The Great NCGOP Senate Conspiracy

The plot against Mark Robinson + Madison Cawthorn tries to be clever + the J&J vaccine pause + a new Medicare model + the trans athlete panic + a new Crook’s Corner chef + the Afghan pullout

Wed., April 14, 2021

Happy Wednesday.

  • Thought for the day: The Marshall Project, among the best criminal justice reporting services out there, says it’s time to retire the word “inmate” from the journalism lexicon.

  • Update: Kim Potter, the Minnesota cop/union president who shot and killed Duante Wright, resigned. The police chief announced his departure, too.

  • Weather: Scattered showers and storms this afternoon heralding a cold(ish) front. High of 80.


Today’s Number: 0.00001

Percentage of Johnson & Johnson COVID vaccine doses reportedly linked to a rare, severe blood clot in the U.S., which led the FDA to call for a pause in administering the one-shot vaccine.

  • That’s six cases out of approximately 6.8 million shots.

  • “All six cases in the United States occurred among women between the ages of 18 and 48, and symptoms occurred six to 13 days after vaccination …. One vaccine recipient died and another is in critical condition, an FDA official said Tuesday.”

  • “The officials said the clots ‘appear to be extremely rare.’ They said people who have received the Johnson & Johnson vaccine who develop severe headache, abdominal pain, leg pain, or shortness of breath within three weeks after vaccination should contact their doctor.” (WaPo)

  • The clots—specifically, a disorder called cerebral venous sinus thrombosis, which reacts dangerously to heparin, the anticoagulant doctors often use to treat everyday blood clots—haven’t been associated with the Pfizer or Moderna vaccines, and the FDA hasn’t yet established a causal link between the J&J shot and the clots, just a correlation.

  • Importantly, the FDA has not ordered the vaccine off the market or canceled its emergency use authorization.

  • NCDHHS quickly announced that it would follow the FDA’s recommendation and pause the J&J vaccine. To date, only about 210,000 J&J vaccines have been administered in North Carolina, accounting for roughly 10% of the fully vaccinated population.

  • The state has another 140,000 J&J doses on hand, according to the NCDHHS dashboard.

  • “Last week, vaccine providers at three North Carolina sites temporarily paused their use of the Johnson & Johnson vaccine because of people having immediate adverse effects. … A CDC review of the Wake County incidents Thursday evening concluded that there were no ‘safety issues or reasons for concern’ with the vaccine.” (N&O)

Cost/benefit analysis: In early February, when vaccine distribution started picking up steam, North Carolina was seeing about 6,000 new COVID cases and 70 COVID deaths per day. On April 9, there were 1,500 new cases and two deaths, according to the DHHS dashboard.

  • More than 2.45 million NC residents—about 24% of residents, and 30% of adults—were fully vaccinated as of April 11. That includes at least 22% of adults in Wake, 26% in Durham, and 31% in Orange. (The county numbers seem to be running behind the state tally).

  • Vaccine comfort is climbing. A recent Elon poll showed it at 63%, double what it was in October. But that still means 37% of adults plan to skip the vaccine. More than simply removing an asset from the pandemic kit, hyping rare apparent reactions could undermine the already tentative public trust in vaccines just when we need it.

  • After all, we’re talking about 1 incident per ~1.15 million shots. For comparison, you have a 1 in 500,000 chance of being struck by lightning in a given year. In the general population, there are 3 or 4 CVST cases per million adults as is.

  • Counterfactual: Had the CDC done nothing and more reports of these clots came in—a dozen, two, three—imagine the blow to public trust then.


+TODAY’S TOP 5

1. The Great NCGOP Senate Conspiracy

Big League Politics is one of those wholly unoriginal, slavishly pro-Trump sites there’s really no good reason to visit. But on Monday, when former Governor Pat McCrory teased a Senate announcement, BLP’s Shane Trejo popped up with a SCOOP! that, if true, would be beautifully Machiavellian.

It would also require more foresight than parties usually have and less self-interest than politicians usually possess. But it seems this conspiracy is making the rounds among state politicos, so put on your tinfoil hats and let’s give it a whirl.

  • The objective: The GOP “establishment” wants to help McCrory defeat Mark Walker in the Senate primary and keep Mark Robinson from being the gov nominee in 2024. (For our purposes, ignore that the NCGOP is run by Trump groupies and define “the establishment” as the mid-2010s Tillis-McCrory power structure.)

    • TBQH, this might be a smart play. Robinson won’t fare so well in a race the NC Dems—meaning Nexus Strategies, which runs political ops for Roy Cooper and Josh Stein, Roy’s all-but-anointed successor—actually care about. The party did next to nothing to help Yvonne Holley, which is how Robinson became LG.

    • I don’t know whether McCrory is a better general election contender than Walker, but man, does BLP a) hate McCrory and b) have a bad read on why he lost in 2016. This Breitbart Bingo Card Word Salad is pretty amazing:

    • “McCrory is considered a RINO who duped tea party constituents on the campaign trail in order to ride that wave into office; only he failed completely to live up to this conservative mandate before ultimately being rejected by the voters.”

    • “McCrory pushed for a massive $2 billion bond after touting his record as a fiscal conservative …. He protected Common Core by appointing globalists to a state-mandated council reviewing those troublesome standards. McCrory implemented an unpopular toll road boondoggle, dooming his re-election chances and hurting Republican candidates across the state. He also joined liberals in slamming the Confederate Flag, which set the stage for Black Lives Matter marxists to gain momentum in their revolution against the Bill of Rights and Constitution.”

    • LOL. He lost because of HB2. And the toll road thing didn’t help. (Also, “globalists”?)

  • The method: Recruit U.S. Rep. Ted Budd—who voted with the Sedition Caucus in January—to run a losing campaign for Senate so he can dilute Walker’s base and give Patty Mac clear sailing. Then, with boosted name recognition, Budd will run for governor.

    • According to BLP, something like this happened in 2014: [Consultant Paul] Shumaker worked with Robin Hayes, a former N.C. Republican Party chairman who pleaded guilty to lying to the FBI in a bribery case, on a similar plan during the 2014 Republican primary for U.S. Senate. Grassroots conservative favorite Dr. Greg Brannon had his hopes dashed after Pastor Mark Harris entered the race as a spoiler, splitting the conservative vote and thereby giving the nomination to Tillis.”

    • Fact check: Tillis, the Speaker of the NC House, got 46% of the primary vote in an eight-way primary. Brannon got 27%. He and Harris combined didn’t get as many votes as Tillis.

  • The sourcing: “Sources within the North Carolina GOP have informed Big League Politics about a plot to run Budd as controlled opposition in the Senate race in order to thwart two constitutional candidates. … This scheme is what sources allege is being hatched to keep the party under RINO control, disrupting the America First uprising among their ranks, even if it means losing more winnable races to Democrats.”

    • Or, you know, trying to win winnable races.

  • Kink in the conspiracy: As it turns out, Robinson—who has spent his three months in office complaining about the scourge of liberal indoctrination in public schools (then stalling on turning over records of complaints that might show this alleged scourge)—is considering abandoning the job he just got to seek the Senate seat himself, according to the Carolina Journal.

    • “CJ has obtained a copy of polling questions for a survey apparently commissioned by people close to Robinson. One question asks whether voters would be more or less likely to vote for him so soon into his term. Another asks whether they think teachers are indoctrinating students on how to think about religion, politics, and social issues.” 

▶️ OTHER NCPOL NEWS

  • Madison Cawthorn—the alleged serial sexual harasser/creep who beat up a tree—once said he was more focused on comms than policy. Looking at his latest proposal, I can see why.

    • Cawthorn announced a legislative piece of Trump fellatio called the (sigh) “Donument Act,” which would declare the border wall a national monument and thus force President Biden to keep building it. Remember this when Cawthorn here gets the vapors about The Deficit™ and votes against the infrastructure bill.


2. Local Docs Test New Medicare Model

I know two-thirds of you scanned the headline and skipped over this one, but it’s important.

  • Medicare pays doctors on a fee-for-service (FFS) basis. That means, obviously, if a patient gets a checkup, the doc gets paid for a checkup. If the patient gets a test, the doc gets paid for reading it.

  • For years, many policymakers have believed this system creates incentives for doctors to run more tests and perform more procedures than are necessary, thus running up costs and making the whole program less efficient.

  • This belief isn’t universal. A recent paper argued that FFS wasn’t itself the problem, but rather that it can be integrated into a more efficient system “by giving consumers information on provider-specific prices and a strong incentive to choose lower-cost providers.”

  • Still, there’s a trend toward what’s called value-based care, in which docs are reimbursed based on the total quality of care provided, ideally motivating better long-term outcomes and relationships between patients and physicians. But this can get complicated, and docs worry about not getting paid.

So, with that background, here’s the news (TBJ, subscription):

  • “A group of independent Triangle physician practices is set to serve as the test case for North Carolina in a new Medicare compensation model intended to reduce costs and increase quality of care.”

  • “Twenty local practices making up the Triangle Senior Care Independent Practice Association and California-based Medicare Advantage company Alignment Healthcare Inc. are part of a joint venture to exclusively serve the area's Medicare population using a new cost-sharing model as part of a five-year program with the Center for Medicare and Medicaid Innovation.”

  • “The new model allows doctors to be compensated a fixed amount per patient per month for a year regardless of how often patients come in for a visit. … Under the new model, a certain portion of the payment that practices receive will be withheld until the end of the year to ensure practices are meeting quality of care and cost-saving outcomes.”

  • In other words, the government wants to ensure the docs aren’t padding their pockets by not providing their patients with services.


3. About That Trans Athlete Panic

With Republicans in the General Assembly pushing the Save Women’s Sports Act—which would ban transgender athletes from participating in school sports—and the NCAA threatening to pull events from any state that passes legislation like that, NC Health News’s Hannah Critchfield asks a good question: How many kids are we talking about here?

  • Fewer than 10 statewide.

  • “It’s likely very few transgender and gender-expansive girls play in women’s school sports in North Carolina. Existing data suggests a very small number of the state’s 1.7 million school-age children are transgender kids, and an even smaller number of them are participating in these activities at all.”

Nationwide, trans student-athletes have been rare:

  • “Retired transgender Mixed Martial Arts fighter Fallon Fox, in her two-year career, fought one 2014 match in her two-year career in which her opponent suffered an orbital bone fracture—an injury that is not uncommon in the sport.”

  • “Two transgender high school girls in Connecticut won a combined 15 championship races between 2017 and 2019, prompting a lawsuit. However, one of the cis female students suing, Chelsea Mitchell, beat the faster of the two transgender sprinters named in the lawsuit, Terry Miller, in their final two races at the Connecticut state championship in February 2020.”

  • “These examples notwithstanding, many lawmakers have struggled to name a single example where transgender girls’ participation has caused problems within their own states, including those in North Carolina.”

  • Bill sponsor Rep. Mark Brody says he’s being proactive: “We’re trying to set a standard—in some cases, all you have to do is make the declaration that you are a female, and not have to go through any sort of tests or anything. The ‘bright line’ definition we used in the bill was one that we completely believe is medically proven: If a transgender female, regardless of the sport, has the Y chromosome, well then, they have to play under the men’s sport.”

  • Brody’s bill will also force transgender boys—some of whom might have received HRT—to compete with the girls. Hannah’s story profiles two of them.

This is important to remember:

  • “Studies indicate playing sports as an adolescent can be a protective factor in a child’s mental health, particularly by decreasing a child’s risk of anxiety and depression. Transgender youth are at a heightened risk for suicide when compared to cis youth.”


4. Crook’s Corner’s New Chef

The storied Chapel Hill restaurant is getting its fourth-ever chef—and its second since Bill Smith retired a few years ago. Alley Twenty Six chef Carrie Schleiffer is taking over the kitchen (she’ll keep the Durham gig, too).

  • In 2019, Alley owner Shannon Healy and Gary Crunkleton (of the tony bar) bought Crook’s from original owner Gene Hamer.

  • Writing this made me realize I haven’t stepped foot inside a restaurant, let alone a bar, in 13 months.

▶️ OTHER NC RESTAURANT NEWS

  • Did you know the second-largest Golden Corral franchisee was based in Jacksonville, North Carolina? On Friday, Platinum Corral filed for Chapter 11 and announced that it would close 16 of its 28 locations as part of a reorganization to climb out of a $50 million hole. (Seven of its NC locations will remain open, if Golden Corral is your thing.) (TBJ, subscription)

    • The largest Golden Corral franchisee filed for bankruptcy last year.

    • The pandemic, it turns out, was hell on buffet restaurants.


5. Troops to Withdraw from Afghanistan by 9/11

The symbolism feels a bit on the nose: 20 years after the terrorist attack that unsettled a nation and defined a generation, the U.S. will finally end its forever war. Unless we change our mind.

  • “The decision will keep more than 3,000 American troops on the ground in Afghanistan beyond the May 1 withdrawal deadline announced by the administration of former President Donald J. Trump. … Administration officials said that since Mr. Biden was fixing a definite date on an American troop withdrawal, he hoped to avoid an increase in violence—which the Taliban have threatened if the United States kept troops beyond May 1.”

  • “A new intelligence report released Tuesday offered a grim assessment of Afghanistan and the prospects for peace. American intelligence agencies assessed that a peace deal was unlikely in the next year, and that the Taliban would make battlefield gains. ‘The Afghan government will struggle to hold the Taliban at bay if the coalition withdraws support,’ the report said.”

  • “Military and other officials who favored troops remaining in the country longer had used a similar classified intelligence assessment to argue for a slower drawdown, worried that an exit of American troops could trigger a wider civil war and an eventual return of terrorist groups. The report released Tuesday did not contain an assessment of the likelihood of a return of Al Qaeda to Afghanistan, and some senior officials remain skeptical the Taliban would allow it.” (NYT)

  • “The U.S. will maintain military assets in the region to counter terrorism threats and hold the Taliban to its commitments, including that it would sever ties with al Qaeda. The senior administration official, briefing reporters on Biden’s decision, said any attack by the Taliban on U.S. or allied forces as the drawdown is in progress will be ‘met with a forceful response.’” (NBC)

  • You’ll be shocked to learn that Lindsey Graham wants More War Forever.

Three things to remember:

  1. The military always wants more time.

  2. We’ve been there 20 years. What is Year 21 supposed to accomplish?

    The U.S. presence isn’t aiding peace talks:

    • “Keeping American forces in Afghanistan isn’t helping bring that nation’s opposing factions closer together. Rather, continuing to stay actively harms the prospects for a meaningful and durable peace. As it stands now, the Taliban negotiates at gunpoint, while the Afghan government negotiates from behind a shield that Washington may remove at any moment. Meanwhile, Afghan soldiers and civilians suffer as the months and years pass with no end to the violence in sight.”

    • A peaceful—or at least stable—Afghanistan won’t happen without a deal with the Taliban.

Unintended consequences: Biden’s decision could mean that a lot of people who trusted the U.S. will suffer, George Packer explains in The Atlantic.

If the purpose of the Afghan War was to prevent terrorists from using Afghanistan to stage attacks on the United States, America could have declared victory and gone home years ago. But if the purpose was also to help build a durable state—to prevent the Taliban from taking power again, destroying the hard-won progress made by millions of Afghan citizens, and perhaps allowing radical Islamists to regain a base on Afghan soil—then the longest war in U.S. history is ending in defeat. President Joe Biden’s announcement that all American forces will be withdrawn by September 11—a neat two decades after the attacks that propelled the U.S. into Afghanistan—simply gives a date after which the clock on the demise of the Afghan government will begin to tick. …

We should assume that Afghan cities could fall within months or weeks and that Kabul will soon become a bloody battleground, as it was in the early 1990s, during the civil war that followed the departure of Soviet troops. We should also assume that the Taliban will be no more merciful toward women, girls, religious minorities, civil-society activists, political opponents, and perceived infidels and spies than during its years in power before September 11, 2001.

… Biden has a relevant personal history. In April 1975, as a first-term senator, he was an outspoken opponent of using American money and risking Americans’ safety to rescue the tens of thousands of South Vietnamese who had bet their lives on American promises. … As South Vietnam fell, 135,000 endangered Vietnamese were evacuated through the heroic efforts of American officials, military veterans, and private citizens. … Those refugees and their descendants are now Americans. I doubt that Biden would wish it otherwise.

Biden failed to see a moral obligation in 1975. Today he can learn from the mistake and redeem it. Seventeen thousand Afghans who have worked for America in Afghanistan, along with tens of thousands of their family members, are waiting for the excruciatingly slow bureaucratic wheels of the U.S. government to process their visa applications. At the normal pace, they will still be waiting years after the last American troops leave their country. While they wait, trying to hide, many of them will be hunted down by the Taliban. We will be gone, and Afghans who believed our promises will be killed. …

These Afghans have to be extricated from the country and taken to an overseas U.S. military base, where their cases can be heard in safety, beyond the reach of the Taliban.

▶️ OTHER NATIONAL NEWS

  • On Nov. 3, you, like me, were probably pretty sure Democrats would romp to victory—at least, you were if you believed the polls. But Election Night turned out to be more of a nailbiter than we expected—just like things went sideways in 2016. Now, the top Dem pollsters are trying to figure out what went wrong.

    • “There’s no simple answer for why the polls have missed the mark in recent elections. But one likely culprit for some of the errors is the deteriorating public trust in institutions, like government and the news media—and the correlation between that wariness and voting for Trump.”

    • “The Democratic pollsters, who typically compete against each other for business, acknowledge that Trump was able to activate large numbers of voters who had turned out less reliably in the past. Looking at one state where the polls were off—Iowa, where Trump beat Biden handily and what had been seen as a toss-up Senate race went decisively for incumbent GOP Sen. Joni Ernst—Republicans classified as ‘low-propensity voters’ turned out at four times the rate of Democrats in that category.”