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OPINION

Detroit

M

ichigan was full of
surprises in the 2016
election. Bernie Sand-
ers trailed Hillary
Clinton by more than
20 points in polls, then overtook
her to win the March Democratic
primary by 1.5 points. FiveThirty-
Eight’s Nate Silver called it “one of
the greatest polling errors in pri-
mary history.” In November Don-
ald Trump beat Mrs. Clinton by
0.23 point—the narrowest margin
in any state—and claimed Michi-
gan for the GOP for the first time
since 1988.
Mr. Sanders hopes for a similar
comeback in next Tuesday’s pri-
mary. Throughout the nomination
race, the media has deemed Mr.
Sanders and Joe Biden to be the
leaders in distinctly separate
“lanes.” Michigan shows why the
two candidates have never seen it
quite that way. To be sure, each

took time out of his celebratory
speech Tuesday evening to tar the
other as a dead end for the party.
Mr. Sanders chided his rival for
peddling “the same old kind of
politics,” and Mr. Biden faulted Mr.
Sanders’s late arrival to the Demo-
cratic Party and his promise of
“revolution.” But both are vying to
get into the lane they believe leads
through Donald Trump and into
the White House—the position of
true champion of the American
worker.
Every candidate for office
pitches his humble beginnings and
mass appeal. Messrs. Biden and
Sanders work overtime to sell the
point, invoking the support of la-
bor unions and ethnic minorities.
More than any Super Tuesday con-
test, the Michigan primary will
test who has the stronger claim.
Mr. Trump’s 2016 margin was
more than accounted for by the in-
roads he made among the state’s
labor unions, which left Mrs. Clin-
ton with 57% of the union vote,
compared with 68% for President
Obama in 2012. With similarly
close wins in Wisconsin and Penn-
sylvania, Mr. Trump staked a claim

to the broad working-class support

that has long been the pride and

succor of Democrats. Messrs.

Sanders and Biden both seek to re-

claim it this year.

Part of Mr. Sanders’s strategy

has been to win over prominent

members of ethnic minority com-

munities, helping to build the

“movement of black, white, Latino,

Native American and Asian-Ameri-

can” voters he invoked Tuesday

night. A March 2 event in Detroit

titled “Faith Leaders for Bernie”

was an opportunity to discuss

campaign messaging and strategy

in a city where black churches

hold strong political sway.

The afternoon following the

event, Pastor Horace Sheffield III

tells me he appreciates the way

Mr. Sanders stands with “a whole

other America that public policy

doesn’t seek to lift.” It’s said that

a rising tide lifts all boats, but it’s

easy to doubt that walking around

the West Side neighborhood that

surrounds Mr. Sheffield’s New Des-

tiny Christian Fellowship, where

collapsed roofs are common and

plywood fills more windows than

glass.

Mr. Sheffield, 65, got his politics

in part from his father, who in the

1950s worked alongside the social-

ist civil-rights leader A. Philip

Randolph at the left-wing Negro

American Labor Council. But he

concedes that when Mr. Sanders

describes a “political revolution to

transform our country,” few blacks

hear it as a continuation of the

civil-rights struggle. “One of the

reasons Martin Luther King caught

on more than Malcolm X is that

blacks have a passive-resistance

approach to politics,” he says.

“Blacks are more conservative

than people give them credit for.”

Mr. Sanders claims only 16% of

black support in Michigan, com-

pared with 41% for Mr. Biden, ac-

cording to a Glengariff Group poll

released Tuesday. “What has Ber-

nie ever done for them?” asks

Keith Williams, a former Wayne

County commissioner and founder

of a youth sports center 10 min-

utes west of New Destiny along

the interstate.

Mr. Williams, 64, is chairman

of the Michigan Democratic Party

Black Caucus, whose endorsement

Mr. Biden cited in a CBS News in-

terview Feb. 10, the eve of his

fifth-place finish in New Hamp-

shire. “Who was able to do the

auto bailout?” Mr. Williams says.

“Obama-Biden.” He credits Mr. Bi-

den as more than a sidekick.

“People need to acknowledge that

Barack couldn’t have won unless

Joe was with him. God made the

perfect pair.”

Mr. Biden earned the esteem of

many Michiganders when he

helped negotiate federal loans to

General Motors and Chrysler in

the wake of the 2008 financial cri-

sis—a feat he recalled often on the

2012 campaign trail with the line

“bin Laden is dead and General

Motors is alive!”

“His dad was the manager of a

car dealership,” Detroit Mayor

Mike Duggan says, “so you don’t

have to explain cars to Joe Biden.”

After Mr. Duggan took office in

2014, “Joe returned to the city ev-

ery three or four months,” includ-

ing an impromptu trip with the

mayor to an East Side resident’s

Labor Day barbecue. “He was

enormously supportive of Michi-

gan when the state was down, and

I think the state has a very per-

sonal connection to him.”

T

oday, the state’s auto work-

ers aren’t necessarily secure.

The United Auto Workers

went on strike at all GM facilities

for 40 days last fall demanding

pay and benefit raises, all while

the union’s President Gary Jones

was being investigated for embez-

zlement. (On Thursday federal

prosecutors unsealed charges

against Mr. Jones, whom they ac-

cuse of stealing $1 million in

worker dues.) The moment is par-

ticularly difficult for workers

around Motor City, where GM last

week shut down its Detroit/Ham-

tramck assembly plant, forcing

production employees to commute

to more-distant plants until the

“D-Ham” retooling is complete in

summer 2021.

Last Tuesday Mr. Sanders ac-

cused Mr. Biden of hurting workers

through the years by voting for

“disastrous trade agreements”—an

attack he’ll likely repeat at emer-

gency rallies this weekend in De-

troit, Dearborn, Grand Rapids and

Ann Arbor. Yet many in the state

still remember the auto bailout as

a pivotal moment and Mr. Biden as

a friend of the industry. “In some

ways you’re always picking the

lesser of two evils,” says HVAC re-

pairman James Philip, 42. “But I’d

have to go with Biden,” he con-

cludes, reflecting in the shuttered

plant’s parking lot. “I mean, from

my viewpoint I’ve gotta think

about that experience under

Obama.”

Though the auto industry still

holds the most political influence

and sentimental power, the share

of Michiganders working in manu-

facturing is much smaller than

during the long postwar heyday, as

production work has diminished

throughout the country. In the De-

troit area, have been recovered in

part through the growth of ser-

vices that has accompanied the re-

cent revival of the downtown busi-

ness district. Unite HERE Local 24

represents more than 7,000 em-

ployees in the region’s hotels, casi-

nos, restaurants and arenas. It offi-

cially endorsed Mr. Biden

Wednesday.

“We know Biden. Our union

knows Biden,” says Local 24 Presi-

dent Nia Winston, whose senior

colleagues praise Mr. Biden’s sup-

port for the union’s strikes over

decades. Ms. Winston reserves her

strongest ire for Mr. Trump,

whose policies and rhetoric on im-

migration she says offend her

members’ values. But she bluntly

criticizes Mr. Sanders’s mission to

impose Medicare for All. “We

went on strike for better health

care in 2018. We fought for it in

our collective-bargaining agree-

ments,” she says. “We do not want

policies that will threaten what

we’ve achieved.”

While Midwestern Democrats

may condemn plant offshoring or

seek more government support in

health care, most working-class

people here, regardless of race,

want economic security—not revo-

lution. Mayor Duggan puts it sim-

ply: “Successful Democrats in

Michigan do not attack business.”

He says Gov. Gretchen Whtimer,

elected in 2018, “has balanced the

interests of the business commu-

nity” and recognizes that “if you

drive business out, the unemploy-

ment rate is very high.” Mr. Dug-

gan believes Detroit residents in

particular have seen the benefit of

working with business, and that

they will back a candidate on

Tuesday who is capable of the

same.

A

Feb. 23 Elections Research

Center poll showed Mr. Sand-

ers leading Michigan by 9

points after his early primary

wins, but Mr. Biden has ridden the

surge that began in South Carolina

to a 7-point lead in Tuesday’s

Glengariff poll. “Biden is actually

leading equally both in outstate

and metro Detroit,” pollster Rich-

ard Czuba told the Detroit News.

His growing appeal crosses racial

lines.

A fundamental gap between the

two candidate’s bases may be the

sense of having a stake in the

economy. Many despondent work-

ers, minorities who perceive wide-

spread racial oppression, and ide-

alistic young people back Mr.

Sanders. But in most of the red

and swing states that voted on Su-

per Tuesday, Mr. Biden won over

enough blacks, Hispanics, working-

class whites and stability-seeking

moderates to win pluralities.

It might be fair to say Mr. Sand-

ers is the choice of voters who

prize worker solidarity so much

that they embrace policies that

would jeopardize workers’ liveli-

hoods in the long run. Mr. Biden’s

success in Michigan and beyond

depends on ensuring that voters

who saw the markets rise after his

Super Tuesday victory aren’t hood-

winked into thinking those gains

benefit only the wealthy. If the

polls are right, working-class Dem-

ocrats are taking a practical ap-

proach to their economic interests.

Mr. Ukueberuwa is an assistant

editorial features editor at the

Journal.

Why Biden Has the Edge in Michigan

CARLOS OSORIO/ASSOCIATED PRESS

In a state Sanders won

four years ago, working-

class voters seem to take

a practical approach to

their economic interests.

By Mene Ukueberuwa

Joe Biden campaigns in Michigan last August.

A

once-renowned Kentucky car-
diologist is being released
from federal prison after an
appeals court threw out his health-
care fraud conviction because the
government withheld critical evi-
dence at his trial.
Richard Paulus was convicted in
2016 of health-care fraud and false
statements. After some back-and-
forth appeals, he reported to prison
last June. He wasn’t supposed to be
released until September 2023, by
which time he would have been 76.
But on Thursday the Sixth U.S. Cir-
cuit Court of Appeals vacated his
conviction. This decision should
bring needed scrutiny to a pattern of
dubious criminal prosecutions of
doctors that lawyers have come to
call “stent cases.”

A Court Corrects a Medical Injustice

The way these cases work is simple:

The government has questions about

a cardiologist and shows a sample of

his angiograms—chosen by the gov-

ernment—to a government-hired doc-

tor. The government doctor reviews

the angiograms and tells investigators

any time he thinks the doctor gave the

patient an unnecessary stent.

The government claimed that Dr.

Paulus did this “frequently, repeti-

tive[ly], daily.” A trio of government

doctors said that between 21% and

50% of the cases they reviewed

showed unnecessary stents. The gov-

ernment called this a “pattern” that

proved Dr. Paulus was a criminal.

But government doctors are no

more reliable than private ones. A

difference of opinion on whether or

not a stent was necessary is often,

well, just that. As one of the judges

hearing Dr. Paulus’s appeal remarked,

the rate at which government doctors

differed with Dr. Paulus wasn’t an er-

ror rate but a “disagreement in medi-

cal judgment rate.”

What’s more, the government

failed to disclose evidence to Dr. Pau-

lus’s lawyers that showed the dis-

agreement rate was in fact much

lower. It wasn’t 50% or even 21% but,

according to an expert hired by Dr.

Paulus’s hospital, just 7%.

The government argued during

the appeal that its failure to disclose

was harmless because a 7% disagree-

ment rate is still too high. It told the

court, as it has in all previous stent

cases, that where one cardiologist

thinks a blockage blocks less than

30% of an artery and another thinks

it’s above 70%, “somebody is right

and somebody is wrong.” The gov-

ernment claimed such disagreements

“should be zero or close to zero.” So,

the theory goes, where a trained car-

diologist like Dr. Paulus gets it wrong

by calling a 30%-or-smaller blockage

greater than 70% enough times, he

must be a criminal.

But the appellate court rejected

the government’s argument and an-

nounced that Dr. Paulus had a right

to know and let the jury decide

whether a 7% disagreement rate is

enough to diagnose him as a crimi-

nal. Indeed, the appellate court won-

dered itself whether it would have

rejected Dr. Paulus’s prior appeal had

it known this information. How,

when the government had known

this all along, had Dr. Paulus just

been forced to spend nine months in

prison?

And so Dr. Paulus is, for the third

time since the government targeted

him nearly a decade ago, an innocent

man in the eyes of the law. If the

government elects to retry him, he

now has the evidence he needs to

show that instead of being a crimi-

nal, at worst he may have made, in

the court’s words, “occasional mis-

takes or had occasional differences

of opinion.” As doctors, like all peo-

ple, sometimes do.

Messrs. Clark and George are trial

lawyers at Baker Botts in Washing-

ton. They have defended and advised

health-care providers in criminal and

civil investigations by the federal

government. Mr. George is also a

member of the Mid-Atlantic Inno-

cence Project’s board.

By Kyle Clark
And Andrew George

Cardiologist Richard

Paulus went to prison

because another doctor

disagreed with his opinion.

Spendthrift Illinois Races Toward Default

For 13 years, Puerto
Rico has been in a
man-made reces-
sion aggravated by
natural disasters.
In 2017 the island
territory asked a
federal court for
bankruptcy protec-
tion, but it’s still
grappling with $
billion in debt.
Puerto Rico’s fiscal fiasco offers a
glimpse of what the future could
hold for Illinois if it doesn’t deal
with its own self-imposed eco-
nomic disaster.
Long the economic hub of the
Midwest, Illinois has lost more than
850,000 residents to other states
during the past decade. The state
has been shrinking for six consecu-
tive years and suffered the largest
raw population decline of any state
in the 2010s. Puerto Rico has been
plagued by people problems too,
shedding population in nine of the
past 10 years.
Like Puerto Rico, Illinois is
drowning in a sea of red ink. Grow-
ing government debt and a crush-
ing tax burden are depressing eco-
nomic growth. State spending is up,

but personal-income growth is lag-

ging. Since 2000, Illinois’s per cap-

ita personal income growth has

been 21% lower than the national

average. Home prices are growing

at the second-slowest pace in the

nation, at only 2% compared with

5.1% on average nationwide. With

speculation that Illinois could be

the first state to go into default,

ratings firms are paying attention.

Illinois’s credit rating is one notch

above junk.

Shortly before Puerto Rico’s

bankruptcy filing, The Wall Street

Journal described “an exodus of

workers, retirees and entire fami-

lies” fleeing a deepening economic

crisis. “For years, Puerto Rico bor-

rowed more—and incurred higher

fixed costs—to buy time to stave

off deeper economic overhauls,” ac-

cording to the Journal report.

Creditors and analysts said Puerto

Rico’s problems were aggravated by

“government overspending and

promises to unions for employee

benefits that officials knew they

wouldn’t have the resources to

properly fund.”

The description also fits Illinois,

but it doesn’t have to. Illinois’s

public pension payments already

consume nearly a third of the state

budget, yet the unfunded liabil-

ity—which the state currently pegs

at $137 billion, though others put

the figure much higher—continues

to rise. Local government services

are also being squeezed by pen-

sions, contributing to rising prop-

erty taxes that are the second-

highest in the nation. Since 2000,

Illinois has increased pension

spending by more than 500% but

cut by a third services that help

students pay for college, protect

children from abuse, aid the poor,

and fight disease.

Moderate reforms could stabilize

Illinois’s five state-run and hundreds

of local pension funds, but politi-

cians have consistently refused to

consider them, preferring instead to

increase taxes steadily. Illinois has a

culture of trying—and failing—to

tax its way out of its problems. In

2011 then-Gov. Pat Quinn approved

a temporary tax hike aimed at mak-

ing a dent in the state’s $8 billion in

unpaid bills. By 2014, Illinois still

had a $6.6 billion bill backlog, and

lawmakers were calling for families

and businesses to give up more

money. Another permanent income-

tax increase came in 2017, but again

more taxes failed to solve Illinois’s

problems.

The problems, in fact, got worse.

In his freshman year, Gov. J.B.

Pritzker signed into law 20 new

taxes and fees totaling nearly $4.

billion, including a doubling of the

gasoline tax. Now Mr. Pritzker

wants a progressive income tax he

claims willreallysolve the issue.

He’s asking voters to give him a

green light on Nov. 3.

Mr. Pritzker is wrong to tell vot-

ers that 97% of them “will not see

an increase.” Because when voters

decide whether to push forward his

progressive tax, they won’t get to

vote on rates. As the Illinois Policy

Institute reported, solving the pen-

sion issue would require a progres-

sive income-tax hike of $10 billion.

Mr. Pritzker’s current plan to tax

$3.7 billion out of the state econ-

omy dedicates only $200 million to

pensions.

There is hope for the people of

Illinois. State pensions can be fully

funded, Illinois taxpayers can save

$50 billion over 25 years, and dol-

lars can be freed to support their

eroding public services. Policy mak-

ers can finally shrink Illinois’s pen-

sion liability by reducing the main

driver of its growth: the cost-of-liv-

ing adjustment, or COLA. Currently,

the COLA doesn’t reflect any actual

cost-of-living increase, since it isn’t

pegged to inflation. By simply re-

placing the existing guaranteed 3%

compounding postretirement raise

with a true COLA pegged to infla-

tion, among other modest changes,

Illinois can save $2.4 billion in the

first year alone. No current retiree

would see a decrease in his pension

check. Current workers would pre-

serve their core benefit.

Failed fiscal policy has left the

Land of Lincoln just a few steps

ahead of Puerto Rico, but all isn’t

lost. Just as Illinois’s financial di-

saster was man-made, so too can

be its recovery.

Mr. Divounguy is chief economist

at the Illinois Policy Institute.

By trying to tax its way

out of fiscal disaster, the

state makes matters worse.

There’s a simple solution.

CROSS
COUNTRY
By Orphe
Divounguy