Relevant and even prescient commentary on news, politics and the economy.

Coronavirus dashboard for June 21: watching the States with flat or increasing rates of new cases

Coronavirus dashboard for June 21: watching the States with flat or increasing rates of new cases

For the past week I have been sounding the alarm about the economic impact of the “delta” variant of COVID. We are probably already beginning to see its impact on the case count in several States, with many more primed to join the pack, so that is what I want to focus on today.

To begin with, let’s compare the 3 countries that have had the most aggressive vaccination programs: the US, UK, and Israel:

Figure 1

The Iranian Presidential Election

The Iranian Presidential Election

 The outcome is as expected, a solid victory with 18 out of 28 million votes or so for the hardline winner, Ebrahim Raisi, who is currently head of the Supreme Court.  He was previously Attorney General, ran four years ago for president, and has a long history of being a public prosecutor going back into his 20s (he is now 60). In 1988 he played a role in the killing of about 5,000 prisoners, which led him to be sanctioned from traveling in the US. He has regularly ordered executions, gaining a reputation as a “hanging judge,” although I think they mostly use the electric chair there.  While has run against corruption, there are reports that he is involved in some, and this will probably be used against selected political opponents. He was clearly the favorite of the supreme leader, Vilayet-al-faqih (numerous transliterations of that title), often translated as “Supreme Jurisprudent,” Ali Khamenei, age 82, who is Commander-in-Chief of the military as well as the top person of the police and judiciary, over Raisi in the court system.  Many see this as Raisi being positioned to succeed Khamenei in that position.

Turnout was unusually low at less than 50 percent, with many voters boycotting the election.  It is clear that Khamenei and the hardliners did not want any “surprise” moderate winners as has happened in the past, arguably 8 years ago with outgoing President Hassan Rouhani.  In 2013 Iran was suffering severe economic sanctions that President Obama organized, with Russia and China largely joining in, which had the goal of bringing Iran to the nuclear negotiating table.  Rouhani ran on doing that and went after he got elected.  This led to the 2015 Joint Comprehensive Plan of Action (JCPOA) nuclear agreement where Iran shut down some reactors and reduced its uranium enrichment to less than 3.75 percent.  Most of the economic sanctions were lifted, although the US retained some that had been on previously due to human rights issues, and the Iranian economy turned around and had positive growth again.  This led to Rouhani being reelected four years ago, even though then President Trump was talking about leaving the agreement, which all agreed Iran was keeping to.  But he had not done so at that point.  He did withdraw the following year, imposing even stronger sanctions and demanding European and other firms follow suit as well, although no other signatory to the agreement supported Trump’s decision.  But the sanctions hit, and the Iranian economy turned around and has been in a steep fall since with solid double-digit unemployment and inflation rates.  Oil exports are now about one-tenth of what they were before. 

Cover All Births And Modernize Maternity Care

Medicare For All? Start At The Beginning: Cover All Births And Modernize Maternity Care | Health Affairs

It has been two years since I wrote on women’s healthcare and three important topics impacting women; clinical trials done without women participants, a failing birth control device – Essure, and maternal healthcare. The Health Affairs article is suggesting Medicare for all Maternal Care as an improvement to lacking healthcare for all women. Improving the availability of maternal healthcare for women is very much needed. As I wrote in A Woman’s Right to Safe Healthcare Outcomes; there is also a need for improving the care. There are too many symptoms being missed or ignored for the mother before, during, and after the birthing of a child.

Medicare is fee for service care. Medicare determines what will be paid. Those are the good parts. Dr. Donald Berwick claimed 30% of Medicare expenditures for care was waste and doctors knew it. However, Medicare for all Maternity is an important step forward which will level the field of care for “all” women.


A Bit of History

EMTALA or the “Emergency Medical Treatment and Active Labor Act” passed Congress in 1986. Its purpose was to require hospitals to provide emergency care for everyone crossing hospital thresholds regardless of the ability to pay. It also provides a means to pay hospitals for those patients who could not afford to pay. With the passing of the PPACA, each person was to be insured in one form (Commercial Insurance) or another (Medicaid/Medicare). The Medicaid Expansion mandate for states fell by the wayside with the Roberts Court ruling. Going with it was the federal government reimbursing hospitals.

Within the EMTALA, Congress was establishing, delivering a baby was an exceptional occurrence with inherent risks, and in such cases, delivery needed to be covered. Unfortunately, universal coverage for pregnancy was never been achieved with the passage of this bill. Although not having insurance at the time of delivery is not common, more than one in five people lack insurance either in the month just before pregnancy, during pregnancy, or in the postpartum period. With that being said, there was no provision made before or after delivery other than Medicaid and Medicaid will only cover 2 months of postpartum care.

The EMTALA is part of the Consolidated Omnibus Budget Reconciliation Act of 1985 or COBRA. Mitch McConnell (elected to the Senate in 1984), passed the bill with a 96-0 vote when bipartisanship was in vogue. President Ronald Reagan signed the bill on April 7, 1986. 

Joe Biden’s American Rescue Plan passed without Republican votes. Within the American Rescue plan are provisions providing states the option to extend postpartum Medicaid coverage from 60 to 365 days. The ARP had  unanimous support in the House as a stand-alone bill. While in the Senate, the support was not so strong and this time McConnell voted against healthcare for pregnant women. Also and as you may or not know, Republicans are attempting to use the funding for the American Rescue Plan to fund the proposed Infrastructure Plan.

Why is this so important?

Producer Prices Rises 0.8% in May

Producer Price Index YoY Records for Final Demand and Intermediate Services; 46 year High for Intermediate Goods, 48 year High for Raw Materials

Commenter RJS and MarketWatch 666 blogger

The seasonally adjusted Producer Price Index (PPI) for final demand rose 0.8% in April, as prices for finished wholesale goods rose 1.5% while margins of final services providers rose 0.6%…that increase followed an April report that the PPI was 0.6% higher, as prices for both finished wholesale goods and margins of final services providers rose 0.6%, a March report that had the PPI 1.0% higher, as prices for finished wholesale goods rose 1.7% while margins of final services providers rose 0.7%, a revised February report that now has the PPI 0.6% higher, with prices for finished wholesale goods on average 1.4% higher, while margins of final services providers increased by 0.2%, and a re-revised January report that now has the PPI 1.2% higher, with average prices for finished wholesale goods rising 1.6%, while margins of final services providers increased by 1.0%….on an unadjusted basis, producer prices are now a record 6.8% higher than a year ago, up from the 6.2% year over year increase indicated by last month’s report, while, the core producer price index, which excludes food, energy and trade services, rose by 0.7% for the month, and is now 5.3% higher than in May a year ago, up from the 4.6% year over year increase as was shown in April . . .

A Bridge Over Troubled Water and Politics?

Commenter Fred Dobbs had much of this in the Open Thread, June 19th at 9:33AM. I highjacked it, added more up to date detail, and an opinion. I did find it interesting.

Somewhere there is a print(s) and BOM for this structure along with specifications (which were alluded to as BD vs BC steel) for materials along with a comparison of structural strength necessary. The Chinese did not build this on a whim.

And why Chinese steel and components?

Bay Bridge spokesperson Bart Ney disputed the accuracy of Paul’s claims and said 70 percent of the steel being used for the new span is fabricated in America. Ney said foreign companies are used out of necessity for some parts of the project.

“The primary contractor chose China to deliver those parts because the capacity is not here in the United States right now. There was no American fabricator that would build those specific parts of the bridge,”

Manufacturing Group Protests Chinese Steel Used in Bay Bridge Construction, KPIX CBS


Bridge Comes to San Francisco With a Made-in-China Label

June 25, 2011

SHANGHAI — Talk about outsourcing. At a sprawling manufacturing complex here, hundreds of Chinese laborers are now completing work on the San Francisco-Oakland Bay Bridge.

Next month, the last four of more than two dozen giant steel modules — each with a roadbed segment about half the size of a football field — will be loaded onto a huge ship and transported 6,500 miles to Oakland. There, they will be assembled to fit into the eastern span of the new Bay Bridge.

The project is part of China’s continual move up the global economic value chain — from cheap toys to Apple iPads to commercial jetliners — as it aims to become the world’s civil engineer. The assembly work in California, and the pouring of the concrete road surface, will be done by Americans. But construction of the bridge decks and the materials that went into them are a Made in China affair. California officials say the state saved hundreds of millions of dollars by turning to China.

Manchin on Voting Rights

The news is that Joe Manchin has described a voting rights compromise which he supports. Also Republicans immediately said it was unacceptable to them. This reminds everyone that there will be no bipartisan compromise on an issue where the two parties have diametrically opposite interests. If there were any Republicans who did not equate democrats with Democrats, and pigs could fly, it would be different, but there aren’t.

I am reasonably confident that nothing will come of this. To pass a bill it would be necessary to eliminate the filibuster and Manchin (and Sinema) won’t do that. However, I am actually interested in an incredibly vague part of Manchin’s proposed bill “Ban partisan gerrymandering and ‘use computer models,’ the latter of which isn’t further specified;”

It does seem that “computer models” doesn’t narrow things down much. However, I think it is quite simple really. It is possible to use precinct level data to calculate the ratio of Republicans elected to Republican votes statewide implied by districts. It is easy to compare proposed districting with the rule that if the ratio is closer to one with one set of districts then it must be preferred. The only non obvious detail I propose is that the results of the most recent 2 elections be used, because the turnout in midterm elections is very different from that in presidential year elections.

I would propose that only if two proposed sets of districts have the exact same estimated partisan bias according to this formula may any other properties of the districts be considered. I am reasonably confident that the bias can be reduced to the fact that we can cut congress people in half (even if the idea is sometimes appealing). In any case, the party with a minority in the state legislature has a very strong incentive to look very hard for proposals to reduce the bias.

I often read that Democrats are necessarily automatically at a disadvantage, because, even aside from partisan gerrymandering, Democratic voters are concentrated in cities and so many Democratic votes must be wasted. I do not believe this at all. Rather I think not explicitly partisan rules about compactness and respecting municipal and county boundries if possible favor the Republicans. There is no reason such rules deserve consideration at all comparabile to the importance that legislative majorities correspond as nearly as possible to the popular vote. I think that (except of course for the US Senate) they can correspond almost exactly.

I would like a law requiring that they do.

Again, I don’t expect to get it, or anything, but the problem is very simple, and the solution is obvious.

Bottom Line On The Biden-Putin Summit

Bottom Line On The Biden-Putin Summit

 According to Robyn Dixon of the Washington Post on 6/18/21 regarding the outcome of the Buden-Putin summit in Geneva, I shall simply quote directly from what looks to be the bottom line from Putin himself:

Despite a packed European tour schedule, Biden “looked fresh” and was “fully aware of the materials” during the two hours of talks, Putin said:

‘Biden is a professional. One should be very observant when working with him in order not to miss anything. He misses nothing. I can assure you,” he added.

 Barkley Rosser

The decline in new jobless claims stalls, as the “delta” variant is ready to strike the unvaccinated States

The decline in new jobless claims stalls, as the “delta” variant is ready to strike the unvaccinated States

New jobless claims continue to be the most important weekly economic data point, as increasing numbers of vaccinated people and outdoor activities have led to an abatement of the pandemic, with both new infections and deaths at their lowest point since the onset of the pandemic in March 2020. I’ll have more to say on the intersection of the pandemic with claims in the conclusion.

My final objective is for claims to average 325,000 or below, which would signify a return to normal expansion levels in the past 30 years.

Turning to this week’s report, new jobless claims rose 37,000 to 412,000, the first increase in weekly claims in nearly 2 months. The 4 week average of claims declined by 8,000 to 395,000, a new pandemic low. (Note that I have discontinued comparisons of non-seasonally adjusted claims, as the period of lockdown distortions YoY has passed.)
At the peak of the pandemic lockdowns, new claims were running 6 million to 7 million per week. Here is the trend since the beginning of last August:

No Risk for Children from Covid? ? ?

Just catching up on my healthcare readings and ran across an article in my email account from MedPage Today. The articles come on a daily basis and I also get them from Modern Healthcare (which limits articles), Health Affairs, NEJM, JAMA, etc. It is more than I could read at any one time unless, I give up more time to read and absorb them.

There has been much conversation and arguing on whether there should be vaccinations for children. I have been waiting for something addressing the issues by those opposing it in a clear, concise, manner including some medical reasoning. “Let’s Recognize Childhood COVID as the Crisis It Is,” MedPage Today, June 2021 appears to do such.

The calculus of risk changes drastically when considered from a public health lens, especially with considerations unique to children. 

“From 1999 to 2019, influenza was the eighth leading cause of death in children. Yet this season, one pediatric flu death has been documented. This year’s result is likely due to aggressive non-pharmaceutical interventions (NPIs). In the same 2020-2021 season, the American Academy of Pediatrics reports (as of early June) 327 U.S. deaths in children, and the CDC reports 452 both due to COVID-19 (both are underestimates, as data is incomplete). In comparison and in ~ 1 year COVID-19, has killed twice as many children as influenza does most years, and hundreds more in the same interval of time, despite painstaking efforts to prevent infection.”

Let’s Recognize Childhood COVID as the Crisis It Is,” MedPage Today

COVID-19 is a leading cause of death amongst children.

The Powell Memo by Senator Whitehouse

Senator Whitehouse posted the clips of his presentation on the Powell Memo at youtube. Ken posted the text of it here. I have known about the Powell memo for a long time. People really do need to come to internalize just what this part of our political history means for our present day social structure and government. People might not be so gullible once they understood what he has been saying for years. Then again, to understand this history one has to be wanting more than a jingle phrase or chant for understanding their condition.

Just reading the words of Senator Whitehouse deprives one of the disgust he has for what has happened to our courts, especially the Supreme Court. So, do take the time to actually listen to his presentation. Enjoy.