“Perverse”: Economic Incentive to Inflate Death Count of the 2019 Novel Coronavirus Acknowledged at Official Hearing

Robert R. Redfield — who is the current director of the Centers for Disease Control and Prevention — acknowledged in a hearing last week that an economic incentive may have contributed to how physicians and hospitals attributed the 2019 Novel Coronavirus to the number of deaths in the United States.

“Perverse”: Economic Incentive to Inflate Death Count of the 2019 Novel Coronavirus Acknowledged at Official Hearing

That acknowledgement occurred during a hearing called The Urgent Need for a National Plan to Contain the Coronavirus on Friday, July 31, 2020 by the Department of Health and Human Services of the United States, of which the witnesses — all who have earned their Doctor of Medicine degrees — who appeared before the House Select Subcommittee on Coronavirus Crisis included the following:

  • Anthony S. Fauci — Director, National Institute of Allergy and Infectious Diseases, National Institutes of Health of the United States
  • Robert Redfield — Director, Centers for Disease Control and Prevention
  • Brett P. Giroir — Admiral, United States Public Health Service Commissioned Corps; Assistant Secretary for Health, Department of Health and Human Services of the United States

The Latest Statistics — But How Reliable Are They?

Before delving into the actual testimony, the latest statistics are that at least 686,703 people — or slightly greater than 3.83 percent — have died of the minimum of 17,918,582 confirmed cases worldwide, according to this situation dashboard from the World Health Organization pertaining to the 2019 Novel Coronavirus…

…and at the same time, at least 690,953 people — or slightly greater than 3.8 percent — have died of the minimum of 18,166,298 confirmed cases worldwide, according to this situation dashboard from Johns Hopkins University & Medicine pertaining to the 2019 Novel Coronavirus.

At the time this article was written, at least 154,471 people — or slightly greater than 3.32 percent — have died of the minimum of 4,649,102 confirmed cases in the United States, according to this situation dashboard from the Centers for Disease Control and Prevention pertaining to the 2019 Novel Coronavirus — and with an estimated population of 331,002,651 people, that means that greater that 0.04 percent of the population of the United States have died from it.

The population of the world is currently at almost 7.8 billion people. Using the higher statistics from Johns Hopkins University & Medicine, that means that slightly greater than 0.23 percent of the population have confirmed cases of 2019 Novel Coronavirus, with almost 0.009 percent — that is nearly nine thousandths of one percent — of the population having died from it.

The Testimony

“…so, perspective to me is something you always need to consider”, said Blaine Luetkemeyer, who is a Republican member of the House of Representatives who represents the third district in Missouri. “One of the things that concerns me also is…ah…I wish that…uh…Admiral…um…Giroir was here yet. I asked this question of him last time he was here and he…we didn’t have enough time to continue…to continue our discussion on it with regards to the sort of perverse incentive for medical folks to claim that somebody died of COVID versus — if it’s an automobile accident for instance — as long as you have COVID in your system, you get to claim it as a COVID death, in which means you get to get more money as the attending physician, hospital, whatever…uhh…and he acknowledges that the statistics he’s getting from the states are overinflated. We found that the governor of Colorado who is a Democrat actually did research on this and found that he had to get rid of 12 percent of the deaths that were recorded in the state. Uh, Dr. Redfield, would you like to comment on that a little bit about the peverse incentive — and is there an effort to try and do something different in the way that these deaths are recorded so we actually have better records and better numbers, better data to go with?”

Robert Redfield responded to that line of questioning with the following statement:

Thank you, Congressman. I think you’re correct in that we’ve seen this in other disease processes too, really in the HIV epidemic. Somebody may have a heart attack, but also have HIV — the hospital would prefer the DRG for HIV because there’s greater reimbursement.

So I do think there’s some reality to that. When it comes to death reporting, though, I mean, ultimately, it’s how the physician defines it in the death certificate in our…our national health statistics…uhh…a group here in Hyattsville, we review all those death certificates.

Um…so I think, it’s probably less operable in the cause of death, although I…I…I won’t say it’s…there are not some cases. I do think though when it comes to hospital reimbursement issues for individuals they…they get discharged, there…there could be some play in that for sure.

In response, Blaine Luetkemeyer said: “Well, the Admiral certainly acknowledged that last time he was here, so I…I think that’s…um…very concerning.”

You can watch and hear the aforementioned portion of the testimony with this official video

…or you can watch the testimony in its entirety with this video:

Republican lawmakers said that Brett Giroir “acknowledged that the statistics he is getting from the states are over-inflated.”

The time between an infection of the 2019 Novel Coronavirus and death from it is typically approximately three weeks.

Summary

That some of the foremost experts in the world pertaining to epidemiology acknowledged that hospitals, physicians, and other entities in the health care system in the United States may have a financial incentive to artificially increase their count of fatalities by attributing them to the 2019 Novel Coronavirus is quite troubling, to say the least, as it likely means that the aforementioned statistics are likely not accurate or reliable — and that the number of deaths which are truly caused by the 2019 Novel Coronavirus may actually be fewer than reported.

As a traveler, you should be outraged about that. Inflated statistics mean more fodder for both the mainstream media to irresponsibly report on the pandemic and politicians whose self interests trump those of their constituents, which may have caused a gross overreaction by the general public who may have been unnecessarily frightened or scared as a result, which then prompted governments and corporations to implement measures and policies — some of them draconian — to appear to mitigate those fears and appease their constituents and customers…

…and that includes the drastically reduced state in which the travel industry finds itself — in the form of fewer flights, closed hotel properties, and sealed borders of countries and other self-governed jurisdictions.

If the numbers in the statistics are indeed proven to be inflated, that is wholly unacceptable, inexcusable, unethical, irresponsible, and morally reprehensible — and those who have indeed contributed to that should be prosecuted to the fullest extent of the law and not hailed as heroes.

Photograph ©2016 by Brian Cohen.

19 thoughts on ““Perverse”: Economic Incentive to Inflate Death Count of the 2019 Novel Coronavirus Acknowledged at Official Hearing”

  1. BCF says:

    This is irresponsible hogwash. I suppose theoretically it could happen, but with coronavirus it clearly isn’t. While we can’t get exact numbers, excess deaths have consistently indicated UNDERCOUNTS in coronavirus deaths. Effectively excess deaths looks at expected deaths in normal conditions vs. actual deaths observed. Clearly from the data many people die who never get tested and never get marked as coronavirus victims which is swamping any pressures to maybe over-count deaths.

    Link below to one analysis but the punchline is:

    Findings In this cohort study, the number of deaths due to any cause increased by approximately 122 000 from March 1 to May 30, 2020, which is 28% higher than the reported number of COVID-19 deaths.

    Meaning Official tallies of deaths due to COVID-19 underestimate the full increase in deaths associated with the pandemic in many states.

    https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2767980

    1. Janeal says:

      I agree with this comment wholeheartedly. The number of excess deaths from “heart attacks”, “strokes” and “pneumonia” have shown to be much higher from January of this year. Since we didn’t have a reliable test and testing is still not widely accessible, I think the deaths are most likely undercounted. If a hospital or doctor is categorizing the death as caused by COVID and the person was actually in a car accident, then that is against the law and needs to be investigated and prosecuted. But we know that corona virus attacks heart muscle causing cardiomyopathy, it causes increased clotting so people are having heart attacks and strokes that don’t have cardiovascular disease and so on. It’s impossible right now to accurately count deaths but I am sure that they are undercounting them.

      1. Janeal says:

        I’m also not sure we can trust the CDC to be independent of political pressure to say what the Trump administration would like to hear. A recent example would be the guidelines for school reopening s. They made a recommendation which was presumably based on the best evidence available but were told to go back and change it to fit in with the president’s desire to open schools. The CDC is just not an independent entity at this point. I would like to see some data on this subject from multiple sources.

        1. NB_ga says:

          I am the last person to sing the accolades of the CDC. They have been laggy and wishy-washy all along in their Covid response. That said, they are touted in article after article, study after study as “The Expert” in controlling a pandemic – we are told we must mask up because the CDC says so. Their word is final.

          But now, when questioned under oath, Dr. Redfield admits that mortality numbers have historically been fudged, and are likely fudged now, in order to procure additional funds for hospitals – and suddenly… the CDC is not to be trusted. Which is it??

          I, too, would love to hear data from multiple sources – on all of this information. But we are repeatedly told who is acceptable to have an opinion and who isn’t… who must be shut down instantly… who must be listened to with cult-like idolatry. When the “valid source” bar changes daily depending on who is following the fear-mongering rhetoric or not, no one can be trusted to look out for our interests.

        2. GUWonder says:

          The CDC isn’t free of being subject to (and falling prey to) political pressure from their Lord Trump and his vassals. I suggest looking into what happened with the CDC dealing with NPR during the course of this pandemic and with the CDC recommendations related to schools.

          And to get back to the blog entry itself, I am a very heavy traveller during ordinary times. As such, we should be outraged by the Trump’s downplaying of the risks from this coronavirus spreading and Trump’s messed up way of dealing with this situation. The Trump virus situation is why travel is as wrecked for me as it is currently and staying wrecked longer. Health statistics having some errors is not the cause of this Trump virus situation being as bad as it is.

          A lot of people who get hit by this coronavirus never get tested for it and thus never even get flagged as having been hit by it.

          And the notion that we have large legions of doctors in the US willing to risk an FBI raid and their personal financial well-being and career over fraudulent billing over COVID-19 records is hogwash. Hogwash coming from the very people who are unwilling to publicly go on record to call out Trump as a bad character, con-man willing to say anything and do anything to try to proclaim himself a winner when it comes to this virus situation too.

          There is no greater American fraud during this Trump virus situation than Trump himself and what Trump enables.

          1. WR2 says:

            Trump shut down travel from China and Europe, dems complained it was an overreaction. Trump claimed absolute authority to put measures in place, dems pushed back. Dem governors and local politicians have implemented their own measures regardless of what feds say or do. So how exactly is this all Trump’s fault? What should he have done in your infinite wisdom and hindsight?

            This virus is 100% China’s fault, nobody elses. To say otherwise is treasonous. They lied about what they knew, they allowed people to export it while shutting down movement within the country. It is on them. Sadly if Biden wins then China will never be held to account, because that would take away from the “it’s all Trump’s fault” narrative.

    2. WR2 says:

      Your comment is irresponsible hogwash. Cases might be undercounted, since many are asymptomatic, or don’t get sick enough to seek care. However, deaths due to covid surely are overcounted. Anyone who dies will certainly get tested, and if they test positive, that will likely be the cause of death listed, full stop. The “experts” admitted it, why won’t you believe them? I thought you libs fully believed in the argument by authority logical fallacy.

      The end result is that with cases undercounted and deaths overcounted, the lethality of covid is much lower than reported. What I am curious to know is what is the overall death rate trend in 2020. I can only find statistics through end of 2019. I suspect that the overall death rate for the US has declined in 2020, as fewer traffic fatalities would offset the covid fatalities.

      1. NB_ga says:

        I completely concur @WR2, except in the assumption that overall deaths are likely down… I agree that traffic fatalities should be lower than prior years and no one is apparently dying from the flu or any standard illnesses as in years past – but the catastrophic fallout from the shutdown has exponentially increased suicide and acts of domestic violence. For every Covid death we *may* have prevented by the extreme reaction, so many more have been lost to despair and anger.

        1. GUWonder says:

          Are you really claiming that suicide deaths have risen across the developed world during lock downs of sort for this pandemic? There are definitely parts where deaths by suicide have declined during lockdowns.

          Not all people who have died in the US during this Trump pandemic are tested for this coronavirus. For a substantial part of this year, even autopsies were not being done for presumed natural deaths at many US health care facilities because the pathologists were not doing them due to a combination of factors including restrictions against elective procedures.

          It’s quite amusing to see the followers of their Lord Trump circle around bashing of anything and everything that gets in the way of a positive PR campaign for their Lord Trump. They take their signals from the Trump PR machine, a propaganda machine that is struggling to convince the general American public that the Trump handling of this coronavirus situation in the US has been anything but what it has been: a series of failures from the sleazy, dishonest salesman-in-chief who can’t talk his way out of his failures when it comes to this pandemic situation but still wants to claim he is offering us the best deal in the world.

          1. NB_ga says:

            I am somewhat unsure of your point @GUWonder. While I do find your obsession with our sitting President to be quite extreme given he has absolutely nothing to do with this article or my comment, it is somewhat humorous to read your rant and imagine your exasperation that I just do not see things your way.

            However, if you are actually attempting to discuss the idea that the social isolation, job loss, and complete uncertainty about the future during this pandemic is leading to a greater loss of life – here a a small sampling of articles for your review. There is no question there has been a massive increase in crisis hotline calls as well as a marked rise in individuals reaching out to mental health professionals. Those already on precarious footing in terms of their mental state are stretched thin. There continue to be multiple reports of suicides tied directly to Covid among otherwise mentally stable individuals in the United States and abroad.

            https://www.psychologytoday.com/us/blog/media-spotlight/202006/are-we-facing-post-covid-19-suicide-epidemic

            https://www.washingtonpost.com/health/2020/05/04/mental-health-coronavirus/

            https://www.usnews.com/news/healthiest-communities/articles/2020-05-22/experts-warn-of-a-surge-of-suicides-tied-to-the-coronavirus-pandemic

  2. NB_ga says:

    Reprehensible, and yet not terribly surprising, that data has been skewed for financial gain. To the detriment of all of us.

    Yet another reason why so-called ‘conspiracy theories’ cannot just be kicked under the rug because they do not match the rhetoric of the day. Information should never be stifled. Thanks for your diligence in bringing us refreshing articles with well-documented primary sources.

  3. MFK says:

    So, you take two persons, who have their own political and reputational incentives to undercount the number of COVID-related deaths, stammering through a Q&A that concludes with a less-than-definitive, “there could be some play in that for sure,” and turn it into a call to arms for *travelers* to be outraged?

    In any event, if this incentive does exist, it may only exist in the USA whose healthcare system is structured differently than most if not all others, leaving one to wonder then why other countries have taken equal or stronger methods to contain the virus?

    1. Peter says:

      The same incidents have been reported in UK, and heavily in Italy as well as Germany (and might be others too, but those went through the news I saw here in Europe), so it is not only US case but also in Europe…

    2. NB_ga says:

      Actually, they have “their own political and reputational incentives” to OVERcount the number of COVID-related deaths.

      If they cannot keep the hysteria of a pandemic alive, these experts will go back to being quiet albeit well-credentialled scientists grinding away in a lab instead of celebrities who throw out first pitches at a baseball game where they are responsible for removing the rest of the audience while then enjoying non-social distanced live viewing themselves. Even intelligent, educated, previously humble people can fall prey to the draw of notoriety.

  4. Robert says:

    Thank you Janeal and NB_ga. Will sleep on this and hopefully the Gate article will be still available to comment if something to add. Just received the book today [8-3-2020] “The Case Against Masks”. Thank you Brian Cohen for posting.

  5. ChrisJohn says:

    Does this post remind anyone else of Don Quixote fighting windmills…? I always appreciate Brian’s unique POVs even if I don’t agree, but this is a real stretch of the imagination…

  6. Jim F. says:

    What makes people conclude that a broad consensus is inherently less reliable than a small sample (often based on anecdotal or one-off examples) never ceases to amaze me; see https://fivethirtyeight.com/features/coronavirus-deaths/

  7. tim says:

    This is still a travel blog, right?

  8. GUWonder says:

    In the first two months of the social distancing measures in Colorado, suicides dropped:

    https://www.google.com/amp/s/www.denverpost.com/2020/05/23/colorado-suicides-dropped-coronavirus-pandemic-calls-to-crisis-line-spiked/amp/

    Germany also saw a drop in suicides about the same period.

    This isn’t to say that social distancing measures can’t result in problems of sorts, but in some parts for some, the partial shutdowns have resulted in reduced stress for a segment of a previously stressed working population.

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