The Fifth Risk

by The Fifth Risk (epub)

  I found Concannon at home in the woods of Maine. On the phone he’d told me that he’d spent most of his career running health and nutrition services for several different states. Back in 2008 he’d retired to this place, purchased long ago, with his wife. The woods were near the sea, and so they had bought a small boat. “I was sort of unhappy being retired,” he said. “We had the boat. But after two weeks in the boat we said,” Okay, what are we going to do now?’ I don’t understand people who say they can’t wait to retire. It’s like living your life in jail or something.” Not long after he’d had that thought, he got a call from the newly appointed secretary of agriculture, Tom Vilsack. “I hired him for several reasons,” said Vilsack. “But the first is: heart.”

  Concannon was pushing seventy, but he came out of retirement to take charge of the box inside the USDA labeled “Food, Nutrition, and Consumer Services.” He’d run the place right up until the Trump people finally arrived, in January 2017. In his job at USDA, Concannon had overseen for eight years the nation’s school-lunch program; the program that ensures that pregnant women, new mothers, and young children receive proper nutrition; and a dozen or so smaller programs designed to alleviate hunger. Together these accounted for approximately 70 percent of the USDA’s budget—he’d spent the better part of a trillion dollars feeding people with taxpayer money while somehow remaining virtually anonymous. “We used to say if we stopped the tourists outside the building and told them what we were doing inside, most of them would have no idea that we were doing it,” he said.

  He’d helped to prepare for the Trump transition, but, of course, that transition never happened. He hadn’t had a single encounter with anyone associated with it. Nor had the Trump people bothered to speak with anyone who reported to him. And so it seemed fair to say, as Concannon had said to me on the phone, that “they don’t seem to be focused on nutrition.” The Trump people were a bit like those tourists outside the Whitten Building. Only now they were inside it.

  Concannon’s house is hidden from the road by trees and so comes as a surprise. So does he: I had expected to meet an old guy with at least some need to convey a sense of his own importance. I expected him to retain at least a trace of the stuffy bureaucrat. Instead I find myself being led through his retirement house by a leprechaun who has disguised himself by shaving his beard. “Media has not been a big part of my life,” he says, laughing, as he leads me to a table and chairs out back. “This is new!” Exposed to the early-autumn chill, we play New England’s favorite outdoor social game: seeing who will be the first to break and beg to go back inside.

  “The food-stamps program,” he says, instantly, when I ask him for his biggest concern. The Trump budget had proposed cutting food stamps by more than 25 percent over the next ten years and more or less abandoning the notion that the country should provide some minimum level of nutrition to its citizens. The Trump budget was just an opening bid and unlikely to become policy, at least not right away, because Congress could always fight it. But it signaled an intention and, perhaps, a shift in public attitude. “Why is it that people channel so many of their hang-ups about people who are poor or unsuccessful into the food-stamps program?” asks Concannon as we settle into our chairs, then answers his own question. “No one really knows when you go to the doctor and the government is paying. But people see you with this card or coupon and react. People would say to me,” I saw someone buying butter with food stamps.’ And I would say,” Well, yes.’”

  Anyone who takes over his old job, he explains, needs to be especially vigilant about fraud, even though there is probably less of it in the program than ever. Actual fraud in the food-stamp program in 2015 was about 5 percent of the $70 billion paid out. People still succeed in understating their income and get benefits they would otherwise not. People occasionally “traffic,” the term of art for exchanging food stamps at less than face value, for cash or ineligible goods. (The storeowner then puts through a bunch of phony purchases, and pockets the difference between what the government pays him and what he has paid to the food-stamper.) And fraud is far more likely in some parts of the country than in others. “The Dakotas—they’re all Boy Scouts and Girl Scouts who live there,” Concannon says. “But just look at Miami. Or Columbus, Ohio.” But replacing food stamps with a card that has a PIN has made fraud, and theft, much less common. The USDA hires specialists to search food-purchase data for suspicious patterns. When they find what appears to be a problem, they send in one of the 100 USDA food-stamp undercover investigators, to gather evidence.

  I stop writing and look up. “The Department of Agriculture has private eyes?”

  “They’re more like Columbos,” he says.

  But that’s not his point, he says. His point is that, while actual fraud is relatively rare, “instances of fraud attract huge media attention and can have big effects—like Surfer Dude.” Surfer Dude was a guy in San Diego who claimed on Fox News that the food-stamp program gave him the cushion he needed to surf all day. The network ate it up. And that was the problem: the distorting media coverage of any cheating creates political resistance to the entire enterprise. No one in the Trump administration was likely to ever come right out and say: “We want to let kids and old people go hungry.” But, obviously, they might run the program so ineptly that it lost political support. And then kids and old people would go hungry.

  What I needed to keep in mind, said Concannon, was just how much was at stake for the people who needed the program. “I used to tell the people that worked for me: You may not ever meet a single person it benefits. You might never see the infants who are fed, or that family that lost a job. To the extent you can keep in mind that they are out there, it will motivate you to do your job better.”

  It now occurs to me that this question of motivation sits somewhere near the middle of the problem I am investigating. Why does someone go to work inside this little box—or any little box—inside the federal government? There’s always an answer to this question. And it’s obviously important. Why a person does what he does has a big effect on how he does it. And yet Kevin Concannon, whose little box had spent nearly a trillion dollars, had never really been asked it.

  He has an answer to the question, as it turns out. He’d grown up in Portland, Maine, in a working-class family with seven children. His older brother had suffered from schizophrenia. His parents, immigrants from Ireland, had been crippled by the sense that they were responsible for their child’s illness. “There was a very strong belief in those days in nurture versus nature,” he says. Then one day—like a bolt from the blue—a pair of social workers from the Veterans Administration visited their home. They put his brother on a new medication, which eased his symptoms. “They helped my parents to understand that the fact that he had this illness had nothing whatever to do with how they raised him,” says Concannon. “It was luck of the draw.”

  The effect of these government angels on his family’s life was astonishing. By the time Concannon left for college, in 1959, he wondered what it might be like to do that kind of work. In college he read The Other America, Michael Harrington’s account of the lives of the American poor, and listened to John F. Kennedy’s inaugural speech, with its bracing call to public service. By the time he graduated he knew what he wanted to be. Fourteen years later he was running Maine’s mental-health services.

  He proved effective enough at the job that, after an election pushed him out of it, other states recruited him. In 1987 he took a job running the mental-health and developmental-disabilities programs for Oregon. Four months into his new gig, Oregon’s governor, Neil Goldschmidt, grabbed him in the hallway. “He said,‘C’mon to the pressroom. They’re naming the new director of human services.’ I said,‘Who is it?’ And he says,” It’s you!’”

  As the head of Oregon’s nutrition programs, he learned that the country’s willingness to feed people who are hungry does not mean that hungry people are always fed. The federal government makes the benefits available but th
en leaves it to states to administer them. “Where you live in this country makes a huge difference if you are poor,” says Concannon. “And it’s not just the weather. You have states with these sixty- or seventy-page documents people have to fill out to get benefits. Poor people are easy to wear down.” Georgia was usually a problem. Texas, too. “If they ran any of their football teams the way they run their food program, they’d fire the coach,” said Concannon. A Wyoming legislator, proud of how badly he had gummed up the state’s nutrition programs, told him, “We pride ourselves on doing the minimum required by the federal government.” An Arizona congressman proposed that the card used by people receiving food-stamp benefits be made prison orange, conferring not just nutrition but shame. In 2016, after several counties in North Carolina suffered severe flooding, the state tried to distribute federal disaster-relief food-benefit cards on the day of the presidential election, to give poor people a choice between eating and voting. In Kansas, Concannon had explained to an executive who oversaw the state’s food-stamp program how he had made it easier for people in Oregon who were going hungry to access their program. “He said,” Jeez, if we did that we’d have more people coming in the door.’ And I said,” Yeah, but isn’t that the idea?’”

  Concannon viewed his job in Oregon simply: to make benefits more easily available to people who qualified for them. Minimize the red tape. Promote the programs. Change the culture that dispensed them from one of suspicion to one of sympathy. From Oregon, at the behest of yet another governor, he returned home to Maine, to run all of the public-health and nutrition programs. There he displayed yet again his unusual gift for finding and slaking need. For instance, he noticed that a lot of people without health insurance in the state were failing to fill their prescriptions, because they couldn’t afford the drugs. In northern Maine, people were crossing the border into Canada, where they could buy the same drugs from the same companies at a fraction of the cost. He thought the situation both outrageous and economically inefficient: help people prevent a stroke and you could avoid the far greater expense of caring for them after they had one. He created a program, Maine Rx, that extended the cheaper Medicaid prices of drugs to people who were well above the poverty line. Within three months, 100,000 people had signed up. (The drug companies challenged the program, taking it all the way to the Supreme Court, which mandated some changes. It is now called Maine Rx Plus.)

  In 2003, at the request of Iowa governor Tom Vilsack, he left Maine for Iowa. In his six years there, he raised the number of Iowans receiving food stamps by 68 percent.

  There was more. But it was getting late.

  “Are you cold?” I ask, hopefully.

  “No,” he says, “but if you are . . .”

  We move back inside, to his kitchen table. He locates a plate of freshly baked banana bread and puts it in front of me. I try not to stare at it. Dry banana bread I find inedible. Moist, sticky banana bread I find hard to resist. His banana bread glistens.

  There are people who would seek to dismiss his entire enterprise with a single line: Why should my hard-earned dollars go to feed anyone else? They’d see Kevin Concannon as the King of Handouts. A promoter of sloth and indolence.

  But the facts of the program he ran for eight years are innocent: its average benefit is just $1.40 cents a meal. Eighty-seven percent of that money goes to households with children, the disabled, and elderly. “The idea that we are going to put these people to work is nonsense.” Able-bodied adults on food stamps are required to work, or attend job training, for at least twenty hours a week. The nation’s private food banks dispense about $8 billion in food each year, while $70 billion in food is provided through food stamps: private charity alone will not feed everyone who needs feeding. The problem with the program is not that people are cheating it. The problem with the program is that people who should be on it are not.

  Kevin Concannon had done a lot to fix it: He’d raised the participation rate of the poor people who qualified for it from 72 percent to 85 percent. And he’d reduced fraud rates to all-time lows. But the myths about the food-stamp program—that food stamps can be used in casinos, or to buy alcohol and tobacco, for instance—persisted.

  I reach for a slice of banana bread. “Anything else you worried about?” I ask.

  “School nutrition,” he says, without missing a beat.

  One week after being sworn in, Sonny Perdue staged a public event at a school in Leesburg, Virginia. The Obama administration had pushed successfully to raise the nutritional requirements of school meals fed to thirty million American schoolchildren, for the first time in twenty years. To receive federal subsidies for the meals they serve, schools are now required to behave more like responsible parents than indifferent ones: more whole grains, more fruits and vegetables, less sodium, no artificially sweetened whole milk, and so on. Concannon expanded the breakfast programs for kids who did not get fed at home—and that meal, too, became more nutritious. “You can’t just serve them pancakes and hot dogs,” he says.

  Big companies that provided the schools with meals fought back: it was more profitable for them to serve pancakes and hot dogs than fruits and vegetables. But by the end of 2016, America’s children were eating better than they had been in 2008. “Ninety-eight percent of the schools were meeting the new standards,” says Concannon, “and to those that weren’t, that had some problem, we’d say,” We’ll work with you!’”

  At the school in Leesburg, Perdue announced that the USDA would no longer require schools to meet the whole-grain standard, or the new sodium standard, or ban fat in artificially sweetened milk. Those changes sound trivial, but the stakes are huge. This is a matter not just of what kind of milk America’s schoolchildren drink but also of the process by which we as a society decide which milk they will drink: will it be driven by the dairy industry and the snack-food industry, or by nutritionists?

  Concannon was deeply disappointed in Perdue’s speech. He saw it as pure politics, not motivated by any concern for children’s welfare. “Look, you can have confidence in the career people,” he said. “Because most of them have migrated to where they are out of desire. They believe in what they are doing.” About the new political people who might replace him he wasn’t so sure. The problem was motive: Why would they come to work at the USDA? A person who worked inside Concannon’s little box, as long as they catered to the food industry, could make a lot more money outside of it.

  Munching on a second slice of banana bread, I look around Concannon’s house. His career was over. He’d spent the better part of fifty years using public money to alleviate suffering. He’d controlled nearly a trillion dollars in government spending. Yet his home is modest. He drives a ten-year-old Volvo. He had gone from state to state, and each time he had been honored for his public service. The plaques were stacked up in his garage. He didn’t own enough wall space for them all.

  What’s striking about Kevin Concannon is what he decided, for whatever reason, he didn’t need. He could have named his price with the drug- and food-company lobbies, and yet he’d never taken a job in the private sector. He claims never to have felt the slightest interest in that kind of work. “I’ve done all right,” he says when I ask him, more or less, why he’s not rich. “I’ve always had enough. I’ve never felt the need to go over to the other side and make three times the amount of money. If you like what you do, you just keep doing it.”

  On my way out the door he stops me. “You didn’t ask me what else I was worried about,” he said. “But if you asked me, I’d say science.”

  The thing you eventually noticed about Cathie Woteki was her detachment. She was slow to talk about the more emotionally charged moments of her career, and even when she did, she didn’t talk for long. It wasn’t until our fourth conversation, for instance, that she bothered to mention she had become an agricultural scientist only after her professors told her that there was no place for women in basic science. She’d graduated in 1969 from Mary Washington College, the women
’s affiliate of the University of Virginia, which at the time didn’t accept women as undergraduates. From there she followed her future husband to Virginia Tech, where she entered the graduate program in biochemistry. Her fellow graduate students in science were all men. It took her a while to sense how the professors treated her differently from the way they did everyone else. “I finally figured it out when all the guys were given assistantships and I wasn’t.” She went to the head of the department and asked what she needed to do to get an assistantship, too. “He said I would not be given one because women were a poor investment. I’d probably only have children and drop out.”

  Looking back, she found it odd that they had let her into the school only to stifle her ambition. But it was the late 1960s, and people were making new, if halfhearted, attempts to address sex discrimination. “If you talk to women scientists of my age, almost all of them have a story similar to mine,” she says.

  Virginia Tech, like most every college in the United States with “Tech” or “A&M” after its name, was established in the wake of an 1862 law passed by the same Congress that created the Department of Agriculture. In the middle of the Civil War, Lincoln had decided it was time to make U.S. agriculture more efficient: each person not needed on the farm was another person freed up to do something else. That’s why the Department of Agriculture was created in the first place, as a vast science lab. Endless statistics illustrate the astonishing effects that lab has had—it has changed the way we live. In 1872, the average American farmer fed roughly four other people; now the average farmer feeds about 155 other people. It’s not just people and plants that have become more productive. In 1950, the average cow yielded 5,300 pounds of milk. In 2016, the average cow yielded 23,000 pounds of milk. A Wisconsin Holstein recently yielded nearly 75,000 pounds of milk in a year, which amounts to roughly 24 gallons a day. Her name is Gigi. You can thank her later.