Celebrating Fatherhood: The Virginian Roots of Father’s Day and Its Enduring Legacy

Our beloved state of Virginia is known for its rich history of individuals and events that have helped shape our great Nation. But did you know that the origin of Father’s Day is also attributed to a Virginian?

According to the Virginia Museum of History and Culture, “Kate Richardson Swineford of Drewry’s Bluff wanted to honor her father, Edward, in a special way. Even before the close of World War I, she began an effort to bring particular recognition to fathers, which led to her formation of the National Fathers’ Day Association in 1921.” Kate also wanted to establish a special day of recognition for Fathers. Gaining local support for her vision, and backed by Virginia governors Westmoreland Davis and E. Lee Trinkle, in 1933 she successfully obtained the trademark status for Fathers’ Day from the United States Patent Office.

In a world that is diminishing the importance of fatherhood, we, like Kate, must continue to honor and celebrate fathers, paternal bonds, and the impact fathers have on society. From our nation’s great heroes to a family’s guide and protector, a father’s influence is immeasurable.

One of our great Virginian Founding Fathers, also known as the “Father of the Declaration of Independence,” Thomas Jefferson wrote: “The happiest moments of my life have been the few which I have passed at home in the bosom of my family.”

Will Rogers, Jr., American politician, writer, and newspaper publisher, commented on fatherhood, “His heritage to his children wasn’t words or possessions, but an unspoken treasure, the treasure of his example as a man and father.”

As we at the Virginia Institute strive to uphold the principles of virtue, integrity and liberty this Nation was founded upon, we reflect with gratitude the “treasured examples” that have come before.

We are ever thankful!

In 1867 when George Henry Broughton painted his iconic “Pilgrims Going to Church,” he captured the essence that is the blessings of our unique Thanksgiving traditions and freedoms.

His work pictures the Pilgrims in family groups, heading to church, to thank God for religious liberty, their freedom to pursue economic security, and the care of their property and persons as mothers guide their children while men vigilantly watch over their safety.

Himself an immigrant to our country, Mr. Broughton used his masterpiece to express the importance of family and American values that make our nation great.

These are the same values and freedoms our team at the Virginia Institute for Public Policy fight for every day – for your individual and economic liberty, freedom to prosper and retain your bounty as a hard working business owner or employee, and the rights of parents to guide and protect their children.

We are ever thankful to you, our Virginia Institute partners, on this 401st anniversary of the first Thanksgiving — and every day of the year for the many ways you demonstrate your support.

Please accept our heartfelt Thanksgiving blessings for you and your family from our team at the Virginia Institute for Public Policy.

“Will Virginia Reject American Federalism?”

By Michael C. Maibach

During the 1788 New York ratification convention, anti-federalists opposed the new Constitution “for lack of a Bill of Rights”.  Alexander Hamilton replied, “The Constitution is itself in every rational sense, and to every useful purpose, A BILL OF RIGHTS” (Federalist #84).  Indeed, it was written to safeguard liberty against the worst form of tyranny, the tyranny of the majority about which Plato, Aristotle, and Montesquieu warned, as did Tocqueville five decades later.

The American Left (no longer worthy of the term “liberal”) has always chaffed against the Founders’’ “checks and balances” within Madison’s “compound republic” (Federalist #51).   If the mission of the Left can be summarized, it is “Tear down every rafter in the Constitutional edifice until all the protections for minority rights and diversity of regions and political thought are gone.”

In 2006 wealthy Californians launched a cynical attempt to remove one of the load bearing pillars of our Constitution – the Electoral College – by way of a National Popular Vote Interstate Compact.  They aim to convince state legislatures to enact their Compact until states representing 270 Electoral College votes sign on, the number needed to elect a President.  Already 15 entirely “blue” states have enacted the Compact for a total of 196 Electoral votes.  Now those Californians have convinced Sen. Adam Ebbin (D) and Del. Mark Levine (D) to advance their model legislation in the January 2021 legislative session in Richmond.  There are five major reasons why this legislation must be defeated:

NPV COMPACT:  A CONSTITUTIONAL ASSAULT

The NPV Compact is a Constitutional assault on three fronts.  First, the State Compact Clause (Article I) reads “No state shall, without the consent of Congress, enter into any Compact with another state…”  The NPV cabal has not sought Congressional approval for their illicit state Compact.  Second, the NPV cabal has not attempted to use the Constitution’s amendment process to achieve their goal as they know 38 states will never agree to this radical change to how we elect our Presidents.  Third, the Framers considered three other ways to elect our President – election by Congress, by state governors, and by a national popular vote. All three were rejected for an Electoral College, what is today a Presidential election in each of our 50 states.  Once agreed in Philadelphia, 13 state ratifying conventions voted to adopt our Constitution as written, including an agreed amendment process.  The manner of electing our President was a keystone in the document’s architecture, one that must not be altered absent agreement with the requisite 38 states.  It was the states that created our Constitution, the Constitution did not create the states.

NPV COMPACT:  CONTRARY TO THEIR OATH’S “SACRED PROMISE”

The dictionary defines an oath as “A solemn promise, often invoking a divine witness, regarding one’s future actions or behavior.”  Members of the Virginia legislature and the Governor affirm this oath of office:  “I do solemnly swear I will support the Constitution of the United States, and the Constitution of the Commonwealth of Virginia… to the best of my ability, so help me God.”   The NPV Compact is an un-Constitutional state compact (its name alone confirms this), a cynical attempt to change the Constitution without the votes of 38 states.

Moreover, the Commonwealth Constitution provides that only Virginia residents are entitled to vote for Virginia’s elected officials.  Yet the NPV Compact would mandate turning the votes of Virginians over to the voters of other states to decide for whom Virginia’s 13 Presidential Electors will cast their votes!  Can Virginia legislators who support the NPV Compact legislation tell the citizens who elected them that they are living up to their oath of office?

NPV COMPACT:  AN AFFRONT TO THOSE THEY REPRESENT

A Virginia legislator or Governor who supports the NPV Compact defies the Constitution and offers a civic afront to the citizens of our state.  They are saying, “Regardless of how the majority of Virginians vote, I favor allowing citizens of larger states to decide how our Electors shall vote –  none of whom elected me, none of whom pay my salary, and to none of whom have I given an oath of office.”

NPV COMPACT:  ONLY NORTHERN VIRGINIA WILL MATTER

The population of “Northern Virginia” has exploded along with the US government and the high-tech industry.   Today NoVA accounts for 67% of the state’s population!   If the NPV Compact were in place, future Presidential candidates would only visit major metropolises like New York, Miami, Houston, Chicago, LA County… and the DC metro area.  Virginia legislators who favor the NPV Compact are saying to the rest of the state – “You will no longer matter.”  Will downstate legislators and the Governor support this unlawful Compact and then explain this additional affront to those who elected them and pay their salaries?

NPV COMPACT:  A FEDERAL GOVERNMENT TAKE-OVER OF PRESIDENTIAL ELECTIONS

In 2020 the vastly different and swiftly changing elections laws of our 50 states have whipsawed our national elections. Over 30 states require photo IDs to vote, the rest do not.  Until 2020 only seven state had 100% mail-in voting, now officials are finding boxes full of ballots all over the place and recounts abound!   With Covid we saw 44 states change their voting laws and systems, often without public hearings. We are now witnessing the bitter harvest of election dysfunctions.  Too many Americans today no longer feel that our elections are “fair and transparent”.  This is a real threat to our ability to govern ourselves with good will and a sense of democratic justice.

Along comes the NPV Compact to heap upon our civic environment even more disruption and cynicism.  It says, “regardless of how your state votes, those states with the most voters will forever rule this Nation.”  Nine US states are home to 50% of our citizens.  LA County has more people than 41 of our states!  The “national popular vote” scheme aims to turn farmers and rural Americans into modern day serfs, feeding the major cities who will forever rule them.  Gone will be the quaint Iowa Caucuses and New Hampshire Primaries.  Want to alienate Americans more than they are now in this republic?  Support the NPV Compact!  And with all of the differences among our 50 state voting systems, the NPV Compact will naturally lead to calls to “nationalize our election laws” by placing the US government in charge of the voting systems of our 50 states.  In turn, this will place a future American President in charge of their own re-election machinery.  Stunningly unwise!

Yes, the Left seeks to take down the US Constitution, pillar-by-pillar.  And they understand that taking down the Electoral College is actually the swiftest way to take down the entire Republic.

 

Michael C. Maibach is a Distinguished Fellow on American Federalism at Save Our States, Managing Director of the James Wilson Institute, and the first American to be elected to public office under the age of 21 in US history.  www.SaveOurStates.com

The Heritage Foundation: The Essential Electoral College E-Book

Original document posted with permission from The Heritage Foundation.

 

Documentary Rebuts Claim That the Electoral College is Racist

Original article posted with permission from Save Our States.

Staff – Sept 03, 2020

Critics of the Electoral College Paint a False Narrative for Partisan Purposes.

Today, Save Our States, a non-partisan nonprofit, responded to critics who allege the Electoral College is racist. In a soon to be released documentary, “Safeguard: An Electoral College Story,” the group shows that the Electoral College serves to protect and promote minority voices.

In the wake of George Floyd’s death, Americans have grappled with race relations. Many communities, especially big cities, have experienced unrest. Some activists and politicians are now arguing that the way we elect our president is a product of racism and hurts black voters.

Prominent civil rights leader Vernon Jordan, who as president of the National Urban League in the 1970s was a vocal defender of the Electoral College, argues this is untrue, “For blacks, abolition of the electoral college would severely limit our political leverage in national elections.”

This issue has come to the forefront as the presidential election approaches and with voters in Colorado about to vote on a “National Popular Vote” (NPV) ballot measure. This effort – openly described as an“end-around” of the Constitution is endorsed by Rep. Alexandria Ocasio-Cortez and funded by George Soros. NPV would essentially give away Colorado’s voice in presidential elections, as voters there would be drowned out by those in bigger states like California or New York.

In a compelling new documentarySave Our States shows the flaws of NPV and the need for the Electoral College. “Safeguard: An Electoral College Story” explains how the American Founders established the Electoral College as part of a system of checks and balances, allowing the people of each state to have a voice in presidential elections. “Safeguard: An Electoral College Story” – will be released nationally and internationally on September 8, 2020. The film will be made available on Amazon Prime (an audience of 120 million viewers), iTunes and other platforms. The film will be submitted to multiple film festivals.

“Attacking the Electoral College as racist makes for a good talking point, but bad history. The constitutional system has helped to moderate our politics, forcing political parties to reach out to new voters. Support for the Electoral College by figures like John F. Kennedy and Vernon Jordan remind us how the system has benefitted minority voters,” writes Trent England, Executive Director of Save Our States.

Trouble Brewing in the Housing Market?

Just this last week, a number of interesting news stories crossed my desk. Two in particular stood out – the Trump administration’s newest moratorium on evictions, and the Federal Reserve’s purchasing $1 trillion worth of mortgage bonds. Now, I don’t think there is any question as to why the feds have chosen this path; times are hard for some people and the feds don’t want them to get harder. The question is, what problem does this solve? The answer: it doesn’t solve any problems. As Thomas Sowell was quoted recently, “There are no solutions, there are only trade-offs; and you try to get the best trade-off you can get, that’s all you can hope for.”

The real question is, then, “what are the trade-offs for these policies?”

Well first, the administration’s moratorium certainly provides some much sought after breathing room for America’s renting population. The Aspen Institute estimates that between 30 and 40 million people are at risk of being evicted: that is quite the number. What happens, however, to the landlords when their troubled but legally protected tenants stop paying rent until the end of the year?

Consider the following: a reasonable percentage of at-risk renters cease paying rent for the next 4 months. Due to this, the less financially prepared property owners must choose to foreclose rather than to continue to deal with the mortgage that many are using the rent to pay. January 2021 comes along, renters are no longer protected, and the houses they live in are now bank-owned assets which will undoubtedly be sold at auction after the tenants are evicted en masse. Potentially millions of rental properties may end up in just such a circumstance, and the potential of a sudden decrease in rental supply could very well mean higher rents in 2021. Will this policy truly help America’s renters, or will the trade-offs come back to bite even those that are not currently “at risk”?

Beyond this, what happens to all those mortgage-backed bonds that are being held by the Federal Reserve if mortgages go belly-up like they did after the 2008 recession? Mortgage delinquency peaked in 2010 at 9.3% as we began the agonizing process of digging ourselves out of a politically driven recession with the same political burdens slowing down our efforts. This last August, mortgage delinquency had reached 8.2% at the same time that the Fed was approaching $1 trillion in what some might consider toxic securities; incidentally, that is approximately 30% of the American housing market. I can only imagine that among the threats of continued lockdowns, a flagging service industry, and the administration’s short-run compassion, we may see considerable difficulties in the new year vis a vis 2008.

This does not address all of the potential trade-off for these policies, but this is what you need to be thinking about when you read the news on new economic programs, public welfare spending, and public policy more generally. It should always be your very first question: “what are the trade-offs?”

Should Government Officials Drop in on Homeschooling Families?

June 17, 2020, article republished with permission from CATO Institute.

By Neal McCluskey

A couple of days ago Cato’s Center for Educational Freedom hosted a discussion on one of the hottest topics in education: homeschooling. The issue is in the front of many people’s minds because COVID-19 forced just about every child in the world to school at home. But people have been debating the right degree of parental and government control of education for centuries, and the debate specifically concerning homeschooling reached peak heat last month with a Harvard Magazine article pondering “a presumptive ban on the practice.” Our event featured Elizabeth Bartholet, the Harvard professor who called for the presumptive ban; Cato adjunct scholar and homeschooling advocate Kerry McDonald; historian and Messiah College professor Milton Gaither; and me, serving as both a panelist and moderator.

Homeschooling: Protecting Freedom, Protecting Children

In my opening remarks I endeavored to quickly work through a libertarian thought process on the role of government vis‐​à‐​vis homeschooling, with an emphasis on the difficulty of fitting children into a basic libertarian framework. That basic framework is grounded in freedom for people whom we assume are capable of self‐​government – typically adults. For at least some amount of time—we can debate how long for any given person—children cannot make many informed decisions for themselves, nor can they defend themselves against abuse or neglect. Someone else controls them.

In light of that, the homeschooling debate is more complicated than simply concluding that parents should be able to do whatever they want with their children. Few people, for instance, would disagree that government should stop child abuse or neglect. Of course, the norm for dealing with criminal activity, as I explained in my remarks, is for someone to suspect a crime is occurring, an investigation to occur, and if an investigation provides sufficient evidence for government to intervene, alleged perpetrators are charged and tried, with their innocence assumed unless they are proven guilty.

That said, our event was intended to discuss difficult issues from multiple perspectives, hopefully with all involved trying to understand how reasonable people could hold opinions different from their own. With such a discussion as a goal, and knowing that there have been very rare, but also very devastating, cases of isolation and abuse of children under the guise of homeschooling, in my remarks I said that it “may” be reasonable to “maybe” annually have some government official drop in unannounced on homeschooling families to briefly check in on children.

Many people heard this and thought that I was asserting that such a policy should be implemented. That was not my intention – I wanted to offer food for thought, and perhaps something that could spur a search for common ground.

So where do I stand? Again, the legal norm is suspicion, investigation, and trial with a presumption of innocence. That remains the best approach because a government empowered to inspect our homes and families without probable cause is a dangerous, insufficiently constrained government. The same presumption of innocence and due process should apply to how we deal with potential educational neglect, which I define as failure to educate a child to read, write, and calculate – the building blocks a child needs to become self‐​governing and access more expansive education.

I also, though, believe that we need to spend more time and effort thinking about how we can protect children from abuse and neglect. This may well mean reforming child protective services, encouraging communities to pay closer attention to families that appear to be isolated or in crisis, and maybe just discussing abuse more to raise the public consciousness. And we must remember that children are not adults—many cannot defend themselves or self-govern—rendering the policy framework we use for them more complicated than simply letting people do as they want as long as they do not forcibly impose things on others. No matter what, someone other than the child is imposing on them.

Relax Pharmacy Regulations to help with COVID-19 Testing and Treatment

March 27, 2020 article republished with permission from Mercatus.org

By James Broughel and Yuliya Yatsyshina

One of the most urgent challenges facing policymakers managing the current COVID-19 public health crisis is how to ramp up diagnostic testing on a mass scale. Companies such as Walgreens, CVS, and Target have already started working with the federal government, as their locations are well-suited to become testing sites. As a result, pharmacies and pharmacists themselves are likely to become instrumental in testing for COVID-19 in the coming weeks and months. However, certain regulatory restrictions on pharmacists should be relaxed so that they can practice to the full extent of their training and abilities.

The Importance of Testing

The president has declared a national emergency and the federal agencies and state governments overseeing the response to the pandemic have recommended or required that citizens stay at home, practice social distancing, and, in some instances, self-isolate, self-quarantine, or shelter in place. To-date, authorities have offered little guidance as to when these recommendations will expire. Without reliable information about how many people are infected with COVID-19 as well as the rate at which the disease spreading, it is likely that policymakers currently have no clear sense of when to recommend a return to normalcy. Critical data required to inform such decisions will only emerge once large-scale testing is implemented.

Tragically, the federal government botched its early response to the crisis. Among other things, the first COVID-19 tests distributed around the country by the Centers for Disease Control and Prevention (CDC) produced unreliable results. Furthermore, commercial labs and public health officials in the states couldn’t get initial approval to perform their own tests (though in some cases, they tested anyway). These failures, largely a result of inflexible regulations, have contributed to delaying the rollout of testing in the United States. Even now that many legal barriers to testing have been removed, shortages of supplies could be hampering the scaling up of testing.

This is a particularly unfortunate outcome because the experience of other countries suggests that testing on a large scale has been a key ingredient of an effective response to the pandemic. Testing, when combined with practices such as isolating infected individuals and using contact tracing methods to identify who else may have been exposed to the virus, has shown promising results in places such as South Korea and Singapore. Testing to confirm that those who are exhibiting no symptoms or who were previously ill are in good health could also potentially speed the transition back to normalcy.

The effectiveness of mass testing is powerfully illustrated by the experience of Vò, a small town that reported Italy’s first death from COVID-19. The town’s 3,300 or so residents were tested and retested as part of an experiment rolled out by the University of Padua, with assistance from the government of the Veneto Region and the Red Cross. Residents were tested regardless of whether they were exhibiting symptoms. Those who were confirmed as infected were quarantined. The second round of testing revealed that the number of infected residents had dropped from 3 percent of the population to nearly zero, and Vò eventually reached zero new cases within a few weeks. Notably, this outcome differs dramatically from the experience of other parts of northern Italy, which has been one of the regions of the world most affected by COVID-19.

The Role that Pharmacists Can Play

At the time of this was written, 579,000 COVID-19 tests had been administered in the United States. If the disease continues to spread exponentially, testing will have to keep up with that pace of growth. Meeting that goal is going to be a significant challenge, as laboratories are already facing shortages of testing equipment. Another challenge is going to be finding safe places where potentially infected individuals can be tested without infecting others and healthy individuals can be tested without getting infected themselves. A role for pharmacies is thus quickly becoming apparent.

Massachusetts, for example, set up one of America’s first drive-through testing facilities in a pharmacy parking lot. Other states, such as Michigan and Pennsylvania, are following suit. Major drug store chains have publicly committed their support for the fight against COVID-19.

Pharmacies are well positioned to become testing sites because of their geographical coverage across the country. There are more than 309,000 employed licensed pharmacists in the United States and its territories, and 90 percent of Americans live within five miles of a pharmacy. Many pharmacies have adequate parking, which makes them well suited for drive-through testing. Some pharmacies even have drive-through windows. The familiarity patients have with pharmacists could prove important if sick individuals are more comfortable driving to their local pharmacy than going to a doctor’s office or a hospital.

Pharmacists can be of critical assistance in triaging the coming avalanche of patients seeking diagnostics and care. Pharmacists could test patients for COVID-19 and, if the results return positive, give directions for home care if the illness is mild. If the illness is severe, pharmacists could direct patients to designated facilities for their particular area. Even if results were to come back negative, the pharmacist would save the patient from having to visit another venue of care, thereby freeing up time for other medical professionals to focus on more urgent cases. Should patients suffer from other minor ailments, pharmacists could also provide treatment (though this might require legal changes in many jurisdictions; to be discussed later in this brief).

Pharmacists’ training makes them capable of providing this kind of basic medical care. It takes about eight years to obtain a doctor of pharmacy degree, a regular requirement for a pharmacist license. This time includes three to four years of undergraduate prerequisite work and four years of additional professional study. The COVID-19 test is relatively simple and usually involves taking swabs from a patient’s nose or throat. This is a task well within the capabilities of a pharmacist to perform. Although for now the analysis of the swab is likely to take place off site at a lab, in the future this work could potentially be done on site. Indeed, rapid-turnaround COVID-19 tests are currently being developed and, in some cases, undergoing FDA approval. Moreover, pharmacists themselves stand ready to assist, as identified by a recent call by the American Pharmacists Association for expanded pharmacist services to combat COVID-19.

Policy Recommendations

Fortunately, there are not many laws standing in the way of pharmacists and pharmacies immediately assisting in testing efforts for COVID-19. Personnel working at testing sites set up near pharmacies should be able to collect specimens from patients and send those specimens to laboratories for analysis without facing significant legal hurdles. These laboratories, however, do need government approval to operate, and indeed this has been one of the central bureaucratic hurdles that has hampered the US government’s response to the crisis.

These same restrictions also affect pharmacists with respect to performing laboratory testing for other ailments. For several decades, many pharmacies have been allowed to perform low-risk health tests thanks to the Clinical Laboratory Improvement Amendments of 1988 (CLIA). Even in ordinary times, pharmacies can obtain CLIA waivers and perform tests related to such ailments as influenza, strep throat, human immunodeficiency virus, and other medical conditions.

Currently, however, the percentage of pharmacies holding CLIA waivers varies enormously across states. One study finds the percentage of pharmacies possessing CLIA waivers to be between 0 and 60 percent, depending on the state, with a median percentage of 19.56 percent. One reason for the disparity across states is varying state and local regulations, which include restrictions related to testing procedures, licensure of the personnel conducting tests or overseeing a lab, phlebotomy requirements, and waste disposal requirements.

Allowing pharmacists to perform tests in ordinary times would better prepare them for crises like the current pandemic. Moreover, as CLIA waivers have increased, pharmacists and lab technicians have been able to incorporate basic testing into their existing workload without needing to work more hours. Pharmacist testing has an additional benefit of potentially reducing the time between symptom development and treatment. Thus, ensuring that CLIA-waived COVID-19 tests quickly become available should be a top priority of the US Department of Health and Human Services.

When pharmacists are testing for an ailment, they are usually qualified to treat similar conditions as well. Florida recently passed a law that allows pharmacists to test and treat for influenza and strep throat. These kinds of changes are likely to alleviate some of the stress on the medical system as pharmacists take on the burden of handling some of the more routine cases. However, Florida’s reform remains far from ideal, in part because it requires a licensed pharmacist to have in place a collaborative agreement with a supervising physician, which can act as a disincentive for many pharmacists.

Idaho is perhaps the model state in this regard, as Idaho allows pharmacists to prescribe autonomously if a pharmacist identifies a medical condition as a result of a CLIA-waived test, as well as under a number of other routine situations, all without a collaborative agreement with a physician in place. Idaho also allows for substitution of therapeutically equivalent drugs without express physician authorization (but with notification to the physician). As more states like Idaho and Florida allow for basic testing and prescribing authority for pharmacists, colleges of pharmacy are likely to respond by updating curricula, thereby enhancing preparedness for future pandemics.

Many states are relaxing other kinds of regulations as a result of the COVID-19 pandemic. Massachusetts has allowed pharmacies to produce hand sanitizer and mandated that insurers cover certain telehealth services. Some states are now accepting out-of-state medical licenses or embarking in reciprocity agreements with other states with regard to medical licenses. Again, Idaho has a reciprocity law for pharmacists that could serve as a model in this regard.

Relaxing restrictions on telepharmacy could also yield beneficial outcomes. Currently, most tests for COVID-19 have a relatively long turnaround time, often requiring patients to wait at home for results. When results become available, tested individuals could have a consultation with the pharmacist on the phone or via video conferencing platforms such as Skype or Zoom. Not only is this convenient for the patient, it also encourages social distancing. Currently, there is a debate taking place about take-at-home COVID-19 tests. If these tests become common, relaxing telepharmacy rules could enable pharmacists to provide remote instructions to patients administering their own tests. Telepharmacy reforms have also been known to increase access to pharmacies among underserved populations, such as rural populations.

Importantly, as pharmacists take on additional responsibilities, they will likely need to rely more on pharmacy technicians to pick up more routine tasks. However, many states have restrictions in place that mandate a maximum ratio of technicians that can work with each pharmacist. Notably, many states have no ratio requirements, and some states even have provisions in place that allow technicians to work remotely, suggesting that some restrictions on pharmacy technicians can be relaxed or lifted altogether.

In short, pharmacists could readily play a role in ramping up COVID-19 testing and treatment, and eventually, when available, providing the vaccine. Relaxing state phlebotomy laws could yield additional benefits, as drawing blood may be necessary in efforts to search for antibodies for COVID-19. Any restrictions on the ability of pharmacists to immunize using FDA approved vaccines should also be reconsidered.

Conclusion

As pharmacies and pharmacists become instrumental in COVID-19 testing, any related regulatory restrictions at the state and federal level should be reconsidered. States should make it easier for pharmacies to obtain CLIA waivers, pharmacists should have the ability to prescribe in low-risk situations, regulations should be amended to make it easier for pharmacists licensed in one state to practice in another state, and the use of telepharmacy should be encouraged. Restrictions on pharmacy technicians and the ability of pharmacists to vaccinate are also areas where liberalization could prove beneficial. Combined, these reforms are likely to improve the public’s access to testing and treatment for COVID-19 as well as a variety of other medical conditions. Equally important, these reforms can enhance preparedness for future pandemics.

Spaced Out, Hidden, Here Come the 2020 Tax Hikes

Stephen D. Haner, Senior Fellow for State and Local Tax Policy at the Thomas Jefferson
Institute for Public Policy, brings us a list of the tax hikes coming to Virginia as early as July 1st of this year.

Highlights include: big increases in state and regional gasoline taxes, double the cigarette tax, and authorization to impose a 5-cent tax on plastic bags. Read the full Jefferson Journal article here.

A Letter to the President of the Virginia Institute

The Importance of the Freedom Caravan

Saturday, April 25, 2020

Dear Lynn,

I have seen our freedoms disappear over the years. The inception of our country was spurned on by our founding father’s revolts against King George’s policies, and they fought relentlessly for the rights and freedoms we now possess in our constitution. This month, we were witness to another tyrannical government in the form of our governor and his administration.

I believe we as citizens of this great nation have a responsibility to stand against the tyranny designed to destroy our state and country. This notion is shared with hundreds of patriots I spoke with on Wednesday, at the rally point near the Capitol in Richmond. These patriots came from all over Virginia to voice that the “free enterprise system is the most productive supplier of human needs and economic justice,” therefore meaning we must open Virginia for business as soon as possible. If we are to survive as a state and nation, we must take a stand against our governor to protect the constitutional values that are under fire.

To not attend the rally on Wednesday out of fear of COVID-19 or government reprisal was not an option. It was an opportunity to peacefully object to the government overreach that is plaguing Virginia today. My hope is that our governor and his administration will view the assembly on Wednesday as leaders of conservative groups that represent thousands of votes this November, and as a peaceful message to reopen the state so that we, as a state and nation, can become economically viable again.

Lynn, I could not begin to tell you how many people commented on the Thomas Jefferson quote on the little blue truck. Thank you for your support!

“When government fears the people, there is liberty. When the people fear the government, there is tyranny.”- Thomas Jefferson

Regards,

Major Mansfield

Kilgore on Telehealth

On May 3, 2020, The Roanoke Times published Del. Kilgore’s reflection on his push for HB1332 and the necessity of telehealth services during the current pandemic. Kilgore mentions the Tuesday Morning Group coalition in his letter Kilgore: Advancing telehealth in the Commonwealth.

Lynn Taylor Interview on the Don Kroah Show

On April 17th, Don Kroah interviewed VIPP President Lynn Taylor on the bills Gov Northam recently signed into effect. Listen to the radio show below.

by JanBaby on Pixabay
National coronavirus response: A road map to reopening

Republished with permission from American Enterprise Institute.

Authors: Scott Gottlieb, Mark McClellan, Lauren Silvis, Caitlin Rivers, Crystal Watson.

Key Points

  • This report provides a road map for navigating through the current COVID-19 pandemic in the United States. It outlines specific directions for adapting our public-health approach away from sweeping mitigation strategies as we limit the epidemic spread of COVID-19, such that we can transition to new tools and approaches to prevent further spread of the disease.
  • The authors outline the steps that can be taken as epidemic transmission is brought under control in different regions. They also suggest measurable milestones for identifying when we can make these transitions and start reopening America for businesses and families.
  • In each phase, the authors outline the steps that the federal government, working with the states and public-health and health care partners, should take to inform the response. This will take time, but planning for each phase should begin now so the infrastructure is in place when it is time to transition.

Executive Summary

This report provides a road map for navigating through the current COVID-19 pandemic in the United States. It outlines specific directions for adapting our public-health strategy as we limit the epidemic spread of COVID-19 and are able to transition to new tools and approaches to prevent further spread of the disease. We outline the steps that can be taken as epidemic transmission is brought under control in different regions. These steps can transition to tools and approaches that target those with infection rather than mitigation tactics that target entire populations in regions where transmission is widespread and not controlled. We suggest measurable milestones for identifying when we can make these transitions and start reopening America for businesses and families.

In each phase, we outline the steps that the federal government, working with the states and public-health and health care partners, should take to inform the response. This will take time, but planning for each phase should begin now so the infrastructure is in place when it is time to transition.

The specific milestones and markers included in the report for transitioning our responses are judgments based on our current understanding, with the goal of facilitating an effective path forward. The epidemic is evolving rapidly, and our understanding of best responses will evolve as well. The broad set of tasks described here requires and will receive high-level, ongoing attention, and it should be updated and refined as additional evidence, context, and insights about the epidemic become available.

To gradually move away from a reliance on physical distancing as our primary tool for controlling future spread, we need:

  1. Better data to identify areas of spread and the rate of exposure and immunity in the population;
  2. Improvements in state and local health care system capabilities, public-health infrastructure for early outbreak identification, case containment, and adequate medical supplies; and
  3. Therapeutic, prophylactic, and preventive treatments and better-informed medical interventions that give us the tools to protect the most vulnerable people and help rescue those who may become very sick.

Our stepwise approach depends on our ability to aggregate and analyze data in real time. To strengthen our public-health surveillance system to account for the unprecedented spread of COVID-19, we need to harness the power of technology and drive additional resources to our state and local public-health departments, which are on the front lines of case identification and contact tracing. Finally, we must expand our investments in pharmaceutical research and development into COVID-19 and promote the rapid deployment of effective diagnostics, therapies, and eventually a vaccine.

Slow the Spread in Phase I. This is the current phase of response. The COVID-19 epidemic in the United States is growing, with community transmission occurring in every state. To slow the spread in this period,1 schools are closed across the country, workers are being asked to do their jobs from home when possible, community gathering spaces such as malls and gyms are closed, and restaurants are being asked to limit their services. These measures will need to be in place in each state until transmission has measurably slowed down and health infrastructure can be scaled up to safely manage the outbreak and care for the sick.

State-by-State Reopening in Phase II. Individual states can move to Phase II when they are able to safely diagnose, treat, and isolate COVID-19 cases and their contacts. During this phase, schools and businesses can reopen, and much of normal life can begin to resume in a phased approach. However, some physical distancing measures and limitations on gatherings will still need to be in place to prevent transmission from accelerating again. For older adults (those over age 60), those with underlying health conditions, and other populations at heightened risk from COVID-19, continuing to limit time in the community will be important.

Public hygiene will be sharply improved, and deep cleanings on shared spaces should become more routine. Shared surfaces will be more frequently sanitized, among other measures. In addition to case-based interventions that more actively identify and isolate people with the disease and their contacts, the public will initially be asked to limit gatherings, and people will initially be asked to wear fabric nonmedical face masks while in the community to reduce their risk of asymptomatic spread. Those who are sick will be asked to stay home and seek testing for COVID-19. Testing should become more widespread and routine as point-of-care diagnostics are fully deployed in doctors’ offices.

While we focus on state-by-state reopening of activities in a responsible manner and based on surveillance data, we note that states may move forward at a county or regional level if these conditions vary within the state and that coordination on reopening among states that share metropolitan regions will be necessary.

Establish Immune Protection and Lift Physical Distancing During Phase III. Physical distancing restrictions and other Phase II measures can be lifted when safe and effective tools for mitigating the risk of COVID-19 are available, including broad surveillance, therapeutics that can rescue patients with significant disease or prevent serious illness in those most at risk, or a safe and effective vaccine.

Rebuild Our Readiness for the Next Pandemic in Phase IV. After we successfully defeat COVID-19, we must ensure that America is never again unprepared to face a new infectious disease threat. This will require investment into research and development initiatives, expansion of public-health and health care infrastructure and workforce, and clear governance structures to execute strong preparedness plans. Properly implemented, the steps described here also provide the foundation for containing the damage that future pathogens may cause.

Phase I: Slow the Spread

Goals

The goal of Phase I is to save lives by:

  1. Slowing the transmission of SARS-CoV-2 across the United States by reducing the effective reproduction number of infections,
  2. Increasing testing capacity to accommodate the ability to test everyone with symptoms and their close contacts, and
  3. Ensuring the health care system has the capacity to safely treat both COVID-19 patients and others requiring care.

A successful Phase I will allow for a significant relaxation of physical distancing measures and a progression to Phase II, when more targeted, case-based interventions are possible.

Thresholds for Action

Trigger to Begin to “Slow the Spread.” The trigger to implement nationwide “slow the spread” measures2 in Phase I is the existence in multiple geographic locations around the country of confirmed cases that cannot be traced back to other known cases (“community spread”).3 This trigger has already been reached in the United States.

Trigger to Move to Phase II. To guard against the risk that large outbreaks or epidemic spread could reignite once we lift our initial efforts to “slow the spread,” the trigger for a move to Phase II should be when a state reports a sustained reduction in cases for at least 14 days (i.e., one incubation period); and local hospitals are safely able to treat all patients requiring hospitalization without resorting to crisis standards of care4and the capacity exists in the state to test all people with COVID-19 symptoms, along with state capacity to conduct active monitoring of all confirmed cases and their contacts.5

Stay-at-Home Advisories

The trigger for issuing a stay-at-home advisory6 in a US state is when case counts are doubling every three to five days7 (based on the current New York experience) or when state and local officials recommend it based on the local context (for example, growth on track to overwhelm the health system’s capacity).

The trigger for issuing a recommendation to step down from a stay-at-home-advisory back to “slow the spread” is when the number of new cases reported in a state has declined steadily for 14 days (i.e., one incubation period) and the jurisdiction is able to test everyone seeking care for COVID-19 symptoms.

Steps Required in Phase I

Maintain Physical Distancing. Each state must maintain community-level physical distancing measures8 until the threshold for moving to Phase II is met. These Phase I measures include:

  • Closing community gathering spaces such as schools, shopping centers, dining areas, museums, and gyms statewide (places where people congregate indoors);
  • Promoting telework for nonessential employees statewide;
  • Urging the public to limit unnecessary domestic or international travel;
  • Canceling or postponing meetings and mass gatherings;
  • Shutting dining areas but encouraging restaurants to provide takeout and delivery services if possible;
  • Issuing stay-at-home advisories in hot spots where transmission is particularly intense (i.e., when case counts are doubling in a city or locality every three to five days); and
  • Monitoring community adherence to physical distancing and stay-at-home advisories, adjusting risk messaging as appropriate, and identifying alternative incentives for compliance if needed.

Increase Diagnostic Testing Capacity and Build Data Infrastructure for Rapid Sharing of Results. Same-day, point-of-care diagnostic testing (widely available in outpatient settings) is crucial for identifying cases, including those with asymptomatic and mild infections. To move from community-wide interventions that focus on large populations to case-based interventions that target and isolate individual people who are infected, capacity should be sufficient to test:

  1. Hospitalized patients (rapid diagnostics are needed for this population);
  2. Health care workers and workers in essential roles (those in community-facing roles in health and public safety);
  3. Close contacts of confirmed cases; and
  4. Outpatients with symptoms. (This is best accomplished with point-of-care diagnostics in doctors’ offices with guidelines that encourage widespread screening and mandated coverage for testing.)

We estimate that a national capacity of at least 750,000 tests per week would be sufficient to move to case-based interventions when paired with sufficient capacity in supportive public-health infrastructure (e.g., contact tracing).9 In conjunction with more widespread testing, we need to invest in new tools to make it efficient for providers to communicate test results and make data easily accessible to public-health officials working to contain future outbreaks.

Ensure Functioning of the Health Care System. Ensure sufficient critical-care capacity10 in hospitals to be able to immediately expand capacity from 2.8 critical-care beds per 10,000 adults to 5–7 beds per 10,000 adults in the setting of an epidemic or other emergency, allowing for regional variation.11 This target is a minimum, must be adequate for the current and forecasted level of demand, and must be accompanied by adequate staffing. Regional variation in capacity reflecting local needs is acceptable.

Expand access to ventilators in hospitals from 3 per 10,000 adults to a goal of 5–7 ventilators per 10,000 adults.12 This target does not include transport or anesthesia machines. This target is a minimum, must be adequate for the current and forecasted level of demand, and must be accompanied by adequate staffing. Regional variation in capacity reflecting local needs is acceptable.

Maintain access to acute-care hospital beds of at least 30 per 10,000 adults.13 Facilities should have a plan, in the case of a surge in hospital demand, for how the beds would be rapidly flexed from more discretionary uses (e.g., elective procedures) and adequately staffed, with access to adequate supplies of oxygen and other medical supplies.

This health care functioning target would also be met if critical-care and ventilator capacity does not expand to that level but COVID-19 incidence is maintained or falls meaningfully below the state’s capacity to meet critical-care demand. These capacity targets can also be partially met through the availability of ample mobile health care infrastructures (supported and perhaps maintained by federal or state governments) that can be distributed and set up on short notice to hot areas with surge capacity needs.

Increase Supply of Personal Protective Equipment. The Centers for Disease Control and Prevention (CDC) recommends, at a minimum, N95 respirators for hospital staff expected to have direct contact with COVID-19 patients, plus disposable procedural or surgical masks for all other clinical personnel in any health care setting.14 The supply chain should be able to reliably distribute sufficient N95 masks, gloves, and other personal protective equipment to protect health care workers from infection.

Implement Comprehensive COVID-19 Surveillance Systems. The move toward less restrictive physical distancing could precipitate another period of acceleration in case counts. Careful surveillance will be needed to monitor trends in incidence. A high-performing disease surveillance system should be established that leverages:

  1. Widespread and rapid testing at the point of care using cheaper, accessible, and sensitive point-of-care diagnostic tools that are authorized by the Food and Drug Administration (FDA);
  2. Serological testing to gauge background rates of exposure and immunity to inform public-health decision-making about the level of population-based mitigation required to prevent continued spread in the setting of an outbreak; and
  3. A comprehensive national sentinel surveillance system, supported by and coordinated with local public-health systems and health care providers, to track the background rate of infection across states and identify community spread while an outbreak is still small and at a stage in which case-based interventions can prevent a larger outbreak.

ILINet, the surveillance system for influenza-like illness in the United States, is a potential model for SARS-CoV-2 surveillance. To enable rapid and more effective detection and case management, SARS-CoV-2 surveillance will also benefit from data sharing and coordination with health care providers and payers. The CDC should convene an intergovernmental task force, with outside experts as needed and input from states and the health care community, to develop and support a new national surveillance system and data infrastructure for tracking and analyzing COVID-19.

Massively Scale Contact Tracing and Isolation and Quarantine. When a new case of COVID-19 is diagnosed, the patient should be isolated either at home or in a hospital, depending on the level of care he or she requires. Current CDC guidelines recommend seven days of isolation.15 Home isolation can be enforced using technology such as GPS tracking on cell phone apps. Also, the close contacts of confirmed cases (as defined by the CDC16) should be quarantined and monitored daily for 14 days. Monitoring of international travelers is also recommended.17

To scale these interventions to accommodate thousands of daily cases and tens of thousands of daily contacts, public-health infrastructure will need to be dramatically scaled up throughout the country, in coordination with the improving capacity of health care providers to prevent, diagnose, and treat COVID-19 cases.

The task force should also be charged with developing and overseeing an initiative to:

  1. Surge the existing public-health workforce to conduct case finding and contact tracing;
  2. Enable rapid reporting to state, local, and federal health authorities, through the public-health workforce and electronic data sharing from health care providers and labs; and
  3. Develop and field a technological approach to enable rapid data entry, reporting, and support for isolation, quarantine, and safe community-based treatment of affected individuals.

Offer Voluntary Local Isolation and Quarantine. Comfortable, free facilities should be provided for cases and their contacts who prefer local isolation, quarantine, and treatment away from home. For example, a member of a large household may wish to recover in a hotel room that has been repurposed rather than risk infecting family members. Isolation and quarantine away from home should not be mandatory or compelled by force.

The Federal Emergency Management Agency is the lead agency tasked with coordinating with state and local jurisdictions to stand up appropriate isolation and quarantine facilities. Field hospitals, dormitories, hotels, and military barracks may be appropriated for this purpose.

Encourage the Public to Wear Masks. There is emerging evidence that asymptomatic and presymptomatic transmission of COVID-19 is possible,18 which complicates efforts to pursue case-based interventions. To reduce this risk during Phase I, everyone, including people without symptoms, should be encouraged to wear nonmedical fabric face masks while in public.19

Face masks will be most effective at slowing the spread of SARS-CoV-2 if they are widely used, because they may help prevent people who are asymptomatically infected from transmitting the disease unknowingly. Face masks are used widely by members of the public in some countries that have successfully managed their outbreaks, including South Korea and Hong Kong.20 The World Health Organization (WHO) recommended members of the public use face masks in the event of a severe influenza pandemic.21

However, personal protective equipment should continue to be reserved for health care workers until supplies are sufficient for them and abundant. For this reason, right now members of the general public should opt to wear nonmedical fabric face masks when going out in public. The CDC should issue guidelines on the proper design of such nonmedical fabric face masks. Consumers may be able to fashion these masks themselves using available washable materials, or they may become available in the consumer marketplace.

Trigger for Moving to Phase II

A state can safely proceed to Phase II when it has achieved all the following:

  • A sustained reduction in cases for at least 14 days,
  • Hospitals in the state are safely able to treat all patients requiring hospitalization without resorting to crisis standards of care,22
  • The state is able to test all people with COVID-19 symptoms, and
  • The state is able to conduct active monitoring of confirmed cases and their contacts.23

Phase II: Reopen, State by State

In Phase II, the majority of schools, universities, and businesses can reopen. Teleworking should continue where convenient; social gatherings should continue to be limited to fewer than 50 people wherever possible. Other local restrictions should be considered, such as those that limit people from congregating in close proximity.

High-contact settings such as schools should continue to review and implement physical distancing measures with guidance from the CDC and input from local officials. Health officials should recommend increased social hygiene measures and cleaning of shared surfaces.

For older adults (those over 60 years old), those with underlying health conditions, and other populations at heightened risk from COVID-19, it should still be recommended that they limit time in the community during Phase II. This recommendation may change if an effective therapeutic becomes available.

We need to consider these activities on a coordinated, regional basis through multistate cooperation. While state and local governments maintain sovereignty over issues related to their public-health response, coordination based on regions that cross state boundaries will be crucial. Large states with multiple urban areas and rural regions may implement reopening at a regional level. States that share major metropolitan areas (for example, New York, New Jersey, and Connecticut) should assure that the conditions for reopening these areas are met across the relevant state boundaries.

Goals

The goals of Phase II are to:

  1. Lift strict physical distancing measures in a concerted and careful fashion,
  2. Allow the vast majority of businesses and schools to open, and
  3. Continue to control SARS-CoV-2 transmission so we do not revert back to Phase I.

The adoption of these Phase II measures will require a careful balance. We will need to constantly reevaluate the implementation of these measures based on available surveillance data, and we will need to be ready to adjust our approach over time according to the epidemiology of local, national, and global spread. This is especially true as we transition from one phase to the next.

Thresholds for Action

Trigger to Lift Physical Distancing Measures. Once the criteria for the transition from Phase I to Phase II have been met and we begin to move away from the “slow the spread” period, leaders at the state level should begin an incremental easing of physical distancing measures. This should be done gradually and should be paired with increased surveillance for new cases. State officials should make decisions about the selection and timing of restrictions to lift based on their local contexts. Restrictions should be eased gradually, with sufficient time between each adjustment to carefully monitor for resurgence of transmission.

Trigger for Returning to Phase I, “Slow the Spread.” As physical distancing is gradually eased, surveillance will be essential for quickly identifying an increase in cases in the state. A state should revert to Phase I and continue “slow the spread” if a substantial number of cases cannot be traced back to known cases, if there is a sustained rise in new cases for five days, or if hospitals in the state are no longer able to safely treat all patients requiring hospitalization.

Trigger for Moving to Phase III. Once a vaccine has been developed, has been tested for safety and efficacy, and receives FDA emergency use authorization,24 or there are other therapeutic options that can be used for preventive or treatment indications and that have a measurable impact on disease activity and can help rescue very sick patients, states can move to Phase III.

Steps Required in Phase II

Implement Case-Based Interventions. Using the public-health capacities developed in Phase I, every confirmed case should be isolated either at home, in a hospital, or (voluntarily) in a local isolation facility for at least seven days, or according to the latest CDC guidance. People awaiting test results should be advised to quarantine until their results are returned.

The close contacts of confirmed cases should be traced and placed under home or central quarantine, with active daily monitoring for at least 14 days, or according to the latest CDC guidance. Diagnostic tests should be immediately administered to any close contacts who develop symptoms.

Begin to Relax Physical Distancing Measures. General physical distancing precautions should still be the norm during Phase II, including teleworking (as much as possible), maintaining hand hygiene and respiratory etiquette, wearing a mask in public, regularly disinfecting high-touch surfaces, and initially limiting social gatherings to fewer than 50 people. These recommendations should be augmented through technological solutions to understand physical distancing behaviors and adjust risk messaging as needed. This should be accomplished through partnerships with the private sector, with careful attention paid to preserving privacy and avoiding coercive means to encourage compliance.

As children return to school and daycare (i.e., high-contact settings) and people return to high-density workplaces, leaders of these organizations should continue to review and implement physical distancing measures based on guidance from the CDC for schools and businesses.25

Special Care for Vulnerable Populations. While easing of physical distancing is taking place, highly vulnerable populations,26 such as individuals older than age 60 and those with compromised immune systems or compromised lung and heart function, should continue to engage in physical distancing as much as possible until a vaccine is available, an effective treatment is available, or there is no longer community transmission. Special attention should be paid to long-term-care facilities and nursing homes.27 These facilities will need to maintain high levels of infection prevention and control efforts and limit visitors to prevent outbreaks.

If a treatment or prophylactic, such as a monoclonal antibody,28 becomes available, high-risk and vulnerable populations should be prioritized to receive it, to both protect those individuals and reduce the likelihood of an increase in severe illnesses and additional patient surge in hospital intensive care units (ICUs).

Accelerate the Development of Therapeutics. Therapeutics play an important role in caring for those who are sick. Accelerating the research, development, production, and distribution of safe and effective therapeutics is a top priority. With effective development strategies and early investments in commercial-scale manufacturing, a successful therapeutic could receive emergency use authorization or approval as early as the summer or fall, if trials demonstrate that it meets either standard.

Therapeutics can serve a number of roles. First, they can serve as a prophylaxis to help prevent infection in those at greatest risk of infection, such as front-line health care workers, or those at risk of bad outcomes, such as individuals with preexisting health conditions and those who are immunocompromised. Such a treatment could include a recombinant antibody that can target the virus surface antigens. As an example, researchers successfully developed such a therapeutic against Ebola. These antibody drugs can also be used to treat early infection or as a postexposure prophylaxis.

Other therapeutics might include antiviral drugs that target features of how the virus replicates. These drugs can be used to treat people who are critically ill or earlier in the course of disease for those at risk of developing a complication. Antiviral drugs can also be used as postexposure prophylaxis, depending on their safety profile. Postexposure prophylaxis and products that shorten the duration and intensity of viral shedding may affect the effective reproduction number only modestly. In addition, immune-modulating treatments may prove to be helpful in mitigating severe lung complications in some patients. A number of promising drugs are in early and mid-stage development.

At a minimum, the optimal profile for a therapeutic that will affect the risk from future spread is one that meaningfully reduces the risk of death or severe disease and perhaps prevents the onset of symptoms or progression to severe disease in those exposed. Oral administration at the outpatient level would be ideal, but alternative administration requirements (e.g., infusion and jet injections) could also be scaled, with sufficient planning.

While private industry has already organized a large task force to share information and capabilities to rapidly advance promising therapies, we need a commensurate focus by federal agencies to make sure the best possible resources are brought to this mission. Federal agencies should join organized efforts already underway in the private sector.

Identify Those Who Are Immune. Serology is a method used to identify evidence of immunity in someone who has recovered from infection. With accurate and widely available serological testing, we can identify people who are immune and therefore no longer vulnerable to infection. While we need to better understand the strength of the immune response in mild cases and how long people remain immune from reinfection, we know there is a period where most people will have sufficient antibodies to offer protection. People who are immune could:

  1. Return to work,
  2. Serve in high-risk roles such as those at the front lines of the health care system, and
  3. Serve in roles that support community functioning for people who are still physically distancing (e.g., the elderly who continue to quarantine at home).

To use serology in this way, serological assays are needed and should be widely available, accurate, rapid, and low cost. Such assays have already been developed by researchers, but they have not yet been fully validated and are not available at scale.

A task force comprised of senior leaders from the CDC, the Biomedical Advanced Research and Development Authority, the National Institute of Allergy and Infectious Diseases, the Department of Defense (DOD), the FDA, academia, and key private-sector groups (e.g., serological manufacturing companies) should be tasked to oversee the development, production, distribution, data collection, serological survey designs, and analytics for use of serology at scale.29

Trigger for Moving to Phase III

Once a vaccine has been developed, has been tested for safety and efficacy, and receives FDA emergency use authorization,30 states can move to Phase III.

Phase III: Establish Protection Then Lift All Restrictions

Once a robust surveillance sentinel system is in place, coupled with widespread point-of-care testing and a robust ability to implement tracing, isolation, and quarantines—and this is supported by the availability of therapeutics that can help mitigate the risk of spread or reduce serious outcomes in those with infections—or alternatively a vaccine has been developed and tested for safety and efficacy, we can enter Phase III. The availability of these technologies (and eventually a safe and effective vaccine) will have economic and social benefits, in addition to health benefits.

Goals

The goals of safe and effective technologies for controlling transmission are to:

  1. Prevent infection;
  2. Treat those with early disease to prevent bad outcomes;
  3. Provide a prophylaxis for those exposed to infection to prevent them from developing disease or reduce its severity;
  4. In the case of a vaccine, build population-level immunity to the virus in order to reduce illness and death and stop or greatly slow spread; and
  5. Enable the lifting of all physical distancing measures.

Thresholds for Action

Trigger to Begin Manufacturing Scale-Up and Vaccine or Therapeutic Prioritization Planning. As soon as a vaccine or therapeutic looks promising in pivotal clinical trials (i.e., it has been shown to be safe and looks like it will also be effective),31 the US government should work with industry to begin planning for mass manufacturing, distribution, and administration. New provisions enacted under the recently passed the Coronavirus Aid, Relief, and Economic Security Act allow for large-scale manufacturing of promising therapies, in advance of approval, to help make sure there will be adequate supply available for mass distribution, should a product demonstrate that it is safe and effective and win regulatory approval.

Trigger for Switch Toward Mass Vaccination. Once availability of a vaccine or therapeutic is able to meet demand, vaccination can expand beyond priority groups. The CDC, state public-health agencies, and vaccine developers should work together to plan for and execute mass vaccination of large populations in the US. This planning can begin before Phase III because preparation can be made regardless of vaccine availability.

Steps to Take in Phase III

Vaccine or Therapeutic Production. Once a safe and effective vaccine or therapeutic has been licensed, it will need to be quickly manufactured at scale. The Public Health Emergency Medical Countermeasures enterprise,32 in coordination with pharmaceutical companies and other private-sector stakeholders, should continue to plan for and implement mass production capable of quickly meeting US demand.

Vaccine or Therapeutic Prioritization—When Supply Is Still Limited. The CDC, the National Institutes of Health, the Office of the Assistant Secretary for Preparedness and Response, the DOD, and other stakeholders should revise prior influenza vaccine prioritization guidance to apply specifically to COVID-19.33 The new prioritization guidance for the COVID-19 vaccine should identify priority groups for targeted distribution when a safe and effective vaccine starts to become available. The guidance should be transparent and explain the reasoning for priorities, including the populations in which the vaccine was studied, and should be a phased approach that expands to additional priority groups as vaccine availability expands. The guidance should be reflected in COVID-19 payment policies implemented by the Centers for Medicare & Medicaid Services (CMS) and private insurers, with treatment available at no cost to individuals who meet the priority guidance and a mechanism for reimbursement for individuals who are uninsured.

Mass Vaccination or Therapeutic Distribution—When Supply Is Abundant. The CDC should work with state and local health officials, health care providers, CMS and health insurers, and other public-health stakeholders to create a national plan for how mass vaccination will be carried out across the country. This plan should identify who will administer vaccinations, where vaccines will be offered, and how data will be collected on vaccination rates, as well as possible adverse events from the vaccine. Indemnification of vaccine developers and manufacturers should also be considered. Congress could enact legislation to support a process for compensation of any individual who has an adverse event from the vaccine, which requires medical care.

Global Vaccine Scale-Up and Vaccination. The CDC, the US Agency for International Development, the State Department, and other US stakeholders should continue to work with WHO and other international organizations and national leaders to plan for how the US will assist other countries (particularly low- and middle-income countries) with obtaining vaccine and implementing mass vaccination. Support from the United States and higher-income nations will be critical for controlling the virus globally and saving lives around the world, as well as reducing the impact that future waves of the pandemic may have on the US population.

Serological Surveys to Determine Population Immunity. One key input for understanding the population at risk is the fraction of the population who have recovered and are protected against reinfection. If a sufficiently high fraction of the population has become immune either through natural recovery or vaccination, remaining restrictions can be lifted. The CDC should be the lead agency for coordinating ongoing serological surveys.

Phase IV: Rebuild Our Readiness for the Next Pandemic

The COVID-19 pandemic has exposed serious gaps in our nation’s pandemic preparedness. COVID-19 will not be the last public-health emergency to threaten American society. We must invest in the scientific, public-health, and medical infrastructure needed to prevent, detect, and respond to the next infectious disease threat.

Develop Vaccines for Novel Viruses in Months, Not Years. In response to COVID-19 and in preparation for the next previously unidentified health threat (“Disease X”34), the United States should lead the way by setting an ambitious goal of rapidly developing medical countermeasures for novel or unknown threats in months, not years. A dedicated strategy, program, and funding will be needed to create the ability at existing agencies within the US Department of Health and Human Services and DOD to quickly develop flexible platforms and countermeasures for any type of novel pathogen.35 This strategy should include supporting flexible manufacturing capacity to scale up production to a global level in an emergency.

Modernize and Fortify the Health Care System. We must improve our hospital-bed and ICU capacity to accommodate large surges of patients through public-private partnerships, for example, by enhancing the Hospital Preparedness Program36 and the Public Health Emergency Preparedness Cooperative Agreement37 and emphasizing preparedness in federal health care programs (e.g., the CMS38 and the Department of Veterans Affairs39). We must also expand the supply chain of personal protective equipment and further the development of crisis standards of care. To reduce future burdens on our critical-care systems, we must also support our primary and community care capabilities to identify populations at elevated risk, detect cases early, and manage them at home or in the community more effectively. Health care payers have been implementing payment reforms to support better screening and population health management. Emergency supplemental payments to health care providers in the current pandemic and future health care payments should be linked to establishing better surge capacity for severe cases and stronger capabilities to partner with public-health authorities to contain outbreaks and reduce the burden on hospitals.

Establish a National Infectious Disease Forecasting Center. Given the important role of infectious disease modeling in supporting public-health decision-making, we should increase our nation’s capacity to use infectious disease modeling40 to support public-health decision-making by establishing a national infectious disease forecasting center. This permanent federal institution would function similarly to the National Weather Service, providing a centralized capability for both producing models and undertaking investigations to improve methods used to advance basic science, data science, and visualization capabilities. It would also provide decision support to public-health agencies based on modeling and analytic results.

Governance. We need to move away from a decentralized system that promotes unequal implementation of preparedness measures across the nation and toward a more coordinated execution of response. We should develop clear and effective plans for the implementation of public-health measures such as quarantine and the unification of actions made by state and local health departments. Outbreaks are matters of regional—and more typically national—concern. Preparedness for public-health emergencies should be elevated as a function in the White House, with a coordinating function analogous to the director of national intelligence.

Acknowledgments

The authors are grateful for policy input and review of the document by Anita Cicero, JD; Thomas Inglesby, MD; Eric Toner, MD; Elena Martin, MPH; Dylan George, PhD; Jason Asher, PhD; and Trevor Bedford, PhD.

About the Authors

Scott Gottlieb is a resident fellow at the American Enterprise Institute and was the Food and Drug Administration commissioner from 2017 to 2019. He serves on the boards of Pfizer Inc. and Illumina.

Mark McClellan, who directs the Duke-Margolis Center for Health Policy, was commissioner of the Food and Drug Administration from 2002 to 2004. He is an independent board member at Alignment Health Care, Cigna, Johnson & Johnson, and Seer. He is a co-chair of the Health Care Payment Learning and Action Network and receives advisory fees from Arsenal Capital, CRG, and Mitre.

Lauren Silvis is a senior vice president at Tempus Inc. and was previously the deputy director of the Food and Drug Administration’s medical device center and the agency’s chief of staff from 2017 to 2019.

Caitlin Rivers is an epidemiologist and assistant professor at the Johns Hopkins Center for Health Security.

Crystal Watson is a health security expert and assistant professor at the Johns Hopkins Center for Health Security.

Notes

1. White House, “15 Days to Slow the Spread,” March 16, 2020, https://www.whitehouse.gov/articles/15-days-slow-spread/.

2. White House, “15 Days to Slow the Spread.”

3. Centers for Disease Control and Prevention, “How Coronavirus Spreads,” March 4, 2020, https://www.cdc.gov/coronavirus/2019-ncov/prevent-getting-sick/how-covid-spreads.html.

4. Institute of Medicine, Crisis Standards of Care: Summary of a Workshop Series (Washington, DC: National Academies Press, 2010), https://www.ncbi.nlm.nih.gov/books/NBK32749/.

5. Centers for Disease Control and Prevention, “Interim US Guidance for Risk Assessment and Public Health Management of Persons with Potential Coronavirus Disease 2019 (COVID-19) Exposures: Geographic Risk and Contacts of Laboratory-Confirmed Cases,” March 22, 2020, https://www.cdc.gov/coronavirus/2019-ncov/php/risk-assessment.html.

6. Sarah Mervosh, Denise Lu, and Vanessa Swales, “See Which States and Cities Have Told Residents to Stay at Home,” New York Times, March 28, 2020, https://www.nytimes.com/interactive/2020/us/coronavirus-stay-at-home-order.html.

7. Qun Li et al., “Early Transmission Dynamics in Wuhan, China, of Novel Coronavirus–Infected Pneumonia,” New England Journal of Medicine 382 (March 2020): 1199–207, https://www.nejm.org/doi/full/10.1056/NEJMoa2001316.

8. Centers for Disease Control and Prevention, “Interim US Guidance for Risk Assessment and Public Health Management of Persons with Potential Coronavirus Disease 2019 (COVID-19) Exposures.”

9. During the 2017–18 flu season (which was particularly severe), there were 18,000,000–27,000,000 medical visits for influenza-like illness spread out over approximately 32 weeks, averaging 562,000–844,000 visits per week. However, those visits were not evenly distributed throughout the season, and peak demand was higher, so we estimate a national capacity of approximately 750,000 would meet demand. South Korea has tested 1 in 170 people, cumulatively. To do the same, we would need to test 1.9 million people, which we could achieve in around 2.5 weeks with a capacity of 750,000/week.

10. Neil A. Halpern and Kay See Tan, “U.S. ICU Resource Availability for COVID-19,” Society of Critical Care Medicine, March 25, 2020, https://sccm.org/getattachment/Blog/March-2020/United-States-Resource-Availability-for-COVID-19/United-States-Resource-Availability-for-COVID-19.pdf.

11. Preliminary research suggests that a Wuhan-like outbreak in the United States would require 2.1 to 4.9 critical care beds per 10,000 adults. However, a majority of those beds are in use for non-COVID-19 patients requiring critical care for other conditions. We estimate that approximately 5–7 beds per 10,000 adults would accommodate both patient groups. Ruoran Li et al., “The Demand for Inpatient and ICU Beds for COVID-19 in the US: Lessons from Chinese Cities” (working paper, March 16, 2020), https://www.medrxiv.org/content/10.1101/2020.03.09.20033241v2.full.pdf.

12. Halpern and See Tan, “U.S. ICU Resource Availability for COVID-19.”

13. Halpern and See Tan, “U.S. ICU Resource Availability for COVID-19.”

14. Centers for Disease Control and Prevention, “Interim Infection Prevention and Control Recommendations for Patients with Suspected or Confirmed Coronavirus Disease 2019 (COVID-19) in Healthcare Settings,” March 19, 2020, https://www.cdc.gov/coronavirus/2019-ncov/infection-control/control-recommendations.html.

15. Centers for Disease Control and Prevention, “Discontinuation of Home Isolation for Persons with COVID-19 (Interim Guidance),” March 16, 2020, https://www.cdc.gov/coronavirus/2019-ncov/hcp/disposition-in-home-patients.html.

16. Centers for Disease Control and Prevention, “Interim US Guidance for Risk Assessment and Public Health Management of Persons with Potential Coronavirus Disease 2019 (COVID-19) Exposures.”

17. Centers for Disease Control and Prevention, “Travelers Returning from International Travel,” March 27, 2020, https://www.cdc.gov/coronavirus/2019-ncov/travelers/after-travel-precautions.html.

18. Centers for Disease Control and Prevention, “Healthcare Professionals: Frequently Asked Questions and Answers,” March 22, 2020, https://www.cdc.gov/coronavirus/2019-ncov/hcp/faq.html.

19. Shuo Feng et al., “Rational Use of Face Masks in the COVID-19 Pandemic,” Lancet, March 20, 2020, https://www.thelancet.com/journals/lanres/article/PIIS2213-2600(20)30134-X/fulltext.

20. Kylie E. C. Ainslie et al., “Report 11: Evidence of Initial Success for China Exiting COVID-19 Social Distancing Policy After Achieving Containment,” Imperial College COVID-19 Response Team, March 24, 2020, https://www.imperial.ac.uk/media/imperial-college/medicine/sph/ide/gida-fellowships/Imperial-College-COVID19-Exiting-Social-Distancing-24-03-2020.pdf.

21. World Health Organization, Non-Pharmaceutical Public Health Measures for Mitigating the Risk and Impact of Epidemic and Pandemic Influenza, 2019, https://apps.who.int/iris/bitstream/handle/10665/329438/9789241516839-eng.pdf.

22. Institute of Medicine, Crisis Standards of Care.

23. Centers for Disease Control and Prevention, “Interim US Guidance for Risk Assessment and Public Health Management of Persons with Potential Coronavirus Disease 2019 (COVID-19) Exposures.”

24. Feng et al., “Rational Use of Face Masks in the COVID-19 Pandemic.”

25. Centers for Disease Control and Prevention, “Schools, Workplaces & Community Locations,” March 21, 2020, https://www.cdc.gov/coronavirus/2019-ncov/community/index.html.

26. Centers for Disease Control and Prevention, “People Who Are at Higher Risk for Severe Illness,” March 26, 2020, https://www.cdc.gov/coronavirus/2019-ncov/need-extra-precautions/people-at-higher-risk.html.

27. Centers for Disease Control and Prevention, “Preparing for COVID-19: Long-Term Care Facilities, Nursing Homes,” March 21, 2020, https://www.cdc.gov/coronavirus/2019-ncov/healthcare-facilities/prevent-spread-in-long-term-care-facilities.html.

28. National Cancer Institute, “NCI Dictionary of Cancer Terms,” s.v. “monoclonal antibody,” https://www.cancer.gov/publications/dictionaries/cancer-terms/def/monoclonal-antibody.

29. Centers for Disease Control and Prevention, “Coronavirus (COVID-19),” https://www.cdc.gov/coronavirus/2019-ncov/index.html; US Department of Health and Human Services, “BARDA’s Novel Coronavirus Medical Countermeasure Portfolio,” March 25, 2020, https://www.phe.gov/emergency/events/COVID19/Pages/BARDA.aspx; National Institute of Allergy and Infectious Diseases, https://www.niaid.nih.gov/; US Department of Defense, “Coronavirus: DOD Response,” https://www.defense.gov/Explore/Spotlight/Coronavirus/; and US Food and Drug Administration, “Coronavirus Disease 2019 (COVID-19),” https://www.fda.gov/emergency-preparedness-and-response/counterterrorism-and-emerging-threats/coronavirus-disease-2019-covid-19.

30. US Food and Drug Administration, “Emergency Use Authorization,” https://www.fda.gov/emergency-preparedness-and-response/mcm-legal-regulatory-and-policy-framework/emergency-use-authorization.

31. US Food and Drug Administration, “Step 3: Clinical Research,” https://www.fda.gov/patients/drug-development-process/step-3-clinical-research#Clinical_Research_Phase_Studies.

32. US Department of Health and Human Services, “Public Health Emergency Medical Countermeasures Enterprise,” January 29, 2020, https://www.phe.gov/Preparedness/mcm/phemce/Pages/default.aspx.

33. Centers for Disease Control and Prevention, Interim Updated Planning Guidance on Allocating and Targeting Pandemic Influenza Vaccine During an Influenza Pandemichttps://www.cdc.gov/flu/pandemic-resources/pdf/2018-Influenza-Guidance.pdf.

34. World Health Organization, “Prioritizing Diseases for Research and Development in Emergency Contexts,” https://www.who.int/activities/prioritizing-diseases-for-research-and-development-in-emergency-contexts.

35. Johns Hopkins Bloomberg School of Public Health, Center for Health Security, Vaccine Platforms: State of the Field and Looming Challenges, 2019, https://www.centerforhealthsecurity.org/our-work/pubs_archive/pubs-pdfs/2019/190423-OPP-platform-report.pdf.

36. US Department of Health and Human Services, “Hospital Preparedness Program (HPP),” https://www.phe.gov/Preparedness/planning/hpp/Pages/default.aspx.

37. Centers for Disease Control and Prevention, “Public Health Emergency Preparedness (PHEP) Cooperative Agreement,” March 27, 2020, https://www.cdc.gov/cpr/readiness/phep.htm.

38. Centers for Medicare & Medicaid Services, “Coronavirus (COVID-19) Partner Toolkit,” March 27, 2020, https://www.cms.gov/outreach-education/partner-resources/coronavirus-covid-19-partner-toolkit.

39. US Department of Veterans Affairs, “Coronavirus FAQs: What Veterans Need to Know,” https://www.va.gov/coronavirus-veteran-frequently-asked-questions/.

40. Johns Hopkins Bloomberg School of Public Health, Center for Health Security, Modernizing and Expanding Outbreak Science to Support Better Decision Making During Public Health Crises: Lessons for COVID-19 and Beyond, 2020, https://www.centerforhealthsecurity.org/our-work/pubs_archive/pubs-pdfs/2020/200324-outbreak-science.pdf.

image by pasja1000 from Pixabay
Letter to the Editor, April 13, 2020: Delay tax increases until economy recovers

This letter re-posted from The Richmond Times-Dispatch.

Delay tax increases until economy recovers

Editor, Times-Dispatch:

The op-ed column by Del. Dave LaRock, R-Loudoun, “We can do this; Gov. Northam can help,” was insightful and on target. One suggestion to Gov. Ralph Northam was to postpone for 12 to 18 months any legislation that imposes regulatory or financial burdens on Virginians or their businesses, including tax increases at the state or local levels. These impactful decisions should only be made after the full economic impact of the virus is known.

There are two proposed tax increases that I find hurtful: fuel taxes and tobacco taxes. Fuel taxes hurt tourism to our state, which impacts restaurants, hotels, parks, beaches, etc. These entities already have been decimated by the virus and will need help to reopen. Tobacco taxes hurt farmers, tobacco workers and convenience stores the most. Tobacco has helped Virginia’s economy for 400 years. Philip Morris USA donated an $8 million property to Richmond Public Schools and in return, the city increased taxes on cigarettes and now the state wishes to impose more. Both taxes bite the hands that help us.

The RTD’s Michael Martz reported that the General Assembly still intends to meet April 22 to take up amendments on winter session legislation. They should cancel the session and stay at home as per Northam’s own order. There is no way that Secretary of Finance Aubrey Layne, Northam chief of staff Clark Mercer or the governor himself can accurately predict where the economy will be in two weeks, much less two months. Postpone and give us a break.

Bob Putney.

Richmond.

Virginia Gun Control – Northam Signs Sweeping Laws

The Second Amendment takes yet another hit in Virginia.

By: Scott D. Cosenza, Esq. April 11, 2020

This article re-posted with permission from Liberty Nation.

Ending a month’s long battle over gun rights in Virginia, Governor Northam signed five new laws on Friday. The gun control struggle started after Democrats gained control over the government in November and was settled Friday. In July, when the new laws take effect, Virginia will go from being a pro-gun jurisdiction to something far less than that. But will it be a Pyrrhic victory?

Governor Northam announced that:

We lose too many Virginians to gun violence, and it is past time we took bold, meaningful action to make our communities safer… I was proud to work with legislators and advocates on these measures, and I am proud to sign them into law. These commonsense laws will save lives.”

And if they don’t?  Opposition to the laws is not just by those who would have liberty at the cost of safety, but see the new restrictions as harmful to both. Virginia Institute for Public Policy president Lynn Taylor* said, “[t]hese laws will make Virginians less safe, not more.” Her group advocates for free markets and individual liberty, and she was particularly concerned about the new “Red Flag” law.

This law, known colloquially as a red flag law, is called an Extreme Gun Violence Protection Order in Virginia. It provides for a new kind of court order that removes the gun rights of people without traditional safeguards for due process. While accused criminals have a bundle of rights to protect them from the state, these laws operate under the fiction that they are civil orders, allowing the state to run roughshod over the people. Taylor foresees a future where people are denied their fundamental rights and may act violently in response. She said the measure would “likely set off more conflict than it will cure, all the while decreasing the liberty of Virginians.”

Private Sales

Another measure prevents Virginians from selling guns to one another privately. The people will now have to get government permission and go to a gun store to complete any transfer. While these types of laws are often the easiest to sell to people outside the gun culture, in today’s lockdown society, we can easily see why they may be damaging to liberty. When the government asserts the power to require you to transfer guns only at gun stores, and then forces gun stores to remain closed, the problem becomes apparent.

Gun rights advocates have fought against the imposition of the new laws, leading a nationwide backlash against the Virginia legislature. Their efforts were not sufficient to prevent the passage of these laws, but they are far from defeated. Liberty Nation spoke with the president of the Virginia Citizens Defense League**, Philip Van Cleave, who coordinated the effort to stop the bills in the first place, claimed the legislation was an “attack on law-abiding people,” and that gun owners are sick of it. He was happy they got the worst of the legislation killed (a ban on “assault weapons”), and that what did pass was “watered down.”

The Next Battle

Now the fight will move forward on two fronts, in the courts, and the ballot box. Mr. Van Cleave went on to say that the group will be challenging much of the new legislation in court, as they plan to sue the commonwealth in short order. On the political front, the new legislators who won in November of 2019 should expect to have a much more difficult path to victory in 2021, seeking re-election. Gun rights advocates have long memories and a penchant for single-issue voting. That’s not all – the gun rights leader thinks President Trump may now see a significant bump in support for his re-election in Virginia. “They have awakened a sleeping giant.”

Other provisions passed include a one handgun per month purchase limit, new penalties for not reporting lost or stolen guns, and for allowing firearms to be unsecured in the presence of juveniles. Absent intervening action from the courts, most of these new laws become enforceable July 1.

*Ms. Taylor sits on the board of One Generation Away, the parent organization of Liberty Nation.

** The author has been a member of the VCDL

We can do this; Governor Northam can help

By Delegate Dave LaRock April 6, 2020

Column originally published in the Richmond Times-Dispatch

I hope you and your family are healthy and safe today. Few were prepared for what we are going through right now, but I know many of us are anxious about family members, jobs and our businesses. Despite all the bluster and politics, Virginia’s legislators are worried for both our families and yours. In considering what we can do to help Virginia make it through the COVID-19 fallout, there have been many promising suggestions.

To provide a little context, in October 1982, single-week unemployment claims spiked to an all-time high of 695,000 people — a record that even the 2008 recession failed to overturn. This was a scary time for America, but we had tough-minded people in key positions who were able to do what was necessary — Paul Volcker, Jimmy Carter and Ronald Reagan to name a few. Because of their efforts, America was able to forego quite a bit more pain than what the late 1970s and early 1980s could have inflicted.

In the week ending March 21, 2020, a record-setting 3,341,000 Americans filed initial claims for unemployment — roughly five times the record number from 1982. The advance figure for seasonally adjusted initial claims for the week ending March 28 was 6,648,000. In two weeks, 10 million Americans have lost their jobs. In Virginia, 160,000 of our friends and neighbors have become unemployed in the past two weeks. Don’t misunderstand, the point of this article is not to lament over the startlingly high number of people claiming unemployment, although these numbers are indicative of where we stand right this moment.

I am writing to call on those tough-minded men and women who are prepared to do what’s necessary to get Virginia through this crisis.

The budget passed in this past General Assembly session made certain rosy assumptions that can no longer be considered reasonable. Most importantly, these assumptions led the commonwealth to forecast a 17% cumulative growth in revenue between fiscal years 2019 and 2022 — very rosy, indeed. I think we can agree that this projection is unlikely at best, if not impossible.

Virginia Secretary of Finance Aubrey Layne recently forecast that we will take a $1 billion hit to state revenues. That’s a shortfall of approximately 3%, which fits well with those reports from early March suggesting that we might see a contraction of 3% to 5% of gross domestic product (GDP). Unfortunately, those forecasts have since been updated to indicate the contraction is expected to be between 10% and 25% of GDP. At this point in time, a $1 billion shortfall in Virginia state revenues appears too optimistic.

I think you know what I am getting at here. Our biennial budget, as it stands today, is frankly impossible to fund, much less to balance. This is not the position we, as a state, want to be in, particularly considering our rainy day fund is $1.9 billion (76%) underfunded, the state pension plan is $19 billion (22%) underfunded, and four of the six state postemployment funds — known as other post-employment benefits (OPEB) — are underfunded from a low of 17% to as much as 87% (this last figure being particular to health care funding for retired teachers). What’s the solution? This might be the simplest answer of this whole mess: There are two specific actions Gov. Ralph Northam should take.

First, deal with legislation recently passed; the governor should add a re-enactment clause to any bill passed in the 2020 session that will impose additional regulatory or financial burdens on Virginians or their businesses, including any increased taxes at the state or local level.

This would mean the General Assembly will re-look at these bills in the 2021 session, once we see how our economy is faring. What might have seemed like a good idea in rosy economic times could easily intensify already tough times. Second, deal with state spending; considering the difficult times to come, the governor needs to offer amendments to begin shifting Virginia’s budget toward a preparatory stance. Specifically, state spending from the General Fund that is not essential should be made contingent on hitting specific revenue benchmarks as we move forward in the next 12 to 18 months. In other words, we spend the money we have, not the money we wish we had.

It’s time Virginia focuses on how COVID-19 is affecting our citizens first, and on our own pet projects second. Northam can make this happen and save us all an excess of heartache and anxiety. The longest economic expansion in history is over. The potential for suffering is high but preparation can help.

Recommendations to Governor Northam re: Virginia’s Solvency

Virginia Del. Dave LaRock’s letter to Gov. Northam (download pdf)

 

Virginia Passes Major Renewable Energy Legislation
Re-posted with permission from Heartland.org.
MARCH 24, 2020
The newly minted Democratic majority legislature in Virginia narrowly passed sweeping legislation designed to overhaul how the state’s utilities generate electricity, sending the bill on to Gov. Ralph Northam for his expected signature.

Multiple Mandates

The Clean Economy Act (CEA), passed March 6, essentially codifies the 100 percent carbon-dioxide-free energy goals outlined in an executive order from Gov. Ralph Northam in September 2019. It also strips the state’s utility regulators of much of their oversight authority over the regulation and approval of electric utilities and puts Virginia on the path to 100 percent renewable energy by 2050.

CEA “directs the [State Air Pollution Control Board] to adopt regulations establishing a carbon dioxide cap-and-trade program to limit and reduce the total carbon dioxide emissions released by electric generation facilities, which regulations shall comply with the Regional Greenhouse Gas Initiative [RGGI] model rule,” the legislation states.

RGGI is a cooperative agreement between Connecticut, Delaware, Maine, Maryland, Massachusetts, New Hampshire, New Jersey, New York, Rhode Island, and Vermont to cap and reduce carbon dioxide emissions from the power sector through regulation.

Preapproval Requirements

Aside from taking Virginia into RGGI, CEA would restrict the Virginia State Corporation Commission’s (SCC) traditional authority to approve new power generation facilities, barring it from approving “any investor-owned utility to own, operate, or construct any electric generating unit that emits carbon [dioxide] as a byproduct of combusting fuel to generate electricity” until the state legislature has had a chance to review a report concerning carbon dioxide emissions being undertaken by Virginia’s Air Pollution Control Board.

The bill also requires utilities and the SCC to consider the social cost of carbon when reviewing the need for a new generation facility.

As part of the effort to meet the target of producing all the state’s electricity from sources that emit no carbon dioxide during operation by 2050, the legislation sets targets for energy storage and offshore wind. The law requires the SCC to approve a minimum of 2.4 gigawatts (Gw) of new energy storage projects by 2035 and set interim targets for storage between now and then. In addition, CEA directs the SCC to expedite the approval of 5.2 Gw of offshore wind by the end of 2034.

The CEA also requires utilities to undertake programs, overseen by the SCC, to reduce the use of electricity by Virginians through conservation measures and programs. Under the bill, utilities should reduce their customers’ electricity use 5 percent below current levels by 2025 and maintain programs to continue reducing use thereafter.

Concerns Energy Costs

Before CEA’s final adoption, state officials warned about the cost of its renewable energy requirements to ratepayers, because offshore wind and battery storage are more expensive than traditional fossil fuel power plants or even other forms of renewable energy.

An analysis of a preliminary version of the bill conducted by the SCC concluded the typical residential household would likely see an increase of $23.30 per month on its monthly electric power bills between 2027 and 2030, solely attributable to the bill’s renewable energy requirements.

In testimony before a state Senate committee developing the bill, Attorney General Mark Herring’s (D) office expressed reservations the bill expressly calls for eliminating the SCC’s role in determining whether the “enormous costs” of implementing the bill’s provisions are reasonable and prudent and therefore can be passed on to ratepayers.

“In our view, the legislation will prevent the regulator from being able to work to accomplish the Commonwealth’s clean-energy goals in a manner consistent with ratepayer protections,” Meade Browder, a senior assistant attorney general, testified before the Senate.

Unnecessary, Premature Closures

CEA will shutter valuable power facilities with years of useful operating life remaining, all for no environmental gain, says Paul Driessen, a senior policy analyst with the Committee for a Constructive Tomorrow (CFACT).

“The Virginia bill would mean tearing down numerous generating stations that have many productive years remaining, and replacing them with hundreds of gargantuan offshore wind turbines, solar installations totaling several times the land area of Washington, D.C., and tens of thousands of Tesla-style backup batteries,” Driessen said. “The price of electricity for air conditioning, computing, cooking, heating, lighting, recharging cell phones and other mobile devices, refrigeration, and other costs will skyrocket for businesses, charitable organizations, churches, families, factories, government agencies, hospitals, and schools.

“The renewable energy technologies would require millions of tons of antimony, carbon fiberglass composites, concrete, copper, rare-earth elements, steel, and other raw materials mined on the cheap overseas with little attention to U.S. laws, regulations, or ethical standards for child labor, workplace safety, fair wages, air and water pollution, wildlife preservation, or mined land reclamation,” Driessen said.

‘Unregulated Corporate Protectionism’

Passage of the CEA reverses progress the legislature had been making to defend ratepayers from monopolistic practices, says Lynn Taylor, president of the Virginia Institute for Public Policy.

“This year there have been a number of promising bipartisan efforts within the General Assembly to regain control of the regional energy monopolies in Virginia,” Taylor said. “In lieu of reasonable reform, the legislature chose to support unregulated corporate protectionism.

“Virginians will ultimately be saddled with the environmental and financial costs of the governor’s poorly conceived ‘clean power’ act for years to come,” Taylor said. “In the long run, a dramatic expansion of nuclear power in Virginia may be the only fragmented solution to serious problems exacerbated by this act.”

Bonner R. Cohen, Ph.D. ([email protected]) is a senior fellow at the National Center for Public Policy Research and a senior policy analyst with CFACT.

Strict Voter Identification Laws, Turnout, and Election Outcomes

This research brief is republished with permission from CATO Institute.

February 19, 2020

By Mark Hoekstra and Vijetha Koppa

From 2000 to 2018, 20 states enacted voter identification requirements, bringing the total to 34 states. The most pronounced shift has been toward strict voter identification. While no states had such laws in 2000, 10 states had enacted (and sustained) such laws as of 2018. Under strict requirements, a vote is counted only if the voter produces a photo ID (in seven states) or nonphoto ID (in three states) within a specified period. These laws are controversial and have come under immense public and legal scrutiny. Proponents argue that these laws are necessary for protecting the election process from fraud and note that identification is required for other normal life activities. Critics argue that voter impersonation fraud is rare and that the laws are designed to disenfranchise low‐​income and minority voters. They also note that as many as 11 percent of American adults lack a valid photo ID required to vote and argue that there are significant costs and impediments associated with acquiring a valid ID. The purpose of this paper is to evaluate the potential effects of these strict voter identification laws on voter turnout and election outcomes

Assessing the causal impact of these laws is difficult for multiple reasons. The infrequency of elections, the recent enactment of these laws, and the fact that the vast majority of prospective voters have IDs make it difficult to evaluate the effects. In addition, ongoing legal challenges muddy the waters. For example, Texas’s strict voter law was enacted in May of 2011, struck down by a federal court in August of 2012, reinstated in June of 2013, struck down again in October of 2014, reinstated five days later, and ultimately struck down by the U.S. Court of Appeals for the Fifth Circuit in July of 2016. In 2017, Texas passed a nonstrict version of the law in which a voter without an ID could cast a provisional ballot and have it counted by signing an affidavit, bringing an end to the seven‐​year‐​long litigation. While Texas is perhaps an extreme example, the general legal ambiguity of these laws raises questions as to whether voters correctly perceived whether the law was in effect and what the law required.

To overcome these challenges, we take a novel approach toward addressing these laws’ impact on turnout and election outcomes. Rather than attempt to identify effects using a typical policy evaluation methodology, we carefully document how many people vote without IDs in states that do not (yet) have strict voter identification laws. Specifically, we use administrative voting records from Michigan and Florida to identify the size of the voting population that potentially could be either fraudulent (if you believe the laws’ proponents) or disenfranchised (if you believe the critics). Both Michigan and Florida have nonstrict voter identification laws, which means they ask for IDs from voters but have provisions through which votes may be cast and counted without voters actually producing IDs. Michigan counts votes cast by voters without IDs after they sign legal affidavits regarding their identities at the polls. Florida allows voters without IDs to cast provisional ballots and then counts the ballots if their signatures at the polls match those on their voter registration forms. Importantly for this study, because of these provisions, both states track the number of ballots cast by individuals who did not have IDs.

Using these data, we are able to record the number of votes cast by individuals without IDs. In doing so, we identify the maximum number of votes cast that might not have been cast and counted if a strict voter ID law were passed in these states. This enables us to show, under a variety of conservative assumptions, the maximum extent to which a strict voter ID law would reduce turnout or affect election outcomes. The strength of this approach is that it enables us to estimate the impact of a strict voter identification requirement without relying on assumptions regarding the counterfactual. In contrast, we identify clear upper bounds of the effect of the law on both turnout and election outcomes. We view this as the central contribution of our study.

The limitations of this approach are twofold. While we can clearly identify effects for potential laws if they are passed in the (large) states of Michigan and Florida, it is an open question as to whether the results would extend to other states. In particular, our results are most relevant for the more than 20 states that already have some voter identification laws in place; we would expect our results to be less relevant for the minority of states that have no voter identification requirements. In addition, while we expect our approach to overestimate effects, given that some people without an ID would acquire one if a law were passed, we do not account for effects on voters who already have the necessary ID. For example, we will not capture effects on those who falsely perceive that the law affects their ability to vote or those who are more likely to vote because they perceive an improvement in election integrity.

Results indicate that there is little scope for strict voter identification laws to affect voter turnout. This finding stems directly from the extremely small number of votes cast by individuals without IDs, even in settings where such votes are explicitly allowed and counted. Specifically, we show that a voter identification law would reduce turnout by no more than 0.06 percent in Florida and 0.2 percent in Michigan. This suggests that at least in these two states, very few voters without IDs choose to vote even when they can.

Unsurprisingly, the small effects on turnout imply that there are very few elections in our sample that could have been affected by a strict voter ID law. Even under the most extreme assumption — that all votes for the winner (and none for the runner‐​up) cast without an ID would be excluded under strict law — we estimate that a strict law could have changed the outcome in fewer than 0.35 percent of local elections and 0.09 percent of state and national elections in Florida. Similarly, we show that fewer than 0.55 percent of state and national elections in Michigan could have been affected. Estimates under more reasonable assumptions result in even smaller (and likely more accurate) potential electoral impacts. In short, the evidence presented here indicates that even if the worst fears of critics or proponents were true — that all those who would have voted without IDs are fraudulent or that all would be disenfranchised — it would have at most a tiny effect on election turnout and outcomes.

To our knowledge, this is the first paper to use administrative data to carefully document the number of voters who voted without IDs and the number of elections that could potentially be affected by strict voter identification laws. In doing so, it complements two other strands of literature on voter identification laws. The first has focused on estimating the number of people in the general population who lack the identification necessary to satisfy strict voter identification laws. Estimates are generally nontrivial, giving rise to concern about these laws’ potential effects. A national survey reports that nearly 7 percent of U.S. citizens did not have ready access to documents providing proof of citizenship and that as many as 11 percent of citizens lacked government‐​issued photo identification. Studies have also documented that the lack of identification is concentrated among those who are low‐​income, female (often due to name change after marriage), elderly, African American, or Hispanic. Similarly, the American National Elections Studies indicates that 7 percent of citizens lack a government‐​issued photo ID. The estimates in this paper do not necessarily imply that those estimates are overstated. Rather, it is possible that the vast majority of individuals without identification do not vote even in the absence of a strict ID requirement. This could be because they have little interest in voting or because they mistakenly believe that their vote will not be counted if they do not have an ID despite efforts by the states to make it clear that the votes count. Regardless, our results indicate that a change from a nonstrict voter ID law to a strict law — the margin over which the most‐​serious legal challenges have been raised — is unlikely to have a meaningful effect on voter turnout or election outcomes.

In addition, our paper also contributes to the literature that uses policy evaluation methodologies to identify the effects of these laws. Results from those studies are mixed, with some finding increased turnout and others finding significant declines. The advantage of our approach relative to these studies is that we can assess the prospective effects of the laws without making assumptions about the counterfactual.

Our results suggest that the practical importance of strict voter identification laws is likely overstated. Specifically, our findings indicate that unless voters without identification in other states vote at much higher rates than their counterparts in Michigan and Florida or unless the laws affect the voting of citizens who have IDs, the passage of these laws is unlikely to affect voting behavior and election outcomes.

NOTE:
This research brief is based on Mark Hoekstra and Vijetha Koppa, “Strict Voter Identification Laws, Turnout, and Election Outcomes,” NBER Working Paper no. 26206, August 2019, https:// www​.nber​.org/​p​a​p​e​r​s​/​w​26206.

Certificate of Need Laws Will Impede Preparedness For The Expected Surge in COVID-19 Cases

Republished with permission from CATO Institute.

March 11, 2020

By Jeffrey A. Singer

The number of confirmed cases of COVID-19 infection in the U.S. continues to increase. All indications are that we are now just seeing the tip of the iceberg. Hospitals across the country are gearing up for an anticipated deluge of sick patients in their emergency departments, and hospital admissions that will stress—and possibly overwhelm—their intensive care units and general bed capacity. In response to the outbreak in China, a 1,000-bed isolation hospital was constructed in just 10 days—a feat that would be difficult to replicate in this country with its web of federal, state, and local regulations.

In today’s Washington Examiner, Lindsey Killen of the Mackinac Center for Public Policy and Naomi Lopez of the Goldwater Institute draw attention to the archaic Certificate of Need Laws (CON laws) that continue to exist in 38 states. These state laws, promoted by the National Health Planning and Resource Act of 1974, were intended to reduce health care costs by eliminating redundancy in health care delivery systems. They vary from state to state, but essentially require a panel to review any plans by hospitals or other health care organizations to expand, build new hospitals, or in some cases, add equipment. The review panels include incumbent health care organizations. Imagine a CON law for restaurants that empanels existing restaurant owners to review applications by persons wishing to build a new restaurant or expand the capacity or offerings of an existing one. It doesn’t take long to understand how that turns into an incumbent protection law. By the early 1980s it became clear, as in all cases of central planning, that CON laws were doing nothing to reduce health care costs and may have had the opposite effect. The federal law was repealed during the Reagan Administration.

More than 3 decades after repeal of the federal law, CON laws persist in 38 states and attempts to reform or repeal them are often met by fierce resistance from incumbents who try to make the case that they only have the interests of the general public in mind. If the expected surge in COVID-19 cases exceeds the capacity of hospitals and emergency rooms, resulting in avoidable deaths, at least some of the blame belongs to CON laws, an example of central planning reminiscent of the “5‑year plans” of the Soviet politburo.

Killen and Lopez alert readers to a paper released last week by the Goldwater Institute’s Christina Sandefur, entitled Competitor’s Veto: State Certificate of Need Laws Violate State Prohibitions on Monopolies,” that makes the case that, in addition to the economic and public health consequences of these outdated laws, CON laws violate state constitutions.

A public health crisis such as the one that now confronts us provides an opportunity to review and repeal laws and regulations that impede preparedness. Certificate of Need Laws are low hanging fruit.

Bloomberg Privately Funds Attorneys in State AG Offices While Running for President

Posted to Politics February 16, 2020 by 

Republished from InsideSources.com

Michael Bloomberg’s billions aren’t just buying ads. In at least two Super Tuesday states, his money funds private lawyers working inside attorneys general offices, advancing his political agenda on the environment.

One Democrat AG compares accepting this private funding from a political candidate with federal funding from “President Trump’s” Department of Justice.

Bloomberg Philanthropies gave $6 million in 2017 to create the New York University School of Law’s Environment and Energy State Impact Center to provide lawyers to state attorneys general whose sole focus would be on environmental and climate change lawsuits and regulatory actions.

Massachusetts and Minnesota, whose Democratic voters will go to the polls on Super Tuesday, are among at least 10 states where activist attorneys are working for the state AGs offices but are paid through the Impact Center. Their mission is to promote state legal action to advance Bloomberg’s political views, such as lawsuits against energy companies.

“Candidates who are approved by the attorneys general and the State Impact Center will receive offers to serve as SAAGs (or the equivalent appropriate title within the office) from the attorneys general, based on an understanding that they will devote their time to clean energy, climate change and environmental matters,” Impact Center Executive Director David J. Hayes wrote in an email inviting attorneys general to apply for the program.

Hayes is a former deputy secretary and chief operating officer of the Department of the Interior for Presidents Clinton and Obama.

The email, obtained by Climate Litigation Watch, was sent to attorneys general offices in California, Hawaii, Illinois, Kentucky, Maine, Mississippi, New Mexico, Oregon, Rhode Island, Vermont, Virginia, Washington, and Washington, D.C., on Aug. 25, 2017. The email noted that the State Impact Center would pay the law fellows’ salaries and explained that each would be an experienced attorney in environmental or related law.

New York participates in the program, and in December lost what environmental activists had dubbed “the trial of the century” against ExxonMobil. Originally brought by former Attorney General Eric Schneiderman, the three-week trial ended with state Supreme Court Justice Barry Ostrager ruling that the energy giant had neither misled investors about the impact of climate change nor broken any state laws.

In the run-up to the trial, lawyers for ExxonMobil objected to what they saw as a conflict of interest in having “two employees of private parties who are currently working in the [New York] Attorney General’s Office … selected and paid for by private interests who were pursuing an agenda” involved in the case, according to a court transcript. ExxonMobil attorney Justin Anderson said the lawyers are “compensated entirely by this third-party … that’s funded by Michael Bloomberg’s philanthropy.”

Kevin Wallace, acting chief for the Investor Protection Bureau for the New York Attorney General, accused ExxonMobil of “picking on an individual, a young lawyer.” Emails from Maryland Attorney General Brian Frosh obtained by Climate Litigation Watch, however, indicate that the legal fellows are experienced attorneys.

“Do you know anyone five to 10 years out of school who would be interested in saving the planet from the predations of [former  EPA Administrator] Scott Pruitt and [former Interior Secretary] Ryan Zinke?” Frosh emailed to the dean of Yale Law School. Frosh served as a recruiter for the State Impact Center program, frequently exchanging emails with Hayes.

A spokesman for the State Impact Center declined to answer questions about the program, including whether anyone other than Bloomberg Philanthropies has provided funds for the legal fellows program. The spokesman also declined to comment on whether there was a conflict of interest with Bloomberg running for president while funding assistant attorneys general in at least 10 offices.

“The nonpartisan State Energy & Environmental Impact Center at the NYU School of Law brings academic rigor and independence to its mission of supporting state attorneys general who are protecting existing environmental regulations, addressing climate change and respecting the law,” spokesman Tom Lalley said in an email. He also declined to name any participating attorneys general who are Republicans to back up the “nonpartisan” description of the program.

Most of the attorneys general offices known to be participating in the program declined to comment either on the program or on the potential conflicts of interest accepting funding from Bloomberg Philanthropies.

Massachusetts Attorney General Maura Healey, whose office participates in the program, is suing ExxonMobil in a case that bears several similarities to New York’s. Healey’s office declined to comment.

A spokesman for New Mexico Attorney General Hector Balderas compared private money given through an individual’s foundation to federal tax dollars.

“Our office accepts fiscal support from President Trump by way of the Department of Justice, as well as NYU, because the Attorney General is independent and only focused on representing the interests of New Mexico,” said spokesman Matt Baca.

Although Bloomberg is a late entrant to the Democratic presidential primary, he has already far outspent his opponents. According to Advertising Analytics, he has spent $209.3 million on broadcast television, $13.7 million on cable, $1.1 million on radio, and $27.2 million on digital ads. His Super Bowl ad reportedly cost $10 million.

Bloomberg’s campaign is entirely self-financed, and he is presenting himself as a centrist in a field crowded with candidates from the progressive left. The Democratic National Committee recently dropped a requirement that candidates receive a minimum number of donors to qualify for debates, prompting an outcry from some former candidates who were unable to meet the arbitrary thresholds that Bloomberg was using to buy his way to the nomination. Bloomberg skipped the Iowa Caucuses to focus on Super Tuesday states.

Steve Milloy, founder of JunkScience.com and a senior fellow with the Energy & Environment Institute, severely criticized Bloomberg’s donations to New York University and the legal fellows program.

“God help anyone on the right who tried to do that,” Milloy said. “The Left and allies in the [mainstream media] would be in total outrage mode if they discovered that the NRA or pro-life movement had funded state AGs to carry out the groups’ political agenda.”

A spokeswoman for the NRA scoffed at the privately funded program.

“No one should be surprised,” said spokeswoman Amy Hunter. “This is yet another example of billionaire Michael Bloomberg using his money to impose his personal agenda on the American people. He wants to be emperor of America, and make every citizen his subject.”

Independent Institute’s List of Books on the Folly of Socialism

What everyone should know about the practical and moral failures of the socialist project

March 11, 2020

Republished with permission from Independent Institute.

(Oakland, CA)—A list of about forty books on the folly of socialism has been downloaded thousands of times and has been endorsed by economists, scholars, and journalists around the world.

More than 30 years after Soviet premier Mikhail Gorbachev implemented reforms that helped burn the ideal of a planned economy to the ground, socialist doctrines are once again gaining in popularity, especially among young people.

The list was compiled by Independent Institute Senior Fellow Williamson Evers, Ph.D., who offers this “counter curriculum” highlighting some of the most insightful critiques of socialism ever written. The list of books highlights the necessity of competition and voluntary free markets, rather than coercive monopolies of industries such as energy, banking, and technology in a socialist society.

“If you can read just one book on this list, then make it Red Plenty, by Francis Spufford,” says Evers. “If you can read only two, make your second pick Socialism: An Economic and Sociological Analysis, by Ludwig von Mises.”

Evers tells young people enamored with Scandinavian-style socialism, that most so-called democratic socialist countries are actually capitalist countries with high income taxes but also with no price controls such as minimum wage laws, and actually have freer trade than the United States in many cases. Real socialism, says Evers, usually promises the public that it will be democratic socialism, but soon puts into effect dictatorship and the crushing of constitutional liberties.

Books on the list include; The Gulag Archipelago, by Alexander I. Solzhenitsyn, Nineteen Eighty-Four, by George Orwell, and The Road to Serfdom, by F. A. Hayek.

The complete list of books can be found at this link on the Independent Institute’s website.

State Versus Federal Licensure in Telemedicine

Published on InsideSources December 23, 2019 by

State Versus Federal Licensure in Telemedicine

Telemedicine challenges the established order of medical licensure in the United States. Medical treatment with a physician in one place and a patient in another raises questions about the efficiency and constitutionality of state-by-state licensure.

Generally, a physician can only practice medicine in states where he or she holds a medical license, regardless of whether the doctor and patient are meeting in person or via electronic means (video conferencing, remote monitoring, online prescriptions, asynchronous consultation, email, or telephone conversations). Some states have partially lowered state-line barriers via mechanisms like the Interstate Medical Licensure Compact.

Fragmentary licensing makes it difficult for telemedicine providers to serve the entire country. A recent CNBC article said that a doctor who wished to practice telemedicine across the entire United States would have to spend around $90,000 and countless hours to obtain licenses in every state—followed by permanent efforts to maintain the licenses.

To minimize queuing and capture economies of scale, it’s important for telemedicine providers to have broad, multistate reach. If I take ill at night while a flu epidemic rages here in Virginia, I might have difficulty reaching an overburdened Virginia telemedicine doctor. But, with access to doctors in all 50 states, there’s a far better chance that I’ll get rapid, potentially lifesaving service. State-by-state licensing inhibits this capability. Presumably, nationwide reach also increases competition, with the potential for cost reduction and quality improvement.

I live in Virginia, and it’s perfectly fine for me to visit a doctor in Texas. However, if I wished to consult with the same doctor via video link from Virginia, the doctor would presumably require a Virginia license as well as a Texas license. Present-day law somewhat arbitrarily presumes that an encounter occurs where the patient sits—not where the doctor sits.

And suppose I engage with the Texas doctor while I’m visiting Florida and the doctor is in Hawaii? Is our encounter deemed to occur in Virginia, Texas, Florida, or Hawaii? Perhaps there’s a simple legal answer, but I’ve raised the question before enough audiences to think the answer isn’t crystal-clear.

Telemedicine adds a powerful new element to America’s health care system. It provides near-instantaneous access to care from any location, at any time, on any day. Cost-benefit analysis requires us to ask how often state-by-state licensing prevents, delays, or heightens the cost of care, along with asking whether state-by-state licensing somehow protects patients better than, say, a regime of national licensing.

This matters, because telemedicine increases access to care in ways that were unimaginable before the digital era. Imagine a Spanish-speaking migrant family whose child becomes ill on a remote ranch in the middle of the night. With telemedicine, a cellphone allows them to reach a Spanish-speaking doctor within minutes. Think of the access challenges faced by members of other linguistic minorities, Native Americans on reservations, people with mobility problems, people in neighborhoods lacking public transportation, those busy with work and childrearing, and individuals who take ill at odd hours and in isolated places.

I once wrote about a physician who saved a woman’s life because she was able to call him at night from her home, rather than waiting for a regular in-person appointment. At age 92, my own mother likely survived a potentially fatal illness because her grandson, a physician, recognized her illness in the course of a social video call on FaceTime. Ever since, I’ve thought that one shouldn’t require a physician in the family to enjoy such care.

When state-by-state medical licensing was devised, these weren’t issues. If you saw a doctor, you were face-to-face in the same state. Telephone calls or mail would likely have been the only potential exceptions. But today, sophisticated communication at a distance is omnipresent in our lives.

There is virtue in the principle of allowing states to manage economic activity within their individual boundaries—“laboratories of democracy,” in the words of Justice Louis Brandeis. But there is also virtue in erasing those lines for some purposes, a principle enshrined in the Constitution’s interstate commerce clause. Philosophically, I grapple with the tension between these two principles. I also wonder whether that tension may ultimately find its resolution at the Supreme Court.

VIPP President Speaks in Support of the Virginia Energy Reform Act

Virginia Institute for Public Policy’s President Lynn Taylor speaks at the January 7th press conference during which Delegate Lee Ware (R) and Delegate Mark Keam (D) announced the Virginia Energy Reform Act as part of the legislative package to be submitted for the 2020 General Assembly session. The goal of the legislation is to lower consumer energy costs by ending monopoly control and creating competition in the retail market of Virginia’s electricity system.

Virginia Has Become An Overnight Tidal Wave Of Second Amendment Sanctuaries

The sudden flood of resolutions to protect gun owners will soon envelop most of the state.

Published Sunday, November 24, 2019 4:30 pm
Gun Rights Watch article by Gun Rights Watch – Chief Editor

This article is re-posted with permission from Gun Rights Watch.

Map of Virginia Second Amendment Sanctuary Counties

For a larger version of this map, click here.

Members of the media wishing to use this image, please email us at [email protected] and we will send you a full-size PNG map of the highest quality.

Chief Editor’s Note:
Virginia’s Second Amendment Sanctuary movement is a fluid, fast-moving situation. This article is being published with some information intentionally missing. We’ll keep editing this story throughout the days and weeks to come. Please check back again for additional or updated information.

In a series of rapidly changing developments, Virginia is undergoing wholesale rebellion by rural and even suburban counties, rejecting the oppressive gun control agenda recently revealed by the new incoming Democrat-controlled legislature. Gun owners all across Old Dominion have been up in arms since anti-gun forces took the House and Senate in the recent election and are now preparing to resist having their arms taken from them in any way possible.

Enter Second Amendment Sanctuary Counties.

The county-level defensive tactic that began originally in Oregon close to a decade ago, then popularized in Illinois, has spread to over a dozen states. It comes as no surprise that with few other options and little to lose, many communities in the state are vowing not to take part in any gun confiscation schemes or enforcement of unconstitutional laws designed to make private citizens less able to defend themselves.

The speed at which they reacted is a testament to how furious they are that their state government now wishes to infringe on their rights. An even dozen counties have passed gun owner sanctuary resolutions already, with new ones coming on a near-daily basis. Here’s the list and what we know so far:

Municipalities That Passed a Second Amendment Sanctuary Resolution:
(green or dark green)

  1. Carroll County – passed resolution on 5/13/2019
  2. Campbell County – passed resolution on 11/7/2019
  3. Charlotte County – passed resolution on 11/13/2019
  4. Patrick County – passed resolution on 11/18/2019
  5. Appomattox County – passed resolution on 11/18/2019
  6. Pittsylvania County – passed resolution on 11/19/2019
  7. Lee County – passed resolution on 11/19/2019
  8. Dickenson County – passed resolution on 11/19/2019
  9. Dinwiddie County – passed resolution on 11/20/2019
  10. Giles County – passed resolution on 11/21/2019
  11. Nottoway County – passed resolution on 11/21/2019
  12. Sussex County – passed resolution on 11/21/2019
  13. King William County – passed resolution on 11/25/2019
  14. Powhatan County – passed resolution on 11/25/2019
  15. Southampton County – passed resolution on 11/25/2019
  16. Wythe County – passed resolution on 11/26/2019
  17. Madison County – passed resolution on 11/26/2019
  18. Washington County – passed resolution on 11/26/2019
  19. Henry County – passed resolution on 11/26/2019
  20. Botetourt County – passed resolution on 11/26/2019
  21. New Kent County – passed resolution on 11/27/2019
  22. Town of Rural Retreat – passed resolution on 11/27/2019
  23. Bland County – passed resolution on 11/27/2019
  24. Town of Exmore – passed resolution on December 2nd
  25. Louisa County – passed resolution on December 2nd
  26. Halifax County – passed resolution on December 2nd
  27. Buchanan County – passed resolution and ordinance on December 2nd
  28. Rappahannock County – passed resolution on December 2nd
  29. Greensville County – passed resolution on December 2nd
  30. Russell County – passed resolution on December 2nd
  31. Culpeper County – passed resolution on December 3rd; Sheriff may deputize citizens to resist
  32. Roanoke County – passed resolution on December 3rd
  33. Gloucester County – passed resolution on December 3rd
  34. Middlesex County – passed resolution on December 3rd
  35. Page County – passed resolution on December 3rd
  36. Tazewell County – passed 2 resolutions on December 3rd
  37. City of Norton – passed resolution on December 3rd
  38. King George County – passed resolution on December 3rd
  39. Allegheny County – passed resolution on December 3rd
  40. Amherst County – passed resolution on December 3rd
  41. Orange County – passed resolution on December 3rd
  42. Scott County – passed resolution on December 4th
  43. Augusta County – passed resolution on December 4th; will join lawsuit against state.
  44. Craig County – passed resolution on December 5th
  45. Bedford County – passed resolution on December 9th
  46. Buckingham County – passed resolution on December 9th
  47. Town of Crewe – passed resolution on December 9th
  48. City of Franklin – passed resolution on December 9th
  49. Town of Grottoes – passed resolution on December 9th
  50. King and Queen County – passed resolution on December 9th
  51. Mecklenburg County – passed resolution on December 9th
  52. City of Poquoson – passed resolution on December 9th
  53. Rockbridge County – passed resolution on December 9th
  54. Town of Rocky Mount – passed resolution on December 9th
  55. Shenandoah County – passed resolution on December 9th
  56. Bath County – passed resolution on December 10th
  57. Town of Big Stone Gap – passed resolution on December 10th
  58. Town of Bluefield – passed resolution on December 10th
  59. Caroline County – passed resolution on December 10th; Sheriff says he will form a militia if necessary.
  60. City of Chesapeake – passed resolution on December 10th; they used the term “constitutional” instead of sanctuary, but resolution is otherwise the same.
  61. Cumberland County – passed resolution on December 10th
  62. Floyd County – passed resolution on December 10th
  63. Greene County – passed resolution on December 10th
  64. City of Martinsville – passed resolution on December 10th
  65. Nelson County – passed resolution on December 10th
  66. Prince George County – passed resolution on December 10th
  67. Prince William County – passed resolution on December 10th
  68. Smyth County – passed resolution on December 10th
  69. Spotsylvania County – passed resolution on December 10th; Sheriff vows to not enforce Red Flag laws.
  70. Town of Strasburg – passed resolution on December 10th
  71. Warren County – passed resolution on December 10th
  72. Colonial Heights – passed resolution on December 10th
  73. City of Covington – passed resolution on December 10th
  74. Town of Bedford – passed resolution on December 10th
  75. Town of Cedar Bluff – passed resolution on December 10th
  76. Fluvanna County – passed resolution on December 11th
  77. Rockingham County – passed resolution on December 11th
  78. Frederick County – passed resolution on December 11th
  79. Westmoreland County – passed resolution on December 11th
  80. Hanover County – passed resolution on December 11th
  81. Brunswick County – passed resolution on December 11th
  82. Grayson County – passed resolution on December 12th;  Sheriff also may deputize citizens to resist
  83. Isle of Wight – passed resolution on December 12th
  84. Lancaster County – passed resolution on December 12th
  85. Lunenburg County – passed resolution on December 12th
  86. Town of Mineral – passed resolution on December 12th
  87. Northumberland County – passed resolution on December 12th
  88. Richmond County – passed resolution on December 12th
  89. Wise County – passed resolution on December 12th
  90. Town of Blackstone – passed resolution on December 16th
  91. Franklin County – passed resolution on December 17th
  92. Town of Pulaski – passed resolution on December 17th
  93. Matthews County – passed resolution on December 17th
  94. Prince Edward County – passed resolution on December 17th
  95. Town of Vinton – passed resolution on December 17th
  96. Stafford County – passed resolution on December 17th
  97. Town of Altavista – discovery of previously passed resolution on Dec. 19th
  98. Town of Chilhowie – discovery of previously passed resolution on Dec. 19th
  99. Town of New Market – discovery of previously passed resolution on Dec. 19th
  100. Town of Saltville – discovery of previously passed resolution on Dec. 19th
  101. City of Buena Vista – passed resolution on December 21st
  102. Charles City County – passed resolution on December 23rd

Municipalities That Passed a Second Amendment Resolution, But Refused to Use The Word Sanctuary:
(light green)

  1. Goochland County – passed resolution on December 3rd
  2. Surry County – passed resolution on December 5th
  3. City of Galax – passed resolution on December 9th
  4. City of Bristol – passed resolution on December 9th
  5. James City County – passed resolution on December 10th
  6. Northampton County – passed resolution on December 10th
  7. Henrico County – passed resolution on December 10th
  8. Pulaski County – passed resolution on December 16th; Sheriff vows to not enforce any unconstitutional laws.
  9. Montgomery County – passed resolution on December 16th; Sheriff vows to not enforce Red Flag laws.
  10. York County – passed resolution on December 17th
  11. Amelia County – passed resolution on December 18th; Sheriff vows to not enforce any unconstitutional laws
  12. Suffolk County – passed resolution on December 18th
  13. Accomack County – passed resolution on December 18th
  14. Fauquier County – passed resolution on December 23rdSheriff vows to not enforce any unconstitutional laws; Commonwealth’s Attorney vows not to prosecute

Municipalities Having a Hearing or Confirmed To Be Voting Soon:
(yellow)

  • Clarke County – had hearing on December 17th; will vote at next meeting on January 6th
  • Highland County – voting on January 7th
  • Essex County – voting on January 7th
  • City of Waynesboro – hearing or voting on January 13th
  • City of Lynchburg – failed by one vote on December 10th; meeting on January 1st; voting on January 14th

Other Counties Or Cities That Have Efforts To Get A Hearing Or Vote Soon:
(orange)

  • Town of Bowling Green – movement underway, no action from town council so far
  • City of Arlington – movement underway, no action from town council so far
  • City of Portsmouth – did not vote on December 10th; another attempt is likely
  • City of Virginia Beach – awaiting word on another meeting after December 3rd
  • City of Newport News – did not vote on December 10th; another attempt made on January 14th; unknown status
  • Radford City – awaiting word on another meeting after December 9th
  • City of Roanoke – 2nd try was at meeting on December 16th; another meeting is expected; fight hard!
  • City of Danville – did not vote again on December 17th; another meeting is expected; make phone calls!
  • Fairfax County – had meeting on January 14th; another try possible; make phone calls!
  • City of Alexandria – movement started
  • City of Harrisonburg – movement started
  • City of Hopewell – City Council may put it on the agenda for January; sign the petition to move this along.
  • City of Fredericksburg – rejected resolution on December 10th; another attempt is likely
  • City of Winchester – failed to pass resolution on December 10th; awaiting word on another meeting
  • Chesterfield County – refused to hold a vote on December 11th; another attempt is likely
  • City of Hampton – failed to pass resolution on December 12th; awaiting word on another meeting
  • City of Staunton – Released statement of no action on Dec. 6th; no mention of 2A Sanctuary at meeting on December 12th; awaiting word on more attempts
  • City of Salem – Mayor read statement of no action at meeting on Dec. 9th; awaiting word on more attempts
  • City of Norfolk – The city council took no action at meeting on Dec. 10th; awaiting word on more attempts

Other Counties Or Cities That Are Strongly Suspected to Never Vote In Favor:
(gray)

  • Albemarle County – awaiting word on another meeting after December 4th; looks dead
  • Loudoun County – no vote at meeting on December 11th; looks dead

Special thanks to the Virginia Citizens’ Defense League for some of this information.
Also, special thanks go to the ever-helpful Jeff Wittenborn as well as Virginia patriot Vincent Smith.

The Second Amendment Sanctuary Movement Is Sweeping Virginia

Gun owners are demanding local government protection from the state – and getting it.

By: Scott D. Cosenza, Esq.

This article posted December 8, 2019, was re-posted with permission from the author.

A sea change came to Virginia on election day.  Democrats won majority control of both houses of the legislature – for the first time in over 20 years.  The new power brokers have taken their win to move the state markedly left on many issues, but especially gun control.  Prefiled bills in the statehouse would make Virginia swing from a state that broadly respects gun rights to one of the most restrictive if passed.  Gun owners have risen to challenge the proposals, not in the legislature just yet, but at the county and city levels.  Under a massive pressure wall, those local governments have, at a furious pace, adopted Second Amendment Sanctuary resolutions, forbidding local officials from acting in opposition to the Second Amendment.

Let No Good Crisis Go to Waste

Ralph Northam

On May 31, 2019, a Virginia Beach employee went on a shooting spree, massacring a dozen people at a municipal building.  Days later, Virginia Governor Ralph Northam (D) ordered a special session of the legislature to be convened.  The legislature, which had adjourned for the year, would be recalled to Richmond to consider previously rejected gun control bills.  The rundown of proposals reads like a letter from Sarah Brady to Santa, including universal background checks; bans on “assault weapons,” sound suppressors, and bump stocks; red flag laws; one gun a month laws; and granting local governments increased authority to issue their own new measures hostile to gun rights, among others.

While legislative leaders had no control over the convening of the session, they asserted their power just after it started, ending the farce within 90 minutes of its beginning.  Republican Speaker of the House Kirk Cox accused Northam of “an election-year stunt.”  That may be just what it was, and effective too, given the results in November.

From Red to Blue

The Democrats last controlled both houses of the legislature in 1994.  While the state was recently considered a swing state, that has changed too; it now seems ever bluer.  Democrats now control all three statewide elected offices, both U.S. Senate seats, both chambers of the General Assembly, and seven of Virginia’s 11 seats in the U.S. House of Representatives.  Quite a list, and driven in large part not by a change in attitudes of Virginians, but the additions of many new Virginians hostile to gun rights.

In a post-election profile called “How Voters Turned Virginia From Deep Red to Solid Blue,” The New York Times tells us that immigrants, both from other states and other countries, are a big cause.  “Unlike three decades ago, the residents are often from other places, like India and Korea. And when they vote, it is often for Democrats.”  That’s not all. Those voters are not like the countrified Democrats who may understand and value the right to keep and bear arms:

“Guns, that is the most pressing issue for me,” said a 38-year-old software engineer from southern India, Vijay Katkuri, 38, as he explained why he voted for a Democratic challenger in Tuesday’s elections. “There are lots of other issues, but you can only fix them if you are alive.”

Mr. Katkuri, we learn, had been a resident of New Jersey before he decided to make his home in the Old Dominion.  Alas, that state had crime levels that were too high, among other factors, to keep him.  The Grey Lady doesn’t mention if Katkuri understood that unsafe New Jersey has had highly restrictive gun control laws for generations, while safer Virginia has honored the right to keep and bear arms.  Liberals who move from high tax, high regulation lefty states in favor of greener pastures in more conservative jurisdictions seem unable to draw the connections that seem plain as day to the rest of us.  Could adopting New Jersey style gun control laws make Virginia less-safe?  Mr. Katkuri doesn’t seem to have considered this possibility.

Not Lying Down

Virginia gun owners have, and they have responded swiftly and intensely to the coming onslaught against their rights.  Over 40 counties and independent cities in Virginia have passed Second Amendment Sanctuary resolutions so far, and the list has grown rapidly.  Led by the Virginia Citizens’ Defense League*, one of the strongest single-issue state policy organizations, they have mounted a massive backlash against new gun controls.  Liberty Nation spoke with VCDL President Phillip Van Cleave about the resistance and sanctuary movement.  He said the idea behind the resolutions is to send a message:

“It’s a whole bunch of localities standing up and telling the Democrat leadership in Richmond we don’t want any more gun control.  These things affect only the law-abiding, and what they’re suggesting doesn’t do anything for criminals.”

He said no county official needs to enforce an unconstitutional law and called the AR-15 the most popular rifle in the U.S. and Virginia. Van Cleave explained that they were gearing up for a huge showing at the legislature on January 20 for VCDL Lobby Day, when they encourage everyone who cares about maintaining the right to keep and bear arms to come to Richmond and show their support.

Before then, however, many, if not most, counties will be Second Amendment Sanctuaries.  Lynn Taylor*, who heads the commonwealth’s leading pro-liberty public policy organization, the Virginia Institute for Public Policy, had this to say about the budding movement: “The 2A sanctuary is a political stance, not a legal protection. Everyone needs to be ready for this reality. Virginia is becoming a battleground for stripping away the rights guaranteed by the Second Amendment. We will need some strong men and women out there willing to take this issue to the mat, and even more to support them financially and with their prayers for freedom.”  Asked if she knew of a movement that has previously animated Virginians so vigorously, she replied, “not since the Founding.”

*This author has been a member of VCDL.  Ms. Taylor sits on the board of Liberty Nation’s parent organization, One Generation Away.

Brennan Gilmore & Lynn Taylor: Charging toward energy reform in Virginia

ONE OF US was chief of staff for Tom Perriello and runs an environmental nonprofit. The other worked for the Koch brothers and facilitates a monthly meeting of Virginia conservative and libertarian activists. Needless to say, we do not exactly subscribe to the same political philosophies.

Here’s where we do agree: The energy sector in Virginia is broken.

An energy sector whose rules were written by monopoly utilities and their well-funded political allies has given us the 11th highest electricity bills in the nation when energy demand in Virginia is flat and energy itself is getting cheaper. It has kept businesses and families across the commonwealth from choosing their electricity provider. It has allowed Dominion Energy to run roughshod over property rights and plow ahead with a ratepayer-backed $7 billion gas pipeline without demonstrating any actual need for it. And it has stifled innovation and the deployment of cleaner, cheaper energy sources.

Virginia — including vast Dominion service territory in the Hampton Roads region — deserves better than this monopoly regulatory system designed to maximize profits for shareholders and greased by donations to politicians.

When faced with a problem this insidious, it is remarkable how quickly two opposing ideologies can find common ground.

The answer to this is simple: Give people a choice. Break up the monopolies, remove the barriers to competition, and remove the constraints preventing Virginia from leading the transition to a 21st century energy economy that is better for our bank accounts, our jobs and our environment.

No matter who they vote for, every Virginian should have the ability to choose their energy provider, just like they choose their car, phone provider, or grocery store. Currently, most Virginians who pay utility bills are stuck with one utility monopoly, and one with a track record of acting in bad faith to enrich shareholders on the backs of mostly unknowing ratepayers.

The core of our system’s rot is a skewed incentive system that allows utility profits to hinge on political gamesmanship rather than customer interest. A utility that both owns and operates the electrical grid has a conflict of interest that inhibits the development and deployment of the cost-effective energy resources of the future.

A utility earns a rate of return on infrastructure like wires and transformers, so it has a financial interest in huge infrastructure investments rather than resources owned or services provided by other entities — large-scale distributed energy storage systems, consumer-owned rooftop solar, or energy efficiency programs, for example — even though they are often cheaper.

Switching to a competitive market with performance-based rules and an independent grid operator will ensure energy providers only get rewarded for being the best on reliability, cost and customer satisfaction and that one monopoly’s special interests cannot hold customers captive.

Virginia’s potential to recharge our economy with 21st century energy is truly untapped. The Department of Energy ranks us a dismal 37th out of 50th for renewable energy production.

North Carolina has seven times as much installed solar as Virginia, and thousands of jobs in the fastest-growing energy sector along with it. On the other hand, Texas moved to a competitive market in the early 2000s and has since seen reduced energy bills, enhanced consumer choice and steady innovation. It is simple. When an energy market is competitive and monopolies are contained, the entire state benefits.

Luckily, this insidious problem is not beyond repair. Energy market reform may sound complex, but this issue is about Virginians paying their utility bills today and choosing the energy that will power their tomorrows. We want to build a statewide movement towards consumer choice and protection, a competitive and innovative economy, and a 21st century energy grid — and movements need people.

Candidates and legislators need to hear from their constituents and voters on this issue and demand that Virginia’s General Assembly advocate for hardworking people across the commonwealth paying their utility bills, not for utility giants whose political influence has allowed them to write the rules of a rigged game.

Take it from a political odd couple. When you take a chance to come together and reform something truly broken, it’s amazing what we can achieve.

Brennan Gilmore is executive director of Clean Virginia. Lynn Taylor is president and co-founder of the Virginia Institute for Public Policy. They are both members of the nonpartisan Virginia Energy Reform Coalition.

Virginia GOP Shoots Down Governor’s Gun Grab

Republican legislators were successful in ending the special legislative session without new restrictions on gun rights of Virginians.

This article posted July 11, 2019, was re-posted with permission from Liberty Nation.

Virginia Governor Ralph Northam instituted a special session of the state’s legislature Tuesday, July 9 for the stated purpose of enacting new gun control laws.  Gun rights supporters won the day as Republican lawmakers, who tenuously control both houses of the law-making body, were able to stop it in its tracks, suspending consideration of the bills until the regular session in the fall.

Some gun supporters openly carried at the rally outside the Capitol July 9th. Richmond Times-Dispatch photo.

Well over a dozen different bills were filed, offering a Vegas-sized buffet of anti-gun rights advocates’ wishes and wants.  A limited sample includes a “Red Flag” law that allows police to seize firearms with little to no due process, one gun a month purchase limits, and legislation that would allow counties and municipalities the right to enact their own gun control laws.  Legislators introduced several pro-gun rights bills, but this session was to be about restricting the rights of Virginians, not expanding them.

Special Session

Northam announced the emergency session in the wake of a Memorial Day massacre in Virginia Beach, where 12 people were murdered by a municipal employee on a rampage.  “If we can save one life because we acted now, it is worth it.”  The Virginia legislature starts sessions in January and finishes no later than 60 calendar days afterward, but there is a provision in the commonwealth’s constitution for the Governor to institute a new one:

“The Governor may convene a special session of the General Assembly when, in his opinion, the interest of the Commonwealth may require …”

Republicans hold a 51-48 majority in the House of Delegates and a 20-19 edge in the Senate, with one vacancy in each chamber.  That was enough to put a stop to the special session on party-line votes in both houses.  They referred the various pieces of legislation to appropriate committees.  Those bills will be voted on in the 2020 session if they are passed out of committee – which they are unlikely to since so many have already been voted down in committee this very year.  From January:

A Republican-led subcommittee in the Virginia House of Delegates voted down more than a dozen Democratic gun control bills Thursday, including a red-flag proposal endorsed by President Donald Trump’s school safety committee.

In a packed hearing room, Republicans on a House Militia, Police and Public Safety subcommittee used their 4-2 majority to methodically defeat the gun bills over the course of more than two hours.

Governor Northam became nationally known earlier this year when his medical school yearbook seemed to show him in blackface.  That, combined with the legislature’s recent consideration of often identical legislation, fueled criticism that politics was the prime motivator behind the session rather than public safety.  Virginia Institute for Public Policy president Lynn Taylor* called it a political move, noting that “not one of the proposed laws would have changed the outcome in Virginia Beach.”

 

State Senator Tommy Norment, R-James City County. AP file photo.

GOP Drama – Tempest In A Teapot

Senate Majority Leader Thomas K. Norment Jr. (R-James City) shocked his fellow Republicans by filing a bill just before the session that would ban guns in local government buildings in Virginia.

The Virginia Citizens Defense League**, a powerful gun rights advocacy group, sent out an email in the wee hours before the session, announcing “VA-ALERT: LEGISLATIVE ACTION ITEM: Senator Tommy Norment stabs gun owners in the back!”  Norment had introduced a bill that would treat all local government buildings like a courthouse, generally banning firearms for everyone but government officials.  That sentiment seemed to be completely reversed by the end of the day, when the group sent an email stating:

Senator Norment explained that the bill was incorrectly drafted due to a communication issue between himself and Legislative Services.  VCDL thanks Senator Norment for doing the right thing and striking that bad gun-bill from the docket!

Norment said Tuesday, “As currently drafted, the legislation represents neither my views nor my intention. I do not support – nor will I support – any measure that restricts the constitutional rights of law-abiding citizens.”

*Ms. Taylor sits on the board of LibertyNation.com’s parent company.

**The author has been a member of VCDL.

Politically Diverse Coalition Pushes Virginia To Create A Free Market For Energy

by: Oliver Mendoza

This article was re-printed with permission from RVA Magazine.

The Virginia Energy Reform Coalition has brought together groups of various political affiliations to push for free-market alternatives to Dominion.

 

With the current divisions between political ideologies in America, the advent of a group like the Virginia Energy Reform Coalition (VERC) can be like a breath of fresh air. VERC is composed of several Virginia organizations of surprisingly varied political stances who have come together to try and put an end to the monopoly Dominion Energy has on Virginia’s electrical supply.

In 1999, Virginia attempted to deregulate the energy market and failed. Now 20 years later, we are seeing groups like the progressive Virginia Poverty Law Center teaming up with the likes of Ken Cuccinelli’s FreedomWorks Foundation to help create a competitive free market for energy in Virginia.

VERC consists of nine different organizations in all: Appalachian Voices, Clean Virginia, Earth Stewardship Alliance, FreedomWorks, Piedmont Environmental Council, R Street Institute, Reason Foundation, Virginia Institute for Public Policy, and Virginia Poverty Law Center.

Some of these groups are advocates for clean energy and clean government. Brennan Gilmore, the Executive Director at Clean Virginia, said that there have been a series of oversteps by Dominion that led to consumers dealing with higher prices and businesses not being able to compete in the commonwealth’s large energy market.

“People across the political spectrum have reacted in a very strong way,” said Gilmore. “It was a testament to just how far these utilities have abused their monopolies that allowed for this type of unprecedented coalition to be built.”

Though some of the groups may clash over other political issues, they agree on the topic at hand: that a free, competitive energy market would benefit all parties.

Ken Cuccinelli speaks at the press conference for the VERC launch. Photo courtesy Appalachian Voices

“I realized that working with folks who have different ideologies with you is actually pretty easy when you’re headed for the same goal,” said Lynn Taylor, the President of Virginia Institute for Public Policy (VIPP). Taylor pointed out that in 2018, according to an article in USA Today, Virginia had the eighth-highest electrical utility bills in the country. According to Taylor, if utilities were allowed to compete for customers, consumers and businesses would have options on the price they pay for electricity, ideally leading to lower prices.

“This is an area where I think transparency does not have a party, and doing the right thing and creating fairness in the system does not have a party,” said Dana Wiggins, director of Outreach and Consumer Advocacy at the Virginia Poverty Law Center (VPLC). VPLC advocates for low-income Virginians, and adds a little more depth and diversity to the VERC.

According to Wiggins, the VPLC has put forth a proposal for a program to help low-income Virginians by implementing energy efficiency measures. Under VPLC’s plan, any Virginians paying more than 6 percent of their income towards electric bills would qualify for a program to cap their payments at 6 percent.

While a group like the VPLC might seem unlikely to make an alliance with high-profile Republican and former Virginia Attorney General Ken Cuccinelli, this isn’t the first time the two have worked together. In 2017, Cuccinelli filed a legal brief on behalf of the VPLC, who were then challenging a law that had locked in Dominion and Appalachian Power Co.’s rates for five years to protect the utilities from costs associated with Obama’s Clean Power Plan.

Clearly the old saying really is true: politics makes strange bedfellows. But for the leaders of the organizations making up the VERC, that isn’t necessarily a bad thing. “In a time when politics and policy seems pretty hopelessly divided, it’s actually been really refreshing to cross that ideological threshold,” said Gilmore.

Top photo by Marco Sanchez, courtesy of Piedmont Environmental Council

Support the Virginia Institute this Giving Tuesday!

Giving Tuesday is around the corner, and the Virginia Institute for Public Policy wants to partner with you for the future of Virginia. This year we are looking forward to the next big battles in the home of American Liberty.

As healthcare costs begin to rise beyond expectations following the expansion of Medicaid, discussion begins in Richmond on where the money will come from. Increased taxes, however, will further depress business and population growth in Virginia. New and decisive answers are needed to get Virginia’s economy back on track. As always, the Virginia Institute is at the forefront, proposing bold solutions, educating legislators and advocates, and bringing people together in support of our home, the Commonwealth of Virginia, the birthplace of American exceptionalism.

We can’t do it without your help! Get involved by donating to the Virginia Institute for Public Policy on Giving Tuesday. Help us to fight for the brightest future for Virginia; one of individual freedom, personal responsibility, and constitutionally-limited government. Support courageous policies in healthcare, taxation, education, and good governance.

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Concerning the recent scandal surrounding Judge Kavanaugh

I recently received this email from Cathy Trauernicht, successful entrepreneur, voter integrity advocate, and member of the Tuesday Morning Group coalition.  I was captivated by Cathy’s masterful articulation — not only of the problem, but of the inappropriate response by the below mentioned educational institution.  As I told her, the all-women’s college I attended has taken some similar, remarkably stupid actions until the alumnae protested.

This issue has suddenly become far more significant. Ms. Ford’s testimony, which has been delayed until Thursday the 27th, would likely preclude Judge Kavanaugh from taking part in the Supreme Court session beginning October 1st, if confirmed. This is true even if he takes the bench during the session.

I wanted to share her email with you, with her permission, of course.

I’m a former parent of the Holton-Arms School community.  As you may have heard, the Head of Holton-Arms sent a letter to the school community, celebrating alumna Christine Blasey Ford for using her “voice.”  https://www.axios.com/kavanaugh-accuser-ford-allegations-school-letter-7cd0102a-8ab8-46b4-8d3d-9d9fb9e21166.html?ref=gazelle.popsugar.com

The persistent abuse of women as political pawns is something I cannot abide.  Nor can I sympathize with women who do not accept personal responsibility for their actions.

Below is the email I sent tonight to Susanna Jones, current Head of the Holton-Arms School.

=================================================================

 

Dear Ms. Jones,

As a former Holton parent, and as a woman, I’d like to weigh in on the Christine Blasey Ford controversy.

Having lived in the Washington, DC, area for a long time, and being an astute observer of political manipulation, I can recognize templates taken out of political play books.  Unfortunately, women are all too often manipulated and used for political gain according to these play books, and it’s not their gain in the long run that is secured.  I strongly suspect that Christine Blasey Ford is such a case of political manipulation.  She is looking more and more foolish by the day, as are those who spring to her defense with no substantiating facts.

Leaving aside the fact that there are no facts to substantiate Ms. Ford’s accusations against Judge Kavanaugh, I would like to suggest that, in your role as Head of the Holton-Arms School, you avoid the mire of the political arena and seize this opportunity to remind young girls and young women about personal responsibility and consequences for their actions.  They are told repeatedly how smart, capable and independent they are.  With these qualities go personal responsibility.  Should they find themselves in situations where they can’t remember what happened,  they must accept the consequences and not hide behind a mantra of victimhood.

Ms. Ford’s inability to recall specific facts of her alleged attack is peculiar.  Her continuing evasion of the facts is doing a disservice to women who have been victims of assault, who can recall every detail of abuse as they desperately fought back against their attacker.

By celebrating Ms. Ford’s “voice” as you did in your letter to the Holton community, you celebrated the voice of victimhood, not empowerment.  She waited 36 years — until a Supreme Court nomination was days away from a vote — to make her voice “heard.”  Thirty-six years without filing a police report.  Thirty-six years with no corroborating witnesses.   The “expression of solidarity is exactly what we would expect from the Holton sisterhood,” you wrote.  Solidarity for what?  For simply being “sisters”? For making an explosive, UNSUBSTANTIATED, 36 year-old allegation with the objective of derailing a Supreme Court nominee who, by all accounts, has conducted himself personally and professionally in admirable fashion?  This is superficial and shameful, Ms. Jones.

I am a product of single-sex education from elementary school through college, and have watched the “women’s liberation movement” morph into “women’s empowerment,” and then pathetically devolve into women’s “victimhood.”  Sometimes, women are victims of their own irresponsible behavior.

One more observation.  Ms. Ford’s unsubstantiated, 36 year-old accusations are making a mockery out of our legal system.  She and her handlers want Judge Kavanaugh tried in the court of public opinion, rather than in a court of law (where they would lose their case).  That is a tactic of cowards, manipulated by craven political opportunists.  The court of public opinion carries no presumption of innocence; it only serves to prey upon emotions and fire people up into a frenzy of irrational behavior.  Does the storied Holton-Arms School no longer teach the Constitution and its protections?

In conclusion, I urge you to stay out of the political swamp, and stay focused on your role as an educator.  Educate young girls and young women to accept responsibility for their own behavior and to stay away from compromising situations.  That is true empowerment.  And they may not be getting that lesson at home.

Thank you for listening,

Catharine Trauernicht

 

In education, like everything, incentives matter.

Another cheating scandal is in the news, and parents always seem so surprised. It really should not be surprising; teachers and administrators are essentially incentivized to cheat. From Bush Jr.’s No Child Left Behind to Obama’s Race to the Top our duly elected representatives have increasingly linked school funding and employee bonuses to standardized tests scores. It was done with the best intentions, but the consequences have been disgraceful. Yet the parents of school age children wait, patiently unaware of their eminent significance as the solution to this problem.

Nearly a decade ago, the Atlanta cheating scandal hit the news. Since then cheating on standardized tests has been reported in 80% of American states, including Virginia. Despite the indictments of 11 former Atlanta public school teachers, some Virginia educators continue to consider the practice to be profitable. A July 30th report from the Virginia Department of Education concluded that “inappropriate assistance was provided by some [staff]” at Richmond’s Blue Ribbon elementary school, G.W. Carver. Furthermore, the extent of the cheating seems to have been considerable. More than 60% of 6th graders at Albert Hill Middle School, high school class of 2023, failed both the math and reading sections of the Standards of Learning tests after leaving Carver.

The reason some teachers and administrators continue to choose to rig standardized testing is because incentives matter. For some teachers, the benefits of cheating, including financial bonuses, outweigh the potential costs (or risks) of either being caught or earnestly trying to improve educational outcomes within a school.

Testing scandals happen more often in lower performing, urban districts and nearly always involve the administration at some level. These two circumstances can lead some teachers to underestimate the risks of cheating. Due to high turnover among teachers, increased training costs, and the tendency of less qualified instructors to end up in high-poverty school systems, improving educational outcomes in poorly performing, high poverty schools can be a difficult challenge. Additionally, the involvement of school or district administrative staff in testing fraud may contribute to a belief that there is a lower probability of being caught or, if caught, being held accountable. In these rather common circumstances, funding and pay bonuses for exemplary or greatly improved testing scores will naturally breed a willingness to game the system among some educators.

What’s further, these incentives also change the dynamic between school administrators and policymakers. In Virginia, the state government makes decisions regarding funding. They base these decisions on standardized testing or through other administrative mechanisms. Unfortunately, this means that students and their families are often left out of the process. This seems especially true in lower income school districts where parents are less equipped to handle the ins and outs of the educational bureaucracy. In fact, the 2018 Virginia Commonwealth Standards of Quality (Word document) largely treat parents as a party of passing significance. They are simply notified of decisions and action plans after the fact, rather than being treated as the principle force and influence in their child’s life whose concerns are of the highest relevance.

The way to correct the perverse incentives that the current educational regime creates is to place the highest value on parental satisfaction. If every state education dollar is directly attached to each student, and follows them to whichever school that parents choose, then the incentives inherent to today’s system must naturally be completely overthrown. Suddenly, teachers and administrators must find innovative and effective ways to improve and maintain positive educational outcomes at the student level, rather than at the level of the district or state. Eliminating top-down curriculum requirements and allowing principals and teachers to firmly address parents’ and students’ needs may lead to considerable positive results. Providing high quality, specialized education would become paramount. Additionally, as standardized testing ceases to be the hinge of school funding, the parental satisfaction model would eliminate the incentives to cheat among educators.

Achieving this policy shift relies on the understanding that incentives truly do matter and that employing this axiom can powerfully affect outcomes in almost any situation. Before positive changes can be made, however, the current paradigm, that optimistic goals make good policy, must change. To continue to judge education strategies based solely on intentions rather than consequences will ultimately ensure sustained failure.

To devise a solution, one must address the problem.

The most popular flavors of the national debate in America today: immigration, healthcare, the Federal debt, and the budding trade war. The American welfare state is the common denominator in each of these quandaries and is the political quagmire which will derail any viable solution for these hot button issues.

The modern American welfare state was effectively borne of the New Deal. It came into being with President Franklin Roosevelt’s words, “Necessitous men are not free men.” It was grand-sired by Woodrow Wilson’s intellectual rejection of the US Constitution. Thanks to a widely misconstrued understanding of the “general welfare” and “charity,” the welfare state has grown into the largest seen in human history. Welfare programs and mandatory interest payments are expected to absorb roughly 60% of total federal spending (excel) this year – more than doubling the estimated 2018 deficit (.pdf). Thus, it’s no wonder this economic millstone has translated into so many different problems.

Illegal immigration, as much as it invades the daily news cycle, is more a correlative symptom of the welfare state than a problem in and of itself. Welfare spending has grown in a series of plateaus. The first began in the 1930s with FDR’s New Deal, and the second coincided with LBJ’s Great Society in the 1960s.

Shortly before, during, and immediately following the New Deal era, there was a decrease in legitimate immigration (which is important as illegal immigration estimations tend to correlate with actual measured immigration numbers). This decrease likely due to the Johnson-Reed Act of 1924 coupled with the U.S. job market during and immediately after the Great Depression. If you also include a series of large, global wars, which were often fought with conscripted soldiers, the first two-thirds of the 20th century would obviously not be the most popular time to move to the US.

Starting at about 1970, after the Great Society programs had taken hold and as the Vietnam War began to wind down, immigration (both legitimate and unauthorized) began to dramatically increase. There was a similar rate of growth in Medicaid vendor payments during this same period of time. Although concurrent growth does not necessitate correlation or causality, it seems that Medicaid spending and immigration at least correlate relative to incentives to immigrate among specifically the low-skilled. As it turns out, people immigrate to take advantage of better opportunities, including “free” money and public services.

Speaking of “free” public services, in the second entitlement plateau of the 1960s, LBJ’s Great Society policies included the guaranteed health insurance program – again referring to Medicaid. Healthcare costs subsequently began to skyrocket, more than doubling as a percentage of GDP by 2014 (excel). However, Medicaid creates a moral hazard, or the “lack of incentive to guard against risk where one is protected from its consequences, e.g., by insurance.”

Insurance is particularly affected by moral hazard, and government-backed insurance especially so. These perverse incentives have led to considerable waste and excess within healthcare markets, which were exacerbated further by the activities of insurance companies and the more recent Affordable Care Act. The welfare state strikes again! But this time it has negatively affected the average American’s ability to access healthcare. In other words, the welfare state doesn’t simply add spice to the daily news cycle, it might actually kill you.

So, logically, everyone has accepted the welfare state as the culprit, right? Unfortunately, this has not been the case. Even conservatives are joining the fray in hopes of expanding it further by restricting free trade through tariffs. As we have all been told, America is not getting a “fair deal” on the world market. U.S. manufacturing has “suffered greatly” at the hands of the Chinese and others who have taken advantage of the US through trade deals, confiscation of intellectual property, and monetary manipulation. All of this is seemingly despite an increase in American manufacturing productivity to the tune of approximately 80% since 1990.

Rather than seeking to address the problem, numerous allegedly “fiscally responsible” and “pro free-market” conservatives have begun to harrumph for tariffs – import taxes that increase the market price of particular goods within the American market. To be clear, these are increased prices that only Americans will pay to subsidize a small portion of American industrial companies like steel and aluminum manufacturers. This is what traditional “free-market” conservatives refer to as “corporate welfare.”

As each new story passes by, it is amazing so few people are addressing the very real problem – the American welfare state. I am hard pressed to find a major story in the news today which does not connect with this quite ubiquitous concern. Where are the intrepid, fiscally responsible conservatives? Where are the sharp, unyielding libertarians or economically sane moderate progressives? There is an objective truth here which certainly applies: all solutions fail which fail to address the problem.

 

Welcome to the New Site, and Happy Independence Day!

To celebrate American Independence, as well as our new website, here is the reason for the season: the Declaration of Independence. Let’s pay particular attention to why the Founders thought this was the best course of action upon which to gamble their lives, fortunes, and sacred honor.

Spoiler Alert: Taxation was neither the first, nor the most consequential of those causes listed below.

When in the Course of human events, it becomes necessary for one people to dissolve the political bands which have connected them with another, and to assume among the Powers of the earth, the separate and equal station to which the Laws of Nature and of Nature’s God entitle them, a decent respect to the opinions of mankind requires that they should declare the causes which impel them to the separation.

We hold these truths to be self-evident, that all men are created equal, that they are endowed by their Creator with certain unalienable Rights, that among these are Life, Liberty and the pursuit of Happiness.

That to secure these rights, Governments are instituted among Men, deriving their just powers from the consent of the governed, That whenever any Form of Government becomes destructive of these ends, it is the Right of the People to alter or to abolish it, and to institute new Government, laying its foundation on such principles and organizing its powers in such form, as to them shall seem most likely to effect their Safety and Happiness.

Prudence, indeed, will dictate that Governments long established should not be changed for light and transient causes; and accordingly all experience hath shown, that mankind are more disposed to suffer, while evils are sufferable, than to right themselves by abolishing the forms to which they are accustomed. But when a long train of abuses and usurpations, pursuing invariably the same Object evinces a design to reduce them under absolute Despotism, it is their right, it is their duty, to throw off such Government, and to provide new Guards for their future security.

Such has been the patient sufferance of these Colonies; and such is now the necessity which constrains them to alter their former Systems of Government. The history of the present King of Great Britain is a history of repeated injuries and usurpations, all having in direct object the establishment of an absolute Tyranny over these States. To prove this, let Facts be submitted to a candid world.

He has refused his Assent to Laws, the most wholesome and necessary for the public good.

He has forbidden his Governors to pass Laws of immediate and pressing importance, unless suspended in their operation till his Assent should be obtained; and when so suspended, he has utterly neglected to attend to them.

He has refused to pass other Laws for the accommodation of large districts of people, unless those people would relinquish the right of Representation in the Legislature, a right inestimable to them and formidable to tyrants only.

He has called together legislative bodies at places unusual, uncomfortable, and distant from the depository of their Public Records, for the sole purpose of fatiguing them into compliance with his measures.

He has dissolved Representative Houses repeatedly, for opposing with manly firmness his invasions on the rights of the people.

He has refused for a long time, after such dissolutions, to cause others to be elected; whereby the Legislative Powers, incapable of Annihilation, have returned to the People at large for their exercise; the State remaining in the mean time exposed to all the dangers of invasion from without, and convulsions within.

He has endeavoured to prevent the population of these States; for that purpose obstructing the Laws for Naturalization of Foreigners; refusing to pass others to encourage their migration hither, and raising the conditions of new Appropriations of Lands.

He has obstructed the Administration of Justice, by refusing his Assent to Laws for establishing Judiciary Powers.

He has made Judges dependent on his Will alone, for the tenure of their offices, and the amount and payment of their salaries.

He has erected a multitude of New Offices, and sent hither swarms of Officers to harass our People, and eat out their substance.

He has kept among us, in times of peace, Standing Armies without the Consent of our legislature.

He has affected to render the Military independent of and superior to the Civil Power.

He has combined with others to subject us to a jurisdiction foreign to our constitution, and unacknowledged by our laws; giving his Assent to their Acts of pretended Legislation:

For quartering large bodies of armed troops among us:

For protecting them, by a mock Trial, from Punishment for any Murders which they should commit on the Inhabitants of these States:

For cutting off our Trade with all parts of the world:

For imposing Taxes on us without our Consent:

For depriving us in many cases, of the benefits of Trial by Jury:

For transporting us beyond Seas to be tried for pretended offences:

For abolishing the free System of English Laws in a neighbouring Province, establishing therein an Arbitrary government, and enlarging its Boundaries so as to render it at once an example and fit instrument for introducing the same absolute rule into these Colonies:

For taking away our Charters, abolishing our most valuable Laws, and altering fundamentally the Forms of our Governments:

For suspending our own Legislatures, and declaring themselves invested with Power to legislate for us in all cases whatsoever.

He has abdicated Government here, by declaring us out of his Protection and waging War against us.

He has plundered our seas, ravaged our Coasts, burnt our towns, and destroyed the Lives of our people.

He is at this time transporting large Armies of foreign Mercenaries to complete the works of death, desolation and tyranny, already begun with circumstances of Cruelty & perfidy scarcely paralleled in the most barbarous ages, and totally unworthy the Head of a civilized nation.

He has constrained our fellow Citizens taken Captive on the high Seas to bear Arms against their Country, to become the executioners of their friends and Brethren, or to fall themselves by their Hands.

He has excited domestic insurrections amongst us, and has endeavoured to bring on the inhabitants of our frontiers, the merciless Indian Savages, whose known rule of warfare, is an undistinguished destruction of all ages, sexes and conditions.

In every stage of these Oppressions We have Petitioned for Redress in the most humble terms: Our repeated Petitions have been answered only by repeated injury. A Prince, whose character is thus marked by every act which may define a Tyrant, is unfit to be the ruler of a free People.

Nor have We been wanting in attention to our British brethren. We have warned them from time to time of attempts by their legislature to extend an unwarrantable jurisdiction over us. We have reminded them of the circumstances of our emigration and settlement here. We have appealed to their native justice and magnanimity, and we have conjured them by the ties of our common kindred to disavow these usurpations, which would inevitably interrupt our connections and correspondence. They too have been deaf to the voice of justice and of consanguinity. We must, therefore, acquiesce in the necessity, which denounces our Separation, and hold them, as we hold the rest of mankind, Enemies in War, in Peace Friends.

We, therefore, the Representatives of the United States of America, in General Congress, Assembled, appealing to the Supreme Judge of the world for the rectitude of our intentions, do, in the Name, and by Authority of the good people of these Colonies, solemnly publish and de clare, That these United Colonies are, and of Right ought to be Free and Independent States; that they are Absolved from all Allegiance to the British Crown, and that all political connection between them and the State of Great Britain, is and ought to be totally dissolved; and that as Free and Independent States, they have full Power to levy War, conclude Peace, contract Alliances, establish Commerce, and to do all other Acts and Things which Independent States may of right do. And for the support of this Declaration, with a firm reliance on the Protection of Divine Providence, we mutually pledge to each other our Lives, our Fortunes and our sacred Honor.

– Thanks to the Foundation for Economic Education for posting this important document every Independence Day.