Running With The Big Dogs: Sybil Norcroft Book Six (5 page)

Chapter Seven

John Burr Physical Education Building, Advanced Judo Course [PHED 015], Howard University, Washington D.C., November 30, 2019

C
erisse Daniels enjoyed physical contact sports, and was very much at home in the John Burr gymnasium. On the upper floor was her home away from home—the judo room. The sport—known by its originators as “the gentle way” was perfect for her because her diminutive size was not a significant factor. That she was nimble, agile, quick, and smart gave her an advantage over many much larger opponents, including males. She had earned respect in the judo room; and because the sport was not particularly popular, the room was often vacant. Cerisse liked the quiet, the familiar smells, and the opportunity to be alone to study. Well—of course—she was never alone. When she started her freshman year at Howard, she had the constant companionship of two secret service agents assigned to her by a presidential order because her mother, Dr. Sybil Norcroft Daniels, was the Surgeon General and was a woman who generated controversy as she went about working to improve and to protect the health of Americans. During the past two weeks—because of an increased threat level coming from the recent cyber-attacks launched by the Russians on the nation’s financial institutions—President Willets increased the Secret Service unit assigned to Cerisse to four men and women; so, she could have at least three protectors at all times.

Having the watchers was a drag for Cerisse. She had enough baggage anyway without having four big brutes hovering around her all of the time. Her very small size, very black skin, and her very high-profile mother, made her stand out like a neon light in a dark room wherever she went. At least, that is what she thought. Today, she was less than her usual sunny self. Her left arm pit hurt—annoying, not really serious—because her mother, the Surgeon General had required her to have a GPS tracking card inserted subcutaneously in her armpit; so, she could be located if anyone kidnapped her, as if anyone would be really interested in anyone as obscure and unimportant as she was. She realized that her self-concepts were inconsistent, almost schizophrenic; and that was part of why she felt out of sorts. What she needed was a fight. She needed to see her boyfriend, Drake. She knew that what she really needed was to get back to work studying for her calculus final, and she was out of sorts about that, too.

This was a mid-day watch for her Secret Service minders; so, all four of them were on guard. Two of them were pretending to be invisible in the judo room with her, and the other two were pretending to blend in with the crowds milling about on the campus between Greene Stadium, Burr Gymnasium, Cook Hall, and Drew Hall. There were several difficulties associated with that effort: there were very few students out and about that afternoon; the agents were huge, powerful looking men in contrast to the average size of and age of the students; the agents were Caucasian—something like the Aryan hordes—whereas, more than 90% of the students and faculty passing by them were African-American; they were all dressed in casual student attire that made them look as phony as a three-dollar bill.

Someone was watching the watchers. A team of six people—a mix of male and female, Asian, Negroid, and Eastern European—mingled with the few students out-and-about that cold winter’s afternoon. They were very much aware of the Secret Service watchers, but the U.S. agents were not aware of them. The six person team knew exactly where little Cerisse Daniels was inside Burr Gymnasium.

Oval Office, The White House, Washington D.C., December 12, 2019, 0730 hrs
Present: POTUS, VPOTUS, DCIA, DDCIA, SURGEON GENERAL
Re: Appointment of a new DCIA

Vice-President Tanner L. Oldroyd, CIA Director Andrew Dillon, DDCIA Porter Farnsworth, and Surgeon General Sybil Norcroft, M.D., Ph.D., F.A.C.S. sat in the comfortable arm chairs and love seat facing the president who was smiling. A steward silently brought in a platter of steaming demitasse cups of an exotic aromatic Asian tea and small breakfast croissants then left just as unobtrusively.

“It’s early, I know, my friends; but I am going to have a very busy day today. Thanks for getting up and braving the storm to meet with me at this painful hour,” President Willets said. “I have an announcement, and I want you all to be witnesses. This is something of an historic occasion. Without further ado, it is my privilege to appoint our own esteemed colleague, Dr. Norcroft, as the new Director of the Central Intelligence Agency. She will replace Andrew Dillon who has given more than forty years of his life to the Agency and has contributed immeasurably to the safety and security of America. I wanted to congratulate Sybil and to give a heartfelt private thank you to Andrew for a job well done. The public announcements will come this evening at a photo-op in the East Room. This appointment is indeed historical; Dr. Norcroft will break another glass ceiling by becoming the first female Director of the Central Intelligence Agency of the United States.

“Because of several recent and ongoing situations—the furor over the austerity measures, the nastiness of the Russian attempt to undermine our financial institutions, and the reaction of the Chinese conservatives to Chairman Liew’s generous help during our financial crisis—I have issued a new—or more accurately, a renewed—presidential order authorizing the Secret Service to provide upgraded security for a number of our top officials and their families, including all present. I realize that it is annoying to have the security details around all of the time; but the FBI is adamant that there is a high-level of threat for attack, kidnapping, and terrorism now. Thank you for your indulgence.”

When the president concluded his brief remarks, the four officers in the Oval Office applauded each other and the president. None of them disagreed with his choices, and all of them recognized that they had their work cut out to get Sybil through the Senate Advise and Consent process since her real past contributions to the espionage world had to remain top secret. The skids had been greased by the administration to ensure smooth passage by giving all of the senior senators a briefing in which President Willets pledged his personal word that Sybil was the woman for the job; not only did she deserve it; but her contributions up to this point—the secret ones—made her a necessary cog in the intelligence world’s wheels.

Conference Room, Office of the Secretary, U.S. Department of Health & Human Services, 200 Independence Avenue, S.W., Washington D.C., December 13, 2019, 1015 hrs

Secretary Margoles invited Dr. Norcroft to his office; so, she could officially bow out of the government’s efforts to establish a National Health Service in time to avert bankruptcy by the American republic. Frank Margoles was frankly miffed at the president and at Sybil for making that choice—changing horses in the middle of the stream. It was not personal; he liked Sybil, respected her, and valued her contributions.

“Oh, Sybil, why hast thou forsaken me?” he said as soon as she took her seat in the spacious office.

“It was a hard decision, Frank; I assure you. Medicine has always been my first love and has dominated my life since I entered college as a freshman. For reasons I can’t discuss, the president wants me to head up the CIA; and it was not a request I could lightly refuse. I’m sure you have more than an inkling of the pressures involved.”

“Of course I do, Sybil; but I don’t have to like it. Getting down to business, I appreciate the research you have been doing, and I hope the new Surgeon General will be able to capture the vision to the degree you have. I’ll buzz in the rest and let you bring us up to speed.”

Margoles tapped a button on his desk top, and his office assistant ushered nine HHS officers into the conference room. The division heads of the AoA [Administration on Aging], ACF [Administration for Children and Families], AHRQ [Agency for Health Care Research and Quality], FDA [Food and Drug Administration], CMS [Centers for Medicare and Medicaid Services], HRSA [Health Resources and Services Administration], IHS [Indian Health Services], NIH [National Institutes of Health], and SAMHSA [Substance Abuse and Mental Health Services Administration] took their seats and opened the folders Drs. Margoles and Norcroft had prepared for them.

Secretary Margoles said, “I presume Gen. Norcroft does not need to be introduced; so, we will hear her parting words for us on the question of establishing a National Health Service.”

Sybil immediately caught the attention of the HHS brain trust by greeting each of them by name.

“Thanks for being willing to hear my last hurrah. I suppose that this is my last act as a medical doctor, and it is a bittersweet day for me. All of us face a daunting task with all of its political, religious, tradition-bound, economic, social, and philosophical ramifications. But, please keep in mind that—absent real health care reform—18% and an increasing percentage of the GDP will be caused by medical care alone. That percentage could climb to 20—25—maybe even 30% by 2030 and 35-40% by 2040 which is unsustainable by itself, to say nothing of our ever upward spiraling national debt. To put it into perspective for the average middle-class family—especially households with employer-sponsored health insurance—this trend indicates that a rapidly progressive smaller fraction of their total compensation will be in the form of take-home pay and a progressively larger fraction will take the form of employer-provided health insurance. That is, if employers remain willing to provide employee benefits which is by no means a certainty.

“The first thirty pages in your folder are the third quarter report from the Congressional Joint Economy Committee. There you will find the most up-to-date information available, and you will promptly recognize why the report has been held back from the general public. You can peruse the data at your leisure, and I do suggest strongly that you digest it. This information will form the basis of your talking points as you spread out to spread the ‘gospel’ of National Health Service. This information should convince you that the need is inescapable.”

The folder held information on the third quarter gross domestic product, income, employment, production, business activity, prices, money, credit, security markets, Federal finance, health care spreadsheet, and international statistics—including health care comparisons among the G-12 nations. The folder had consumed most of Sybil’s time in her office during her tenure as the Surgeon General, and she was justifiably proud of her work and was willing to give strong support to her conclusions.

“The economy is improving, but not to the extent necessary to permit us to pay down on our national indebtedness; we are on the brink of being unable to pay the interest, as you well know. Our saving grace is that the Chinese have floated us yet another loan—one with serious fiduciary requirements. The problem is that the jobs being created do not pay enough to have our middle-class contribute sufficiently in taxes to allow us to get control of our indebtedness. Not with our current rate of spending. And the biggest culprit in the equation is medical care delivery.

“The CEA [Council of Economic Advisers] has undertaken a comprehensive analysis of the economic impacts of health care reform since 2010 when the PPACA was signed into law. In your folder there is an overview of current and projected economic impacts of health care in the United States and a forecast of where we would be headed in the absence of reform. Unfortunately, the flaws of the PPACA—mainly the result of the partisan political animus which surrounded its enactment—cancelled out its well-intentioned benefits. That does not change the facts of the critical need for healthcare reform—the inefficiencies, market failures, waste, and greed—prior to 2010 and which still persist in the current health care system. The fundamentals are still there, and we will have a limited discussion of the key components of health care.

We will conclude with an analysis of the economic effects of slowing health care cost growth and expanding coverage—which were the principle aims of the PPACA. The faults of U.S. health care delivery are myriad, and the blame can be spread far and wide. We must learn from the failures that became so blaringly apparent in late fall 2013, stop playing politics, and start the repair. All of that will take a radical departure from the status quo, and there will be a great many important toes that get stepped on. That cannot dissuade you; the answer is a single-party payer under the control of the United States government—a National Health Service.

“The CEA report reveals large economic impacts of genuine health care reform, not just good intentions or party rhetoric. Even a modest 1.5% slowing of the rate of health care costs would increase the real GDP by 2% in two years from now and up to nearly 8% ten years from now. That is a start and not good enough, but it is real. That would increase the income of a typical family of four by $2,600 in 2022 and $10,000 in 2030. That degree of slowing cost growth would lower our unemployment rate to a point consistent with steady inflation by improving our situation by approximately one-quarter of a percentage point. The CEA’s estimate of beneficial impact on employment rates is that—in the short and medium run—it is estimated to be approximately 500,000 new jobs
each year
that the effect is felt.

“Furthermore, expanding health insurance coverage to the uninsured—to decrease dramatically the number of so-called ‘free-riders’ would increase net economic well-being of the United States by roughly $100 billion a year or 0.67%—two-thirds of a percent—of GDP. Real reform would likely increase labor supply, decrease our dependence on illegal foreign labor, remove unnecessary barriers to job mobility, and help to equalize the small business versus large business discrepancies which put small businesses—the backbone of the middle-class—at such a disadvantage.

The progressive aging of our population is a factor that must be reckoned with since aging adds an additional onequarter to the GDP percentage consumed by health care. There is no question that even that small savings would go a long way towards preventing disastrous increases in the federal budget deficit if we had the time. Unfortunately, we do not have the time. We have at an absolute maximum two years; so, our timetable must be quickly put into high gear.