The Ethical Barometer

There is something about third-party pharmacy benefit managers. Put them together with state attorneys general and you have a 100% chance of uncovering overpayments under medical plans for government and private business employees as well as for recipients of Medicare benefits. The pharmacy managers do a lot of managing, from negotiating prices with pharmaceuticals, to deciding on drug coverage, to formulas for reimbursement, and developing relationships with retail pharmacies. With all those layers of managing it becomes difficult to understand who is paying whom how much and how much the third-party manager is getting for its work.

Centene just agreed, without admitting fault or liability, to settle disputes with Ohio and Mississippi for $88 million and $55 million respectively. Despite admitting nothing, Centene indicated that the settlement related to its practices in 2017 and 2018 and those practices have now been halted. We did not do anything wrong, but, just in case, we’ve changed what we are doing. That last line seems to be a part of every settlement at both state and federal levels when it comes to regulatory oversight.

Some follow-up questions:

1. If it was not wrong, was it a gray area?
2. Were you operating in loophole territory?
3. Was there full disclosure to all involved about your practices, procedures, and payments?
4. Did other companies engage in the same practices?

Those four questions would go a long way in preventing the settlements for doing nothing wrong.

Alphabet, Inc. (Google parent) hired Kamau Bobb in 2018 as its “global lead of diversity strategy and research.” Ironically, research revealed that in 2007, Mr. Bobb wrote a post entitled, “If I Were a Jew.” Dr. Bobb wrote in his post that if he were a Jew he would “be concerned about my insatiable appetite for war and killing in defense of myself.” Dr. Bobb has been reassigned at Google. Google’s spokesperson assures us that Dr. Bobb will be nowhere near the diversity team. Good decision.

When will companies learn to check the online activities of senior officers before hiring? Here’s an idea — Google their names and see what pops up. Or ask Google Assistant. Even better: Ask Amazon to ask Alexa.

Natalie Mayflower Sours Edwards was once a senior advisor in the Department of Treasury’s Financial Crimes Enforcement Network. During the Trump administration, from October 2017 until her arrest in October 2018, Ms. Mayflower Sours Edwards leaked SARs (suspicious activity reports) to that crackerjack news operation, BuzzFeed.

The SARs included information about former Trump campaign aides, Paul Manafort and Richard Gates. Ms. Mayflower Sours Edwards entered a guilty plea in January 2021 to conspiring to unlawfully disclose confidential financial reports. Ms. Mayflower Sours Edwards was sentenced to six months in prison on June 3, 2021.

No matter how a federal employee feels politically about the commander in chief or his aides, confidential means confidential. SARs are confidential with good reason. Suspicious activity reports (SARs) are just that: suspicious. It is a fundamental deprivation of due process to leak such reports before an investigation, and perhaps most importantly, before those named have the opportunity to respond. If you have ever wired money in excess of $10,000, well, you might have had a SARs.

You don’t leak suspicions, no matter how your politics lean or how long your last name. Rationalizing your personal exceptions to laws and policy are the roots of corruption. Corruption undermines markets, republics, and the law itself. See the Wild West.

Lovely Warren in the mayor of Rochester. Her name is musical. Her luck is bad. And her husband has been arrested for being part of a cocaine-trafficking ring. Her Honor herself was indicted one year ago for financial fraud in her 2017 campaign. “People will try anything to break me,” said the lovely Lovely Warren. Maybe so, but when a police raid nets $100,000 in cash and $60,000 in crack cocaine and powder, political motivation seems like a stretch. Mr. Warren has entered a plea of not guilty. Mrs. Warren, lovely though she is, currently trails her primary opponent by 10 points. And she trails him in cash raised by $100,000. You cannot make up either the names nor the facts of these cases,

In the 1970s TV series, Taxi, Louie DePalma (Danny DeVito strikes again) had to get a temporary job as a stock broker. He used the obituaries to make cold calls to widows, posing as a cousin.

That age-old practice may not be disappearing soon, but Merrill Lynch has prohibited cold-call instruction in its revamped training program. Lest we believe in the nobility of the move, the underlying reason may be simply that no one picks up their phones any more or their phones block unknown numbers. In short, cold calls do not work anymore. It must have been bad because in the 1980s, a broker who got 1% of those called to purchase a stock, they were like gods in the training room. In an industry based on ROI, something was clearly wrong with the whole picture of the boiler room with young ‘runs driven by the promises of Wall Street millions.

Ferris Bueller rollbacks and Danny DeVito antics in Matilda aside, altering an odometer reading has been illegal since 1972. Since 1986, those selling used cars must disclose the mileage on their vehicles, under that federal penalty thing. However, apparently with the penalties in leases (especially on luxury cars) there is a real market for tools that can swing that odometer back. There is even a YouTube video that shows you how to freeze the odometer on an Audi A8. So much for the crackerjack Zuckerberg committee on pulling videos, accounts, and posts. Apparently, social media community rules are not as outraged over odometer tampering.

Using software that takes over student computers, colleges and universities can now examine what students were doing with their computers during their exams. At Dartmouth Medical School they found 17 students had looked up information on the internet in order to answer exam questions. Student are protesting invasion of their privacy and lack of due process. The students are pushing for in-person exams and asking for leniency. One quote, “Some students have built their whole lives around medical school and now they’re being thrown out like they’re worthless.” Natasha Singer and Aaron Krolik, “Cheating Charges at Dartmouth Show Pitfalls of Tech Tracking,” New York Times, May 9, 2021, p. A1.

Actually they are being thrown out for cheating, not because they are worthless. As Dean Duane A. Compton of Dartmouth’s Giesel Medical School explained, “We take academic integrity very seriously. We wouldn’t want people to be able to be eligible for a medical license without really having the appropriate training.” The privacy issues are red herrings. Most colleges and universities make it very clear that when you are using their online programs you have no privacy. Indeed, colleges and universities are required to monitor things such as the unauthorized downloading and pirating of copyrighted films and music or risk costs and penalties themselves. That those systems can pick up cheating is a given once the student has signed one. Another given is that the tests is to be done alone and without Google.

Speaking as a patient, the Barometer feels that a doctor should know the basics by heart: That the shoulder bone is connected to the arm bone and the arm bone’s connected to the wrist bone, etc. Having one’s doctor looking up terms and body parts online during a visit would rattle all a patient’s bones and nerves.

Update: All the cheating charges were dropped against the students. The dean apologized to the students who were charged with violations of the honor code. In seven of the cases the administration decided that the online activity data of Canvas can be in error as to whether students are online during exam times. With the remaining ten students, the dean decided to just let things go, Canvas error or not. Given the Canvas cover, we will never know. The university is silent due to privacy rights of the students. The students are silent because, well, why risk anything? You have a pass and a plausible explanation. Still, that question of whether they know about the knee bone connected to the leg bone and all– it looms large.

You knew it was coming. Todd Anderson, the owner of a bar in Clements, California, was arrested on charges of identity theft, forging government documents, falsifying medical documents, and, for good measure, having a loaded, unregistered handgun. Mr. Anderson allegedly sold four fraudulent vaccine cards to undercover agents from the California Department of Alcoholic Beverages. The transaction, for $20 per card, went down at Anderson’s Old Corner Saloon.

The agents obtained a warrant and found 30 blank vaccine cards and a laminating machine. FYI — the cards are ubiquitous on social media sites, commerce platforms, and blogs. No longer, however, are they available at the Old Corner Saloon.

Pandemics bring out the best in doctors, nurses, and those who care for the elderly. They also bring out the worst in some governors, bar owners, and that blasted internet. Let’s hope the tech powers-that-be get busy banning these folks for life.

As the Wall Street Journal noted, London’s sailor shop, one that had survived Nazi bombings, bubonic plague, and fires, was brought down by COVID 19. Located in the heart of the theater district, the shop was the vendor of ropes needed in the production of plays. It costs $140,000 in rent and taxes to run the shop. With no plays, London locked down three times, and little to no sailing allowed, there was no choice. Arthur Beale will head to the internet.

As we continue to read about all we have lost we know that life will never be the same. Even now, with the mask-mandate lifted, friends and loved ones are gone, learning was suspended, graduations, weddings, and celebrations were canceled. There is a sadness that comes because of all that we have lost. With the ability to see faces once again, we can once again mourn together our losses and hope that in the future public health crises are handled with greater perspective and common sense. Arthur Beale, we hardly knew ye. But we still mourn for your ship bells that will toll no more.

While West Point is focused on catching those who cheat on exams, the rest of us are facing a bigger problem. You know that trouble is afoot when you read these words, “Consider hiring me to do your assignments.” Bless the little cherubs. Whilst the adults are arguing over masks and teacher pay, students are not only finishing their jokes-of-homework, they have captured the entrepreneuiral spirit and are offering assignment services and even their own homework assignments. You can put in bids to grab an assignment. Clever little demons, aren’t they? You can buy an assignment instead of copying something from the internet because schools have software to detect that kind of cheating.

Face it, all you educators on your health-concerned high horses and computers at home, no one believes that real learning has gone on for the past year. The Wall Street Journal confirmed it with its solid work on cheating. In fact, cheating is so rampant that we now have firms that will help schools detect who is behind the cheating scams, schemes, and auctions. Tawnell D. Holmes, “Cheating at School Grows Rampant,” Wall Street Journal, May 13, 2021, p. A1. The net revenue for one of these online detective firms increased 57% over the past year.

One more thing, and something that emerged in defense of the cadets who cheated on an exam, rationalizations abound. One teacher noted that students commented that it was “unfair” to put them trough a disciplinary process because they “were going through a pandemic.” Ah, COVID 19 has taken the place of “The dog ate my homework.”

Oh, the things we learn about ourselves when we shut down the country for over a year. Kids grew businesses to facilitate cheating. Adults gamed the system to leap-frog ahead on vaccines. Government officials stepped in to get friends, relatives, and donors tested and vaccinated ahead of our most vulnerable. And presidents gave away patents. Looks like the rules don’t matter, and if someone calls us on violations, well, just say, “The pandemic made me do it.”

On September 22, 2019. July 30, 2020, and November 6, 2020, the Barometer posted Bob Baffert stories. All of them involved horses Mr. Baffert was training. All of the horses had tested positive for some banned substance. All of them found Baffert excused with a slap on the hand. All of them involved the same type of explanation: The banned drug was in the feed. The banned drug came from the groomer’s hands because he was using the ointment to treat his back pain.

Now comes a positive drug test for Medina Spirit, the horse with 12-1 odds who won the Kentucky Derby a a nose. The initial story from Mr. Baffert was that he would never give his horses betamethasone. The story changed today and now goes back to the original formula: Medina Spirit had dermatitis on his bottom and the vet recommended Otomax, a cream that contains betamethasone, as the treatment. Mr. Baffert says that he did not know, but the vet informed him. And it remains to be seen whether the cream treatment could produce the drug test result of 21 picograms in Medina Spirit’s drug test. The follow-up second test will reveal more information.

However, the follow-up test will take weeks. So, we are into the same pattern that we had with Justify. The horse keeps running while the tests are done. The Preakness at Pimlico is this Saturday. The Maryland Racing Commission has a decision to make. There is due process. There is also a Baffert pattern. Perhaps he just did not know or perhaps he just pushes the envelope. In his book be prayed for help when he neglected to vet a horse before buying him for an owner. The horse turned out to be fine. It is not his first rodeo before a racing commission. Always an accident. He did not know. Who does know? Perhaps no one, but a pattern of positive drug tests and lame, as it were, excuses does add up.

This story makes the Wells Fargo fake-account-creating employees look angelic. Two Hialeah, Florida police officers have been charged with alleged professional misconduct for issuing dozens of bogus tickets to drivers they never pulled over and ticketed. Cuts way back on the time required to meet your quota of tickets if you can just make stuff up.

Perhaps the most-jaw-dropping part of the story is how the fake tickets were discovered. Florida has no shortage of lawyers. One type of lawyer is the traffic ticket specialist. These specialists do their marketing. “No pagues ese ticket!” and “Don’t Pay That Ticket!” The lawyers send out cards and mailers to drivers (and they find them on public records) who have been issued tickets. These lawyers are also on TV and billboards. Their marketing efforts brought clients clambering to their doors. However, many of those clients swore that they had never been pulled over but they did remember passing two motorcycle police officers.

The clever lawyers took what they were finding to the city police department. Enter internal affairs. Following their investigation, the department concluded that the two officers simply wrote down license numbers and made-up names with the tickets going to the address for the vehicle license. One made-up name was “Martcello Strovanov.” Sounds like a chicken dish. One driver had six tickets issued on the same day by these same officers.

If the Barometer had to guess, she would say that the officers were trying to meet goals or quotas for tickets issued. Be careful what you measure. Be careful about goals and incentives. Employees will reach their numbers, but, just like the Wells Fargo accounts, what they are using to meet the goals and get their incentives might not be real.

The above West Point Honor Code appears in marble at the West Point Honor Plaza. However, in 2015, West Point adopted a self-reporting policy that eased up on the absolute nature of the code. If cadets self-reported their cheating, they would not be thrown out. Known as the second-chance program, the hope was self-reporting would increase.

It appears the self-reporting may not have worked as well as hoped. Last spring, during the nightmare of online classes and tests, 73 cadets cheated on a calculus exam. The final punishments? 51 have to repeat a full year of their schooling, two must repeat one-half year of their schooling, and eight have been expelled. Six cadets quit the academy and four were acquitted of any wrongdoing. Two had their cases dropped because of insufficient evidence. If those numbers do not add up to 73, well, math seems to be a struggle at West Point.

Of the 73 first-year plebes investigated, 52 were student-athletes. West Point’s previous cheating scandals were in 1976 (involving 150 senior student-athletes cheating on a final exam in electrical engineering) and a 1951 scandal involving mostly the football team. The other branches of the military are not immune. The Navy had a cheating scandal in 1994 involving 125 cadets. The Air Force had one in 2007 with 18 cadets expelled.

The self-reporting as well as reporting on classmates, an imagined benefit of the second-chance program, did not increase the number of reports of cheating. The 2020 exam cheating mess was uncovered as faculty members discovered irregularities in grading the exams. Translation: All the papers had the same answers, right or wrong, the plebes were all for one and one for all in their plot. In addition, as a former graduate put it, “You’re asking an awful lot of these young people to turn somebody else in.” Rats, finks, rat-fink, stool pigeons, stoolies, tattletales, whistleblowers, snitches, and narcs, — all not welcome, never revered, and under great pressure as they wrestle conscience and, perhaps, peers.

If it were up to the Barometer the root cause would go right to the admissions process. Are the athletes truly prepared for the rigors of calculus and electrical engineering? When employees fool with numbers at work, it is generally because they cannot get to the numbers without manipulation. Pressure trumps honor.

Wall Street Journal headline, April 4, 2021, p. A9.

Why is this a headline? If you are sitting around with Alexa rolling and mention the term “skin tags,” you will find ads in your mailbox for skin-tag removal. In addition, that tidbit will start a parade of ads for cremation, support hose, senior living communities, burial plots, and those ejecto-chairs that can propel you to your feet. We caught on to Google many years ago. Alexa is no longer with us. In fact, we used to say certain terms just to see what kind of ads would show up the next day. DuckDuck-Go works very well in lieu of Google. The titans of Silicon Valley are now and always have been marketing firms. They signal virtue and hide vice.