov. Philip D. Murphy, a Democrat, announced a deal with legislative leaders to increase state taxes on income over $1 million by nearly 2 percentage points, giving New Jersey one of the highest state tax rates on wealthy people in the country. The agreement also includes an annual rebate of as much as $500 for families making less than $150,000.

The good news is that Governor Murphy will be a hero in literature and movies 800 years from now, just like Robin Hood. Murphy is taking from the rich (assuming that they can’t figure out how to escape to Florida, Wyoming, Nevada, Tennessee, Texas, Alaska, et al) and giving to the poor (where “poverty” starts at $150k/year, not a great argument for attracting new residents hoping to enjoy a comfortable lifestyle!). New Jersey is already the third highest tax state (percentage of residents’ income harvested for state and local government).

On the one hand, people are fleeing Manhattan to get extra space, which favors suburban New Jersey. On the other hand, New Jersey is not blessed with a California-style climate that might induce people to pay huge $$. year after year.

(You might reasonably ask “If tax rates are relevant, why didn’t rich people move away some years ago?” It is true that New Jersey has been a high-tax state for a long time. However, until 2018, roughly half of those high taxes were paid by the generous folks in Kansas, Indiana, Texas, Florida, etc. A wealthy New Jersey resident might pay a lot to New Jersey, but could turn around and deduct this payment from his/her/zi/their federal taxable income. So we would expect people today to be a lot more sensitive to state tax rates than they were back in 2017, for example. And the fact that work and social life are now Internet-based should also reduce barriers to moving.)

Readers: What’s a good test to see if this tax hike works as advertised. My theory is that it takes people about three years after a tax law change to get organized and adapt. So we should try to look at New Jersey’s relative fiscal health in 2024. But what do we look at? Unfunded pension and health insurance liabilities for state and local government employees? Right now it is “$151 billion, the worst in the nation”. But if the stock market rises or falls under the able stewardship of President Harris, that might move this number enough to swamp any effect from this tax. How about IRS data? Try to find the percentage of America’s high earners (over $1 million/year in income) who live in New Jersey in 2020 and then in 2024. (example map of money migration produced with these data)

From the glorious days of film… pig racing at the New Jersey State Fair:

And, even before 93 percent peaceful protests…

Related:

  • “One Top Taxpayer Moved, and New Jersey Shuddered” (NYT, April 2016): the hedge-fund billionaire David Tepper … declared himself a resident of Florida after living for over 20 years in New Jersey. He later moved the official headquarters of his hedge fund, Appaloosa Management, to Miami. … Tax experts say his move to Florida could cost New Jersey — which has a top tax rate of 8.97 percent — hundreds of millions of dollars in lost payments.
  • Pennsylvania’s top income tax rate is 3 percent; if you need to go into Manhattan only once per week, why not drive an extra hour and save $100,000/year in tax?
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Maskachusetts limits in-person school to the rich white towns

by philg

“Mass. Communities’ COVID Risk Would Guide Schools’ Reopening Plans: Report” (NBC):

Massachusetts’ education department is reportedly issuing guidance on the amount of remote learning schools should use based on the coronavirus risk level in their communities.

As school districts scramble to submit reopening plans to the Department of Elementary and Secondary Education by Friday, superintendents received a memo from Commissioner Jeffrey Riley Tuesday night that would limit the use of online learning, according to The Boston Globe.

Here’s the map….

From a linked page:

Chelsea, Everett, Lynn and Revere are included in the high risk category, meaning they have over eight cases per 100,000 residents. Twenty-nine other communities, including Auburn, Belchertown, Boston, Brockton, Charlton, Chicopee, Fall River, Framingham, Georgetown, Granby, Holyoke, Hull, Lawrence, Longmeadow, Malden, Marlborough, Maynard, Middleton, Northampton, Peabody, Salem, Saugus, Springfield, Quincy, Randolph, Taunton, Winthrop Worcester, Wrentham, are in the moderate risk category, meaning they have between four and eight cases per 100,000.

In other words, if your town is packed with welfare-dependent People of Color and migrants… no school (“remote learning” in your crowded public housing apartment). The rich white kids in Wellesley and Dover can go back to school, though!

Related:

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Government, Hygiene, and Coronaplague

by philg

We recently flew a Cirrus SR20 to Martha’s Vineyard, an instrument training flight for an IFR student that, of course, turned into an actual IMC experience (thanks, Maskachusetts weather!).

We brought his 12-year-old daughter along in the back seat. After touring around the island for a bit, it was time to change into bathing suits. We availed ourselves of the government-run public restrooms for this purpose. The 12-year-old complained about their filthy condition. Of course, I responded with “Remember that the country that hasn’t ever been able to provide clean public restrooms will beat the coronaplague via superior hygiene.”

She then shared her idea: “People who are on welfare, instead of just sitting at home to get checks and benefits should have to clean public bathrooms.” (that would be a workforce of at least 70 million!) She had previously been disparaging Dr. Donald J. Trump, M.D. and singing the praises of Democrats, presumably a result of her years of contact with unionized public school teachers here in the Boston suburbs. I told her “you know, there is actually an established political party in the U.S. that is already lined up with your thinking.”

One of the clean public restrooms in every Shanghai Metro station:

(Bonus: While taking these photos, I learned how the locals say “What is that stupid white guy doing?”)

If you go to a private shopping mall, which are spaced at intervals of just a few blocks in many areas, the level of luxury is a lot higher:

Note, in both cases, the provision of low sinks for children. Also note the Chinese conception of (1) possible gender IDs for humans, and (2) most likely family structure.

Houses in Oak Bluffs, failing to social distance:

(This was the site of a 19th century religious summer camp, prior to Americans’ conversion to the Church of Shutdown.)

Separately, we received a notice from our Town Administrator:

Effective Monday August 10, 2020, Notary services will temporarily be unavailable at Lincoln Town Offices due to the inability to maintain safe social distancing. Notary services will resume when deemed safe to do so. In the meantime, you can contact the following local businesses that advertise notary services…

In other words, it isn’t safe for government workers (who could easily walk a few steps to meet a taxpayer outside and the town hall already has a covered-from-the-rain entry), who will be paid at 100 percent regardless of how much or little they do. So let’s make private-sector employees, who need to work in order to get money, take the risk of close encounters with the public.

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NASA’s new mission: Inclusion

by philg

A friend’s Facebook post from July 23:

NASA today added Inclusion to its set of core values, reminding me, again, why this is the best place to work in government.

Inclusion – NASA is committed to a culture of diversity, inclusion, and equity, where all employees feel welcome, respected, and engaged. To achieve the greatest mission success, NASA embraces hiring, developing, and growing a diverse and inclusive workforce in a positive and safe work environment where individuals can be authentic. This value will enable NASA to attract the best talent, grow the capabilities of the entire workforce, and empower everyone to fully contribute.

Incorporating Inclusion as a NASA core value is an important step to ensuring this principle remains a long-term focus for our agency and becomes ingrained in the NASA family DNA. Together, we can continue to accomplish great things for all of humanity.

There is a new logo/graphic to go with this:

So… making employees feel welcome (why did they run a hostile work environment from 1915 through 2020, more than 100 years?) is now at the same level as “safety” (not killing pilots and passengers on the various rockets, airplanes, and helicopters operated by the agency).

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Will coronaplague boost teacher income the way that it has for daycare workers?

by philg

Parents in the western suburbs of Boston like to talk about First World problems. The License Raj here in Maskachusetts is has allowed daycares to reopen with some limitations (boston.com). Great news for working parents, right? (or for parents who are simply tired of dealing with their children 24/7) “It is impossible to enroll,” said one mom. “The daycare workers won’t go back because they’re getting $600/week plus regular unemployment plus under-the-table cash from parents who hired them to do in-home care after the daycares were shut down. If they went back to work, it would be a 70 percent pay cut.”

I wonder if the same thing will happen with school teachers. Based on my Facebook feed, teachers and rich parents are opposed to opening in-person schools. Unionized schoolteachers in particular say that they won’t work unless their safety is guaranteed somehow. “School closures ‘a mistake’ as no teachers infected in classroom” (Times of London):

Scientists are yet to find a single confirmed case of a teacher catching coronavirus from a pupil anywhere in the world, a leading epidemiologist has said.

Mark Woolhouse, an infectious disease epidemiologist at Edinburgh University, offered reassurance to staff preparing for the full reopening of schools next month.

Professor Woolhouse is definitely going to be an exception to the #FollowScientists rule!

Is there a cash value to #RejectScienceAndStayHome? In the cower-in-place system, public school teachers in Lincoln, Brookline, and Newton are required to work only a handful of hours per week (see “Massachusetts private school students zoom ahead”). If a teacher must send out one email on Monday morning, host a couple of chats on Tuesday and Thursday, and provide a bit of feedback on assignments emailed in on Friday afternoon, that leaves at least 40 hours in the middle of the week to… teach! Every public school teacher can offer to come into the homes of richer parents and provide some actual instruction at $100/hour in cash. As a practical matter, maybe this works for only 20 hours per week, but that should still be enough to at least double the spending power of a teacher receiving $70,000 per year (plus pension and benefits) from taxpayers.

(“Florida Orders Schools To Reopen In The Fall For In-Person Instruction” (NPR) is a possible exception:

In the state where more than 7,300 new coronavirus cases were announced on Tuesday, Education Commissioner Richard Corcoran declared that upon reopening in August, “all school boards and charter school governing boards must open brick and mortar schools at least five days per week for all students.”

but there are no guarantees for taxpaying parents: “Those services include in-person instruction unless barred by a state or local health directive“)

An aircraft owner friend hired a public school teacher at $60/hour cash to teach two children. If this were 4 hours per day, 180 days per year (the standard school year), that’s only $21,600 per year per child, i.e., much less than a lot of Boston-area districts spend even without counting the lavish capital spending.

His children are examples of “The Latest in School Segregation: Private Pandemic ‘Pods’” (NYT):

If they become the norm, less privileged kids will suffer. … As school districts across the nation announce that their buildings will remain closed in the fall, parents are quickly organizing “learning pods” or “pandemic pods” — small groupings of children who gather every day and learn in a shared space, often participating in the online instruction provided by their schools. Pods are supervised either by a hired private teacher or other adult, or with parents taking turns. … Based on what I’ve seen online, the learning pod movement appears to be led by families with means, a large portion of whom are white. Paradoxically, at a time when the Black Lives Matter movement has prompted a national reckoning with white supremacy, white parents are again ignoring racial and class inequality when it comes to educating their children.

Parents are also more likely to join pods with families who have similarly low exposure to the coronavirus. This seemingly rational impulse will, in practice, exclude many Black and Latinx families, who are disproportionately infected by the virus.

Related:

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Free rent today leads to higher housing costs tomorrow for America’s poorest?

by philg

One good thing about the U.S. response to coronaplague has been allowing our low-income residents, documented and otherwise, to skip paying rent while simultaneously forbidding landlords from initiating evictions (maybe until mid-2021 here in Maskachusetts?). So… the working poor are protected from harm by a benevolent government during this period when they are no longer “working” (probably making more money, though!).

Maybe not!

We’ve been doing a lot of helicopter flying lately with a photographer whose bread and butter is aerial real estate images. A typical mission involves going to a town with a lot of low-skill immigrants and/or multi-generational welfare-dependent native-born Americans and photographing an apartment building from the 1950s.

Why does anyone need these pictures? “All the rental landlords are trying to organize condominium conversions. Since they can’t collect rent, it makes a lot more sense to sell the apartments,” was the answer.

Especially given the high transaction costs of buying and selling real estate in the U.S. (5-6 percent every time someone needs to move!), is it fair to say that the result of today’s policy change will be higher long-run housing costs for low-income residents of the U.S.? With millions of immigrants arriving, plus population expansion from children of already-present immigrants, and a shrinking pool of rental housing, won’t that translate into higher rents?

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Republicans could win in November if they gave Americans universal health insurance?

by philg

In September 2009, I wrote “Health Care Reform”. Essentially the government would take the $trillions being spent on Medicare and Medicaid and put it into buying every American a reasonably good HMO policy.

  • each resident will be given a voucher good for signing up at the clinic or HMO of his or her choice; the amount of the voucher will depend on the resident’s age and sex (the weighted average of all vouchers will equal $2,000 or whatever we’ve decided we want to spend)
  • a clinic or HMO that wishes to get any revenue from the federal government will be required to take any person who submits a voucher, regardless of preexisting conditions
  • a resident of the U.S. can switch clinics annually, let’s say on May 1.
  • the clinic is responsible to pay for the resident’s emergency medical care at another facility

A note:

One likely side effect of this reform is the return to centrality of the primary care physician. Joe Medicare Patient often does not have any doctor who understands much less coordinates his care. If Joe has seen six specialists, he may be on drugs that are working at cross purposes. If Joe is in the ICU at a typical hospital, the multiple doctors treating him may never talk to each other. Each one knows what tests and procedures he or she has ordered, but, except by looking at the patient’s chart, has no idea what the other doctors are investigating. One primary care doctor who reviewed this proposal said “The first item I address with new patients in my office is to try to get them off as many drugs as possible; when a 70-year-old is on 11 meds you better believe there are many unintended interactions.”

How has this aged and what would be different during coronaplague?

Americans want, most of all, for the Great Father in Washington to love them. “Trump, like Herbert Hoover, is ‘the man who doesn’t care.’ Biden can make that stick.” (USA Today, June 28):

Most of all, Trump is the man who doesn’t care. He doesn’t feel your pain. He doesn’t mourn the dead, comfort the grieving, or support the struggling. He doesn’t consider his words or worry that they could have consequences. He doesn’t listen to experts or ponder his options.

Congress is almost finished with its “work” for this session. If the Republicans want to win in November, why not make Americans feel that the they are loved and cared for? We don’t care about money anymore, right? We are happy to spend 100 percent of our accumulated wealth hiding from coronaplague if that is what it takes to cut the death toll slightly. We are happy to print and borrow trillions. A universal HMO policy for every resident of the U.S. wouldn’t have to cost any more than the current bleeding for Medicaid and Medicare plus whatever employers pay for mid-range coverage.

Will anyone, other than folks in the industry, miss the current system? A couple of recent news items:

At least to judge by my Facebook feed, Americans are convinced that, despite the lack of any effective therapy for Covid-19 and despite the fact that the Feds pick up the tab when the uninsured are treated for Covid-19, universal health insurance would hugely cut the number of Covid-19 deaths.

Readers: What do you think? Could Trump and the Republicans take most of the wind out of the Democrats’ sails with one big health care hand-out? (of course, all of the money for this would just come from taxpayers themselves, but somehow Americans never seem to consider that they will ultimately have to work for whatever the government “gives’ them)

Bonus pictures of the house that Medicaid and Medicare built, in Nome, Alaska, from September 2019. This single building is likely worth more than all of the rest of the houses and commercial real estate in the city.

Related:

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Get rid of single-family zoned suburbs?

by philg

“It’s Time To Abolish Single-Family Zoning” (The American Conservative, so you know already that it can’t be right!):

The first of many ironies, of course, is that single-family zoning became the standard for American suburbs during the New Deal when the Roosevelt administration, through various programs such as the Home Owners Loan Corporation, required it for home refinancing assistance.

These onerous regulations were further mandated for new construction by the Federal Housing Administration as well as the government-sponsored enterprises Fannie Mae and Freddie Mac.

So if you want federal support for your housing, build a single-family home. If you want to live in that downtown shop with the house on the second floor, convert your house to a two- or three-unit building and rent it out—or do any number of normal and reasonable things that humans had been doing with their property for centuries to build their own wealth and prosperity—don’t expect assistance from the government.

Regarding some new proposed laws and regulations:

So, suburban governments, you won’t get the subsidy this time unless you repeal the regulation we required you to enact decades ago to get the subsidy we were offering back then. And we oppose this today because we are conservatives?

This article seems ill-timed in light of the fact that Americans, as evidenced by recent policy and spending, care about only one thing: coronavirus infection. Isn’t the bleak isolated car-dependent suburban lifestyle (“broad lawns and narrow minds”) the best defense against the evils of Covid-19?

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Fairfax County School Shutdown Karen thought process

by philg

A friend sent me this post from Joe the Shutdown Karen of Fairfax County:

To our fellow FCPS families, this is it gang, 5 days until the 2 days in school vs. 100% virtual decision. Let’s talk it out, in my traditional mammoth TL/DR form.

Full disclosure, we initially chose the 2 days option and are now having serious reservations. As I consider the positions and arguments I see in my feed, these are where my mind goes. Of note, when I started working on this piece at 12:19 PM today the COVID death tally in the United States stood at 133,420.

“My kids want to go back to school.”

I challenge that position. I believe what the kids desire is more abstract. I believe what they want is a return to normalcy. They want their idea of yesterday. And yesterday isn’t on the menu.

“I want my child in school so they can socialize.”

This was the principle reason for our 2 days decision. As I think more on it though, what do we think ‘social’ will look like? There aren’t going to be any lunch table groups, any lockers, any recess games, any study halls, any sitting next to friends, any talking to people in the hallway, any dances. All of that is off the menu. So, when we say that we want the kids to benefit from the social experience, what are we deluding ourselves into thinking in-building socialization will actually look like in the Fall?

“My kid is going to be left behind.”

Left behind who? The entire country is grappling with the same issue, leaving all children in the same quagmire. Who exactly would they be behind? I believe the rhetorical answer to that is “They’ll be behind where they should be,” to which I’ll counter that “where they should be” is a fictional goal post that we as a society have taken as gospel because it maps to standardized tests which are used to grade schools and counties as they chase funding.

In other words, the public school Shutdown Karens imagine that rich kids in private school won’t be working and learning! (see https://philip.greenspun.com/blog/2020/05/20/massachusetts-private-school-students-zoom-ahead/ for the educational gulf that has opened up in Maskachusetts between public and private school children; see nytimes for how low-income students of color are the Shutdown Karens’ biggest victims).

How do people in the third richest country in the United States deal with numbers?

FCPS has 189,000 children. .0016 of that is 302. 302 dead children are the Calvary Hill you’re erecting your argument on. So, let’s agree to do this: stop presenting this as a data point. If this is your argument, I challenge you to have courage equal to your conviction. Go ahead, plant a flag on the internet and say, “Only 302 children will die.” No one will. That’s the kind action on social media that gets you fired from your job. And I trust our social media enclave isn’t so careless and irresponsible with life that it would even, for even a millisecond, enter any of your minds to make such an argument.

Out of more than 8,000 people (average age 82 and 98 percent with “underlying conditions”) killed in thoroughly-plagued Massachusetts (population 7 million), exactly 0 have been under the age of 20 (dashboard). Yet the 1.1 million rich government workers, contractors, and lobbyists of Fairfax County are going to experience 302 extra deaths among children (equivalent to over 2,000 for an MA-sized population). (Of course, if they still believe the March dogma of Flatten the Curve, a 10-year school shutdown won’t have any effect on the infection/death rate among children; the same number of infections and deaths will simply be spread out.)

I’m kind of amazed at the lack of imagination and lack of expectations among the subjects of American government. Our theory used to be that the U.S. had liberty while the Chinese had competence. They had the Shanghai Metro while we had complete freedom of speech, assembly, religion, etc. Our liberties are mostly gone, subject to the potentially arbitrary decisions of state governors (the perfect example of a “a government of men rather than a government of laws”) and of the mob (getting people fired from jobs if they don’t worship at the churches of BLM, #MeToo, and the Rainbow Flag). The Fourteenth Amendment is gone, with students being entitled to an education depending on their skin color. But nobody insists on receiving competent government in return. For example, if the Karens of Fairfax want their brats to be spaced farther apart in the schools, why can’t the schools rent more space? With retail going bankrupt and office buildings shut down, would it actually be hard for every school to double its physical size? The Chinese built a hospital for 5,000 people in 10 days. A U.S. school system can’t rent a bankrupt Sears store’s old space given six months to negotiate? And then drive to IKEA for some desks? Keep in mind that Fairfax is insanely rich by U.S. standards (thank you for paying your federal taxes!).

Related:

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