Flint and lead screenings

One of the things that puzzled me about the Flint lead poisoning is why the problem took so long to identify.  Medicaid gives strong incentives to managed care organizations to test their pediatric members for lead poisoning.  Michigan has their own lead policy:

All Medicaid enrolled children are considered to be at high risk for blood lead poisoning. In accordance with the Centers for Medicare and Medicaid Services guidelines, Michigan Medicaid policy requires that all Medicaid enrolled children be blood lead tested at 12 and 24 months of age, or between 36 and 72 months of age if not previously tested.

Public Act 55 of 2004 required that by October 1, 2007, 80% of Medicaid enrolled children were to have been blood lead tested. MDCH designed a report, theMedicaid Blood Lead Testing report, to monitor compliance with this law.

The January 2013 report showed that there were 3,000+ kids in Medicaid under the age of 2  in Genesee County.  70% of those kids had a lead screening.

Someone should have been screaming that the Medicaid pediatric population was seeing a massive lead level spike.  It should have been either at the provider level, or more readily, at the insurer level as they should have been seeing the claims for follow-up visits after positive lead tests started to come back in high numbers.  And if the providers and insurers were not screaming their heads off, the Michigan medicaid administrative offices should have been as soon as they started to see the claims come across their data encounter system.

Unfortunately, it looks like the state of Michigan put their head in the sand (via the ACLU)

In a posting Monday on the website FlintWaterStudy.org, Virginia Tech professor Marc Edwards accused the state of neglecting the lead-poisoning issue even though Michigan officials knew as early as summer 2014 that there was a problem.

“They [Michigan Department of Human and Services officials] discovered scientifically conclusive evidence of an anomalous increase in childhood lead poisoning in summer 2014 immediately after the switch in water sources, but stood by silently as Michigan Department of Environmental Quality (MDEQ) officials repeatedly and falsely stated that no spike in blood lead levels (BLL) of children had occurred,” wrote Edwards

Lead poisoning is something that should be picked up through multiple systems.  I can’t figure out why the public health system failed so obviously.

97 replies
  1. 1
    MomSense says:

    I think they wanted to fail. No one wants to take responsibility for the harm that was done to those children. I’m sick about this.

  2. 2
    debbie says:

    @MomSense:

    This is similar to Houston authorities not giving a shit about the rise in juvenile asthma rates in neighborhoods near power plants back in the 1980s. Heads need to roll (and worse)) at MDEQ.

  3. 3
    trollhattan says:

    Not to mention routine, federally mandated drinking water testing should have identified lead levels out of compliance soon after the supply switch. Serial failures occurred there.

  4. 4
    John says:

    What are the demographics like in Flint? I suppose a similar problem in Grosse Point would have been similarly mishandled?

  5. 5

    @John: Grosse Pointe would not have had the data source that I am thinking about as a warning light. Touche

  6. 6
    Linnaeus says:

    MomSense has the right of it. The system failed because it was meant to fail.

    The political context sheds some light on why. Flint was under emergency management at the time, and one of the hallmarks of emergency management is a ruthless focus on cost cutting. For state authorities to realize and take responsibility for this problem early on would have put emergency management – a concept that the Snyder administration is heavily invested in – in a negative light, especially in an election year when Snyder was getting a lot of credit for his actions in the Detroit bankruptcy. Race and class matter, of course – Flint is an economically depressed area with a large minority population. This would not have happened in, say, Bloomfield Hills.

  7. 7
    LevelB says:

    EPA (the feds) typically monitors the water quality of the water leaving the treatment plant, not the water entering residences/businesses/factories. There are exceptions to this, but I found it to be fairly rare.

    That would be an expensive hole to plug, but what’s the money for, anyway?

    B.

  8. 8
    AMinNC says:

    I also think it would be interesting to take a look at funding/staffing levels at MDEQ. Here in NC, McCrory and the GOP legislature can’t defund (and politicize) our regulatory agencies fast enough. But hey, you know, gotta run government like the business it is, right?

  9. 9
    trollhattan says:

    @John:
    They only use city water for toilets. Everything else: Perrier.

  10. 10
    Linnaeus says:

    @debbie:

    Heads need to roll (and worse)) at MDEQ.

    And maybe not just at MDEQ. This may go all the way to the governor’s mansion. I’m skeptical, though, that the governor’s “independent commission” will actually be allowed to do the limited job it’s been charged with. The legislature sure as shit won’t do anything.

  11. 11
    Cervantes says:

    Yes, that’s strange, there is a surveillance system for childhood lead poisoning, as far as I know in every state. They regularly report data on geographic distribution of elevated lead levels, should be publicly available. At least that was the case in Massachusetts when I worked in public health.

  12. 12
    🚸 Martin says:

    Maddow has been covering this pretty well, and it’s clear that the system failed because it was expressly designed to fail. Flint is under administrative management from the state. The water source change was textbook GOP fiscal management – ignore environmental warnings, ignore process, cut costs, everything will be fine – just you watch. And it was done with the deliberate intention of ignoring local voter concerns. The state-appointed administrator has no obligation to the voters. This is a local dictatorship so nobody should be surprised that you get the same outcomes as the USSR.

    So when concerned were raised over a year ago, Snyder’s administration swept them under the rug because protecting the system of putting cities under administrative control was more important than protecting the people that lived in Flint. There was an ideology to preserve.

  13. 13
    D58826 says:

    Poor and probably mostly ‘the other’ so why should the GOP care as long ass the tax cuts and consulting contract money keeps flowing.

  14. 14
    trollhattan says:

    @LevelB:
    The lead and copper rule is summarize here. It includes testing at the tap, but doesn’t go into detail.

  15. 15
    Linnaeus says:

    @🚸 Martin:

    Yes, this. Minor quibble: Flint is no longer under emergency management, per se. That ended in April of this year. Now the mayor and city council are back to running things, but their decisions can be reviewed by a “transition board” for a period of time (though I don’t know how long that is).

  16. 16
    WereBear says:

    This is the fate that lies ahead for all of us if modern Republicans get their way. Heed the warnings!

  17. 17
    Linnaeus says:

    By the way, Darnell Earley, who was the EM of Flint and turned down Detroit’s offer to stay on the Detroit water system until the new water authority that Flint was switching to was ready, is now the EM of Detroit Public Schools. Nice work if you can get it.

  18. 18
    WereBear says:

    Right now, at the Dick Cheney Center for Evil Laughter, there are plans to take all that toxic waste and inject it into the Government Cheese.

    Let them complain about the funny tastes. Their symptoms can be blamed on slacking off. And then they die quickly.

    Somebody got a gold star.

  19. 19
    a hip hop artist from Idaho (fka Bella Q) says:

    @🚸 Martin: There you go. That’s the concise explanation.

  20. 20
    Debbie says:

    @WereBear:

    Not just Cheney. MBAs everywhere will chortle.

  21. 21
    🚸 Martin says:

    I’m guessing there is no way to put a criminal complaint on this, but there should be. This was criminal negligence. And what’s worse is that you know the costs to care for these kids and clean up this mess will be put on Flint’s books and be used as evidence that voters can’t self-govern and earn them yet another emergency administration.

    It should be put against whatever ‘savings’ the governor is claiming under his emergency administrator actions, which would probably be sufficient to show that program is a complete failure. On top of that, the administrator and the Governor should be in orange jumpsuits.

  22. 22
    Sherparick says:

    Someone, I think Charles Pierce or perhaps Matt Tabbai, wrote once that Democracy and the need to account to voters is about the only thing preventing society from turning into a giant Stanford Prison Experiment with our elite as their minions as the guards and the rest of us as the inmates. This Flint situation illustrates what happens when the decision makers completes separate accountability for their decisions from the persons bearing the consequences of those decisions. This is also an example where “stupid and malicious” are not exclusive.

  23. 23
    dedc79 says:

    Michigan has exactly the overwhelmed and underfunded environmental agency (MDEQ) that its republican elected leadership advocated for. If the people of Michigan want a more competent and more effective environmental regulatory agency, then they need to pay for it.

  24. 24
    Dave L says:

    This is almost too easy: They didn’t care. It’s a Republican administration. And now they get to point out that government doesn’t work.

  25. 25
    JaneE says:

    As soon as the test results became known, lead went from an unintended consequence to a deliberate harmful action on the part of the people in charge. They need to be charged with whatever statutes apply to causing injury by deliberate action. The people who deliberately lied and covered it up should be charged with conspiracy as well.

  26. 26
    WereBear says:

    First, they put lead in the poor kid’s water, and I didn’t care, because I didn’t have a poor kid…

  27. 27
    scav says:

    What’s a little collateral damage so long as the target (Fewer taxes! Less Intrusive Government!) is achieved? Besides, all those collateralled would have felt uncomfortable in any elite educational (and other) settings they might have stumbled into in later life Now they’ll be more firmly settled among their own kind. Win-win!

  28. 28
    Jackie says:

    It has been many years since i saw a child with a high lead level,(thank god) but at the time in Illinois the data passed to the health dept to id the source of the lead.They took this pretty seriously, followed the child to make sure they were treated, got the rest of the family tested etc. At the time it was lead paint and proximity to highways. Don’t know the protocol in MI but sure as shooting they had to know that they were getting a lot of positives. At the individual MD level wasn’t it a local pediatrician that noticed and did a study?

    now that i think of it I saw her interviewed, she sat next to a friend who was a water expert and told her the water was going to leach lead from the pipes and then she looked. And got pilloried by the state for shoddy research, always projection with these folks

  29. 29
    WereBear says:

    A few threads back, commenter rikyrah pointed out:

    The entire, ‘ but, I don’t believe they’ll do what they TELL ME what they’re going to do.’

    Non-White people don’t have the luxury to gamble on that.

    Was what I thought absolutely defined privilege.

    Every single Republican I’ve ever discussed issues with are DEAD CERTAIN none of the bad fallout is going to fall on them. They deny it’s a thing, it’s only going to happen to “those people,” their candidate doesn’t really mean it… there’s got to be a hundred of these stupid excuses where their indulgence of their racism/sexism/spite appetite is going to have zero blowback for them.

    I don’t know about you, but when I’m rounded up in the “earning lower than the median” FEMA camps, and we’re all lurching towards the “big barn where the mooing stops” I’m going to have a very hard time not beating one of these assholes to jelly.

    Jelly, I tells ya.

  30. 30
    trollhattan says:

    @dedc79:
    Usurper Obama’s EPA should take over for the state if they can’t comply with federal SDWA regs. Kind of like the state did with Detroit.

  31. 31
    central texas says:

    I suggest two words that explain most of it. Republican. Conservative.

  32. 32
    JohnM says:

    @Linnaeus: You’re right. To make it worse, the legislature and the Governor’s office are controlled by the same party, the Republicans. To have said anything would mean that they screwed up and that was simply not feasible. The whole point of the emergency manager law was to allow the state to take over those poor municipalities that were in dire straits and show that they could make everything wonderful by making the “hard” decisions. Also, the leg & the gov are term-limited. Every incentive for the powers that be was to sweep this under the carpet and hope it goes away or at least not become an issue until they’re out of office.

    As a Michigander, it ticks me off that this happened in my state. As a person, I am furious that thousands of children have suffered permanent cognitive damage and that probably more will suffer the same until the state decides to actually fix things. Based on our on-going roads problem, it should take no more than 10-20 years. I hope that there is a class action suit that directly goes after the SOBs that allowed this to happen.

  33. 33
    D58826 says:

    @Richard Mayhew: If one child in Gross Point during his pediatric check up had been diagnosed with an elevated lead level, the governor would have declared a state of emergency. The lead poisoning would not have been detected using the data points that Richard is talking about but by high quality medical care provided by parents who can affords only the best.

  34. 34
    Mnemosyne says:

    I wish I had some snark for this, but I just don’t. The “pro-life” crowd is happy to permanently damage children’s brains in order to save themselves a few bucks. Why should they care? It’s not their kids who will be damaged or their families who will have to suffer, so why should they give a fuck?

    Every fucking “pro-life” protester out in front of a Michigan clinic should be asked why they don’t give a shit about kids once they’re actually born. The mere fact that they’re out protesting clinics instead of storming the statehouse over this is proof positive they don’t give a fuck about born kids. At all.

  35. 35
    OzarkHillbilly says:

    @LevelB:

    EPA (the feds) typically monitors the water quality of the water leaving the treatment plant, not the water entering residences/businesses/factories.

    This is exactly how it came about as I understand it. The source of the lead is NOT the river, it is the cities old water pipes. The water leaving the plant is still acidic from toxins not removed in treatment (toxins that are in the polluted river water) and they are eating away the calcification in the old pipes and exposing the water to the lead which is then dissolved into the water.

  36. 36
    Elie says:

    @MomSense:

    I think our public health systems are very minimal and led by weak, politically focused administrators. The other piece — a very very important piece in my mind, and an area that progressives should own, is the failure of community leadership and true grass roots organizing. The data was there, but no one cared and as always in life, you have to stand up for yourself first before others care. This is a missed opportunity but salvageable. It has to be politicized aggressively and a bullhorn used to blast the leadership of the county and state. We progressives need to be working the grass roots. Instead we like to cry in our soups and wait for someone else to do it. Up here in the NW, the right wing Christians are working youngsters and teenagers who are left behind in all the social change. What the eff are we progressives doing or offering? Not much as far as I can tell.

  37. 37
    WereBear says:

    @Mnemosyne: The mere fact that they’re out protesting clinics instead of storming the statehouse over this is proof positive they don’t give a fuck about born kids. At all.

    Yes, like the “pro-life” guy who shot up a Colorado Planned Parenthood. He didn’t care about born adults, either.

  38. 38
    Elie says:

    @Mnemosyne:

    We’d be wasting our time.

    We need to find our communities and kids and work with them for a continuation of black lives matter movement. Black lives matter in way more ways than just police killings. How do you really kill people? How do you condemn them to third class lives forever? Poison the brains of their children either through lead or through the thousands of shit assed schools. You might as well kill us.

  39. 39
    Villago Delenda Est says:

    Rethuglicans do not give a rat’s ass about the common welfare. Never mind that concern for it is black letter Constitutional concern. That’s just boilerplate, according to these assholes, like “a well regulated militia” is.

  40. 40
    WereBear says:

    Seriously, though. This is outrageous.

    To pick up from a previous thread, if NPR does not make a big deal of this… if CNN covers it for more than a collective five minutes… if people do not know a Republican governor cripples kids out of ideology… then they are only fools who dance at the king’s pleasure.

    They certainly are not “news” organizations.

  41. 41
    alce_e_ ardilla says:

    Lead poisoning is something that should be picked up through multiple systems. I can’t figure out why the public health system failed so obviously.

    Now let me think….. what color are the children we are talking about? That might be your answer right there.The Snyder administration couldn’t care less about the children, only cared about saving money for the wealthy

  42. 42

    @trollhattan:

    Not to mention routine, federally mandated drinking water testing should have identified lead levels out of compliance soon after the supply switch.

    Not necessarily; it depends on where the lead is coming from. It sounds as if the problem is more likely from the new water supply being more acidic, which makes it dissolve lead out of older piping that uses lead-based solder, than it is from lead in the river water. That would mean there would be no sign of high lead levels when testing the water, which might help to explain why officials didn’t believe the water switch was at fault. It would also mean the lead problems would tend to be more concentrated in poor people living in older housing.

  43. 43
    pea says:

    if one considers the # of low income individuals who’ve had their water shut off for failure to pay their bills (while convention centers and golf courses can owe thousands of $ for years), that Flint/Pontiac have fallen into neglect since GM abandoned them 20+ years ago, and the current Rethug governing party, there is no mystery here.
    i grew up in Michigan (60 years ago).
    breaks my heart.

    “water water everywhere
    and not a drop to drink.”

  44. 44
    Sad_Dem says:

    @Mnemosyne:

    Every fucking “pro-life” protester out in front of a Michigan clinic should be asked why they don’t give a shit about kids once they’re actually born.

    Many of those kids are black and/or poor.

  45. 45
    Linnaeus says:

    @JohnM:

    Yep. I know that Jim Ananich, the minority leader in the state Senate, is calling for hearings and subpoenas, but the Republican majority isn’t going to allow that. We’ll only have the governor’s “independent” commission, which I suspect will only be a CYA operation – that’s not an indictment of the members of the commission, but they’re already pretty handcuffed in what they’re allowed to do. Snyder is already voicing the “let’s move forward” rhetoric, which is a good sign that he doesn’t intend to have anyone held accountable for what they did (or didn’t) do.

    As a born and raised Michigander who is visiting the state for the holidays, this infuriates me. “Crisis” or “emergency” doesn’t do the situation justice. It’s a crime.

  46. 46
    MomSense says:

    @Mnemosyne:

    I wish I had some snark for this, but I just don’t. The “pro-life” crowd is happy to permanently damage children’s brains in order to save themselves a few bucks. Why should they care? It’s not their kids who will be damaged or their families who will have to suffer, so why should they give a fuck?

    Every fucking “pro-life” protester out in front of a Michigan clinic should be asked why they don’t give a shit about kids once they’re actually born. The mere fact that they’re out protesting clinics instead of storming the statehouse over this is proof positive they don’t give a fuck about born kids. At all.

    The doctor who blew the whistle on this is now testing cord-blood. Will the “pro-lifers” care?

  47. 47
    Elie says:

    @Linnaeus:

    Again, this has to start at the community or there is not impetus for the elected leadership to pay attention. No one wants to do that lift, but its the most important. Community citizens starting meetings and getting themselves organized and (hopefully), teaming up with progressives to raise awareness and bring appropriate pressure…

  48. 48
    Villago Delenda Est says:

    @Sad_Dem: They don’t care about white kids after they’ve exited the womb.

    The entire “pro life” movement is about punishing the sluts. Nothing more.

  49. 49
    moderateindy says:

    If those people had just pulled themselves up by their bootstraps, then they would have been able to afford a nicer place to live that didn’t have tainted water, or at least bottled water.
    As it is it’s simply another liberal elite big government program that doesn’t work. In the end let’s face it, the NiClangs that live there were just going to end up in jail. Now that they have incurred brain damage they will work for minimum wage, and have no idea that they are getting screwed! Plus they are a posible new demographic for Fox News.
    Saving money, passive exploitable workers, minority community who are impaired enough that they might vote Republican, man the list of good news just goes on and on!!

  50. 50
    Linnaeus says:

    @WereBear:

    If you have an hour to spare, the Michigan Public Radio documentary on the Flint water poisoning is worth a listen.

    This really should be national news.

  51. 51
    MomSense says:

    @Elie:

    We need to find our communities and kids and work with them for a continuation of black lives matter movement. Black lives matter in way more ways than just police killings. How do you really kill people? How do you condemn them to third class lives forever? Poison the brains of their children either through lead or through the thousands of shit assed schools. You might as well kill us.

    QFT I need to figure out how to be more helpful to BLM because I think it is the key to a lot of the problems we are facing right now.

  52. 52
    WereBear says:

    @Linnaeus: Shared on social media, at least. And, good for them!

  53. 53
    liberal says:

    Frankly, these people need to be executed.

  54. 54
    Felanius Kootea says:

    @Linnaeus: Bingo. There was a focus on short-term cost-cutting above all else. In the long term the medical costs from lead poisoning will make this look like the idiotic strategy it was.

  55. 55
    OzarkHillbilly says:

    @liberal: Nah. They need to drink the water.

  56. 56
    Elie says:

    @MomSense:

    I agree. I also want to become more involved with that movement. But its gotta be at the grass roots where people have the outcomes. Flying along at 35,000 ft just aint gonna do it. People have to recognize each other as interested citizens in local meetings. That gives us confidence and a sense that others also see the problems and are willing to take action. Open, public meetings is where the energy can build…led by local people who care (with assist from knowledgeable outsiders). It begins locally.

  57. 57
    liberal says:

    @moderateindy:

    If those people had just pulled themselves up by their bootstraps, then they would have been able to afford a nicer place to live that didn’t have tainted water, or at least bottled water.

    The bottled water bullshit is a part of the problem. I wince every time I see someone frickin’ stupid enough to be buying a bushel of goddamn bottled water bottles at the grocery store.

  58. 58
  59. 59
    MomSense says:

    @Elie:

    Such a good comment. I’m going to see what the situation is locally.

  60. 60
    Felanius Kootea says:

    I saw a detailed program about this on Al Jazeera. Interestingly, most of the Flint families on that show (including a woman whose son tested off the charts for lead poisoning) were white. She moved to Virginia.

  61. 61
    WereBear says:

    @Felanius Kootea: She moved to Virginia.

    I just hope she didn’t move from the frying pan into the fire.

    But then, a similar impulse moved me from Florida to New York. And I have never looked back.

  62. 62
    Elie says:

    @MomSense:

    I have to check it out here locally but I have been involved in several grass roots initiatives here related to the environment and other social issues. It makes such a huge difference to see your neighbors! To work with them is so energizing and encouraging! And believe me, the elected officials start to pay attention to you then. ONLY then. A couple of experts testifying at the county or state don’t mean shit.

  63. 63
    trollhattan says:

    @Roger Moore:
    Protocol should be to identify soft and/or acidic source water with leaching potential and test for metals along the distribution network, including the endpoints. If metals show at action levels then adjust the water chemistry as needed. Basic stuff.

  64. 64
    Mnemosyne says:

    @MomSense:

    They will probably find a cluster of increased miscarriages in Flint since that’s what happened in Washington DC when their water lead levels went up for a similar reason. But I guess that’s okay since it’s God’s Will and not a woman making an adult decision.

  65. 65
    Felanius Kootea says:

    @WereBear: I remember thinking the same thing but I think Virginia has at least a Democratic governor even if the state legislature is overwhelmingly Republican (and likely to vote for the kinds of simplistic cost-cutting measures that led to the lead-poisoning situation in Flint).

  66. 66
    Mnemosyne says:

    @Elie:

    I agree with you, but I’m half a country away, so there’s not much I can do other than be pissed off. You are correct that community engagement is the best long-term solution.

  67. 67
    Linnaeus says:

    @Elie:

    Yes, and there’s quite a bit being done at the community level. That’s how this whole thing got noticed in the first place.

  68. 68
    Linnaeus says:

    @trollhattan:

    Corrosion control is a pretty standard procedure – the water that Flint got from Detroit had corrosion control treatment. This should have been done from the outset of the switch, but MDEQ approved Flint’s switch to the Flint River without corrosion control.

  69. 69

    @alce_e_ ardilla: Doesn’t matter, one of the Medicaid Managed Care organizations (3 for that county) should have been looking at their data and have someone say “OH SHIT… our pediatric case mixture looks to be getting really fucking expensive really soon”

  70. 70
    Original Lee says:

    Snyder’s buddies hadn’t figured out how to monetize it yet, that’s how.

  71. 71
    Elie says:

    @Mnemosyne:

    Oh I hear you for sure. But I think we can all get involved in our local issues of similar importance.

    This energy here has helped promote success for progressives in local elections. Local movements raise our energy and sense of connection to each other, I believe. Gosh, I know its a pain to start putting together. My husband and I would drive around and put leaflets about upcoming meetings in the neighborhood newspaper slots (its illegal to put anything in people’s mailboxes). We would staple announcements to lightpoles. Finding places to meet was also a challenge at times… vested interests would sometimes make it hard to find meeting places big enough.

    Trump’s following are all estranged from the system and from each other. There is no sustained power in hate and Trump is not an organizer who wants to do anything except be popular and have followers. He has not articulated any actually do able agenda and certainly nothing that will help their plight.

    We progressives have to figure out a way to start to reach the edges of these folks who are not too racist or far gone to reach. One way is through the common community experience talking in language that they can relate to. I know — that seems light years away worth of impossible.

  72. 72
    lowercase steve says:

    @Sad_Dem:

    You need poor blah people to point to so you can work up white people about “moochers” and convince them to vote for you so you can cut your own taxes. Works out quite nicely.

  73. 73
    trollhattan says:

    @Linnaeus:
    It’s as though every possible safeguard was discarded along the way. I’m only surprised we haven’t read about flaming tapwater from fracking.

  74. 74
    Elie says:

    @Richard Mayhew:

    Richard, one of the lasting frustrations that I had in working with Medicaid or even private employer clients is that no one actually looks and interprets data on a regular basis. Of course some do and some are better than others, but it is continually surprising that organizations who actually pay a significant price for not knowing either don’t really hire people to do it or don’t have the analytical and database tools to accomplish the analysis you speak of. Yeah, they turn in obligatory reports to the state or whatever required entity, but the well integrated sharing of results and the so whats, not so much. All of the ACA changes, and new delivery models that use the electronic record… none of them have formats that allow for using data across their own organizations, much less with others! Its all backing into conclusions, except for a small group.

  75. 75
    Linnaeus says:

    @trollhattan:

    It really is ridiculous – this isn’t cutting edge engineering. We’ve known how to do this right for decades. Hell, it was being done right in Flint until they decided that cost cutting was paramount.

    On top of that, the state didn’t even pay the full bill for the switch back to Detroit water. A private philanthropic foundation (the Mott Foundation) kicked in for some of it.

  76. 76
    Linnaeus says:

    @Felanius Kootea:

    Interesting. Flint’s about 60% African-American and 40% white.

  77. 77
    WereBear says:

    @Elie: As a data specialist, yes, you are right. I feel your pain without being able to relieve it.

  78. 78
    Elie says:

    @WereBear:

    Nice (but sad to hear) my reality confirmed…

    And yet we have this very lucrative data tools and health care analytics industry. Great databases and data warehouses and I can tell you, I spent years trying to help these organizations not only to look at their data but to try to actually use it! I have no idea how they managed their financials in some of these plans cause they had no idea what some of their real service volume and population acuities actually were…

  79. 79
    PhoenixRising says:

    @Richard Mayhew: You’re assuming that the MCO with the Medicaid contract complied with lead testing requirements rather than sink testing a portion of the tubes that made the problem less clear in real time with that statement “had a lead screening”.

    You have insurance expertise but I’m guessing no lab experience. There is always a cheat that allows providers to “forget”, omit or dump some tubes down the sink, to reduce overhead and increase profit on a contract like this. In the 1980s about half of Pap tests administered under Title X were never read at some locations in Alameda County, CA. It was a local story in 1988. Women died from a treatable cancer they had been “screened” for…there is always a way not to run tests and get paid as if you had.

  80. 80
    NCSteve says:

    Silly man. You’re talking like Michigan is a still a U.S. state rather than a province of the Kochtopus Empire.

  81. 81
    Elie says:

    There is always a cheat that allows providers to “forget”, omit or dump some tubes down the sink, to reduce overhead and increase profit

    Yes, this is true. That said, what is sad is that the doctor and other team members outside of that incentive structure knew that Ms X had a pap smear on x date and should be reviewing charts for those missing values. If the tests are “lost”, they should be redone. Oh, I know it happens, but every professional has a responsibility for the care given, not just the owner/managers who incent cost cutting. This is supposed to be why you have professionals with certification and licensing requirements giving care. In theory, they are agents for their patients and act on their behalf. Any manager how actually requires someone to throw out vials or testing is fraudulent or worse, committing manslaughter if a person dies. This is not a light crime. It is a felony and anyone party to doing that is complicit in that felony.

  82. 82
    Elie says:

    @NCSteve:

    You have to watch the cynicism that actually confers so much power to the other side. I give these creeps nothing. We should not concede any state to the Kochs or any other entity. My goodness!

  83. 83
    low-tech cyclist says:

    I’m speechless. They let kids keep getting poisoned by lead for a year and a half after they knew about it?

    If any of those kids was one of mine, I’d want to kill the people responsible.

    But since they’re not my kids, I’d settle for life without parole for everyone responsible.

  84. 84
    moderateindy says:

    @liberal: I just laugh, because I don’t think they realize that the vast majority of bottled water comes straight from the tap. It isn’t even filtered for FSM sake.
    Of course I have to block out the environmental catastrophe that is the bottled water industry otherwise laughter will be replaced with depression. I mean if we can’t get people to stop paying $1.50-2.00 for something they can get for free that, with a quick run through a filter, is better for you, and tastes better, how are we ever going to be able to fix stuff that is hard, and will actually take real sacrifice?

  85. 85
    Villago Delenda Est says:

    @low-tech cyclist: They just don’t care about other people’s (especially THOSE people’s) children. Yet they’re all “good Christians”.

  86. 86
    Bill Arnold says:

    @low-tech cyclist:

    …life without parole for everyone responsible.

    I agree with the sentiment (after a trial where they are found guilty), but we need also to fix the sociopathic politics (“toxic politics” if you prefer) that encourage this sort of behavior.
    E.g. the “Let Them Drink Lead” memo: should not be possible in a first world nation.

  87. 87
    Bill Arnold says:

    @low-tech cyclist:

    …life without parole for everyone responsible.

    I agree with the sentiment (after a trial where they are found guilty), but we need also to fix the sociopathic politics (“toxic politics” if you prefer) that encourage this sort of behavior.
    E.g. the “Let Them Drink Lead” memo should not be possible in a first world nation.

  88. 88
    boatboy_srq says:

    @OzarkHillbilly: That will make them less amoral and criminally negligent? Seems to me the GOTea is founded on the presumption that toxic waste is good for you because it obviously has been effective on the leadership. If I didn’t know better I’d swear that most of them got lead as a dietary supplement when they were kids.

  89. 89
    J R in WV says:

    @liberal:

    No, no!

    I live outside Charleston WV, where the public water supply for about 300,000 people was contaminated by a vile industrial chemical a couple of years ago. Now, at Krogers where everyone shops, they keep a huge pile of bottled water, because many people don’t trust WV-American Water Company to provide safe water for them to drink. I see people on public water buying multiple cases of water every time I shop.

    We get our water from a well on the farm – but our farm is in an oil and gas patch. So the O&G production companies can destroy the aquifer at a moment’s notice… well without any notice at all, really. We have a connection available to a local public service district, in case the aquifer is actually destroyed. Then we have to start paying attention to the “boil-water” advisories that we get on the phone alert system every few days.

    No win…

  90. 90
    MomSense says:

    @Elie:

    In this case I think the data were diluted with test results from other towns and cities.

  91. 91
    Elie says:

    @MomSense:

    Well, there is a public health data infrastructure that (in theory), should allow them to get samples from various locations and make sense of what is happening. This is also a CDC function and the lead screening program is one that they have a lot of program money dedicated. They should be on this like a duck on a june bug, but it does fall to the state to make sure that they can track what is happening for sensitive outcomes like this. What is so so tragic is that it is so preventable while at the same time being uncorrectable once the child has been exposed and had consequence for too long. No excuse and no, they should be able to cone down on specific municipalities even as they have aggregate results from multiple communities.

  92. 92
    Sad_Dem says:

    The GOP strategy–destroy government and then claim that government doesn’t work, so more destruction is needed. Two more examples: Postal Service (added bonus–the Post Office is in the Constitution that they claim to have such respect for but don’t) and a new head of education in Arizona.

  93. 93
    Elie says:

    @Sad_Dem:

    Man, that is old news.

    I’m more interested in what to do about it.

  94. 94
    Sad_Dem says:

    @Elie: Vote?

  95. 95
    The Other Chuck says:

    I can’t figure out why the public health system failed so obviously.

    Sabotage. SATSQ.

  96. 96

    Surely the explanation is simply that all the state government departments that might have responded all ultimately report to the state governor, and he did not want this to be known?

  97. 97

    It might help, I suppose, if we had a federal law in this area. Or maybe federal criminal law already applies, and it needs only action on the part of the Justice Department to enforce it.

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