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Ebola and the CDC: Scourge in the Making Marcum LLP | Accountants and Advisors | New York, New Jersey, Massachusetts, Connecticut, Rhode Island, Pennsylvania, California and Florida Certified Public Accountants
Ebola and the CDC: Scourge in the Making

Thomas Eric Duncan will go down in infamy as Patient Zero, the person who brought Ebola to the United States. Nina Pham, a nurse who cared for Mr. Duncan in Dallas, Texas, will go down in history as the first person to be infected with Ebola on U.S. soil. Her co-worker, Amber Vinson, another caregiver to Mr. Duncan, is victim number 2. As of this writing, they are the only U.S. victims so far, but with certainty, more are to come.

Dr. Thomas R. Frieden, whom we can only hope one day in the not-too-distant future will become the former Director of the Centers for Disease Control and Prevention ("CDC"), recently admitted that perhaps the CDC "could have done more" to prevent the unprecedented outbreak of Ebola in the U.S. Among the mistakes that the CDC admits to are:

  • Failure to determine that Mr. Duncan had arrived in the U.S. from Liberia and discharging him from his initial ER visit with a simple dose of antibiotics.
  • Failure to advise Dallas Emergency Services to screen 911 calls for Ebola.
  • Allowing the ambulance that returned Mr. Duncan to the hospital to remain in use for an additional 48 hours.
  • Failure to alert Dallas officials that ambulances should be equipped for Ebola calls.
  • The absence of a protocol for safely disposing of Mr. Duncan's bedding, clothing and hospital waste.

Perhaps Dr. Frieden should take a page from the playbook of Julia Pierson, the former Director of the United States Secret Service, who resigned on October 1, 2014, after putting President Obama in more potentially dangerous situations than anyone in that position previously ever allowed to happen to a sitting U.S. Commander in Chief. At least Ms. Pierson had the common sense to resign before her inevitable firing, which was a foregone conclusion. Dr. Frieden under-estimated the Ebola threat, and now it's only a matter of time before countless people could be stricken by the disease. If only the CDC had acted more responsibly and sooner.

I did some research about Ebola and here's some of what I found out:

  • Ebola was first discovered in 1976 in Yambuku in the Democratic Republic of Congo, a village near the Ebola River, from which the disease takes its name. Anyone for an all-expense-paid cruise down the Ebola River?
  • The current outbreak started in March 2014 and is the largest and most complex since 1976. There have been more cases and deaths in this outbreak than all others combined. It started in Guinea, then spread to Sierra Leone, Liberia, Nigeria and Senegal. And now the United States.
  • The average fatality rate from Ebola is 50% but ranges from 25% to 90%. The virulent spread of the disease in West Africa has resulted from the sad fact that the most severely affected countries have very weak health systems at best, lacking human and infrastructural resources.
  • The incubation period from infection to virus onset is between two and 21 days. Symptoms include the sudden onset of fever, fatigue, muscle pain and sore throat, followed by vomiting, diarrhea, rash, internal bleeding and the list goes on. It's an out-and-out nightmare (I will resist the sophomoric comparisons).
  • There's currently NO vaccine to prevent Ebola.

To further complicate things, Ms. Vinson (patient #2), who developed a low grade fever late Monday and was confirmed with Ebola Wednesday, took a flight from Cleveland to Dallas Monday night, after advising the CDC of her fever and getting their permission to fly - Frontier Airlines flight 1143, which had 132 passengers plus crew aboard. Dr. Friedan and the CDC have said that the risk to passengers who shared the flight with Ms. Vinson was very low. Based on how they've misstepped so far, I can't seem to find comfort in their assurances.

I hate to be an alarmist, but if the CDC were as concerned as I am, perhaps I'd be writing about something else this week. It seems the CDC forgot part of their job is prevention, not just containment after the fact. We can only pray for a full recovery for those currently stricken and those sure to be in the days to come.


The High Cost of Litigation Marcum LLP | Accountants and Advisors | New York, New Jersey, Massachusetts, Connecticut, Rhode Island, Pennsylvania, California and Florida Certified Public Accountants
The High Cost of Litigation

In today's world, litigation has become a practically unavoidable fact of life. AIG's lawsuit against the U.S. government, claiming that the terms of the tax payer-funded bailout that saved the company's butt in 2008 were too draconian, is just the latest headline-grabber. Coca-Cola, Infosys, Actavis and Sirius XM are just a few of the legions of other companies out there currently or recently embroiled in legal battle. And that's not to mention the government entities and individuals also taking up time and space on the court docket.

Both individuals and business entities are facing litigation with ever-increasing frequency. Invariably, this becomes an expensive proposition, whether you are a plaintiff or a defendant. In some cases, exorbitantly so.

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The Healthcare Balancing Act Marcum LLP | Accountants and Advisors | New York, New Jersey, Massachusetts, Connecticut, Rhode Island, Pennsylvania, California and Florida Certified Public Accountants
The Healthcare Balancing Act

Almost every day the Wall Street Journal and the New York Times have in-depth articles about the current state of our healthcare delivery system, often citing one aspect or another of the Affordable Care Act (aka Obamacare). It's also not unusual to read about one patient receiving care at one facility at one price and another receiving the same treatment down the street at a much different price. Many lament the difficulty in getting quality care or the cost to our healthcare system of routine care. We still have one of the world's best healthcare systems. Our challenge is to get to a balance - great care, reasonable cost, more efficient use of big data in diagnosing, treating and cost control. Let's talk a few specifics.

The WSJ recently reported on the use of assistant surgeons charging very high fees when the patient had no idea in advance that the assistant even existed. He literally woke up from surgery with a possible $100,000-plus additional bill. I know if one of our clients asks a tax partner to prepare a tax return, and agrees on a fee for that service, we can't then tell him we consulted another "expert" on one aspect of his return and that added significantly to his bill, and expect to get paid. We have engagement letters that spell out what we will do and how we will charge. If we see a need for a change, we tell our client and get an understanding of the change before we go forward.

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Private Thoughts on Alibaba's Public Offering Marcum LLP | Accountants and Advisors | New York, New Jersey, Massachusetts, Connecticut, Rhode Island, Pennsylvania, California and Florida Certified Public Accountants
Private Thoughts on Alibaba's Public Offering

The IPO of Alibaba Group last Friday was the biggest business news of the day, the week, the month and maybe the year. Guessing at the offering price; calculating the margin by which it would out-capitalize Visa and Facebook, then the largest IPOs on record; and analyzing Alibaba's enigmatic CEO, Jack Ma, constituted a virtual feeding frenzy.

Drew Bernstein, who is co-managing partner of Marcum Bernstein & Pinchuk, our China affiliate, had some thoughts on Alibaba's public debut. Drew has deep experience in the China market and understands the nuances and vagaries of Chinese public companies like few others do or can. He penned those thoughts in an op ed for Forbes, that posted 24 hours before the IPO.

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About Jeffrey M. Weiner

Jeffrey M. Weiner joined Marcum in 1981 and has served as Managing Partner since 1990. Under his leadership, Marcum has expanded from a one-office Firm of 20 employees to a Firm ranked #15 in the United States.

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Ebola and the CDC: Scourge in the Making
The High Cost of Litigation
The Healthcare Balancing Act
Private Thoughts on Alibaba's Public Offering
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