dagblog - Comments for "WHY FIRING SHINSEKI IS COUNTERPRODUCTIVE"

1) Clinton's personality

PeraclesPlease — Fri, 06 Jun 2014 09:15:20 +0000

In reply to Seem to remember something

1) Clinton's personality seemed to thrive on difficult odds, and peter out when things were going well - he liked a challenge to push himself.

2) Civil service probably has invited little dictators and slow-moving grumps since forever. Part is likely the "you're set forever, just show up at X o'clock". I'm sure academia without tenure would move faster - whether in the right direction, I don't know.

The genome project is a good example where gov effort was slower than bejeezus, while someone came along in private sector and flew by them. Space flight is now approachable enough where private vehicles & private processes can adapt faster than slow gov projects. [gov contractors are typically just extensions of the slow internal civil service. as some forgiveness, you have to be pretty slow to wade through typically 100s of pages of nonsense to bid on even the tiniest contract, and then wait around for a year for it to actually happen. One gov tender I followed/pushed for 3 years, and then when it came, they gave me a week to apply - obviously the fix was in.]

But then there's the steady beat of "government is the problem" since 1980. Even though Clinton did a good job of proving that wrong, reality wasn't able to penetrate the disinformation campaign/sloganeering well enough, so we elected a government designed to make government the problem.

Seem to remember something

artappraiser — Fri, 06 Jun 2014 07:30:15 +0000

In reply to Given the NSA and VA

Seem to remember something along those lines happening before. I don't think it's a total coincidence that in the second term, even through an impeachment, it ended up a very popular presidency with very high approval ratings.

....In September 1993, the National Performance Review issued its initial report, noting that successful organizations—businesses, city and state governments, and organizations of the federal government—do four things well. These four things became the recipe for reinventing government: 1) Put customers first; 2) Cut red tape; 3) Empower employees to get results; 4) Cut back to basics.^[7]

In March 1993 Clinton stated that he planned to “reinvent government” when he declared that “Our goal is to make the entire federal government less expensive and more efficient, and to change the culture of our national bureaucracy away from complacency and entitlement toward initiative and empowerment....

I am reminded of Dasani's story for some reason. When did it become okay not to expect excellence from government workers? Why do some people expect less performance for their tax dollars than they do for the dollars they spend for private services? It didn't start out that way with FDR's plans, those getting those government jobs were proud to be given the chance to excel for their employers, the citizens of their country, whether it was digging ditches or painting murals. There's something about a slow creeping sense of entitlement that slowly kills good things. Many of the rich happen to have that now. But it's not something inherent to just the rich. This is getting at why the idea of a job guarantee espoused by some MMT economics fans sort of sticks in my craw. I think of Soviet society in its death throes...no shoes, no shirts, no services, no products...nothing but bureaucracy feeding on itself....

Given the NSA and VA

Peter Schwartz — Tue, 03 Jun 2014 12:10:09 +0000

In reply to WHY FIRING SHINSEKI IS COUNTERPRODUCTIVE

Given the NSA and VA problems--and who knows what else is messed up--I'm starting to think that a smart presidency would look something like this:

• First four years: A complete IG-style audit of ALL government agencies to get all the problems, or as many as possible, on the table. Maybe this takes one year. The second year, all the teams develop proposals for fixing the big problems. Years three and four are devoted to fixing those problems, or getting a solid start on them.

• Second four years: New stuff that builds on what we've learned in the first four years.

• Both terms: Dealing with all the unexpected stuff, particularly in foreign policy, but also domestic events, that no one can predict.

A candidate would run on this sequence of events, promising to uncover and fix problems that most people, including the candidate, don't know exist first before adding more to government's plate. It wouldn't be a sexy campaign, but I think it makes sense.

Good point... and should be

oldenGoldenDecoy — Sun, 01 Jun 2014 17:47:46 +0000

In reply to Why should vets have access

Good point... and should be obvious . . .

The moral reason is that vets agreed to die and/or become maimed for life to defend the country. We owe them.

And that's also why "ordinary people" who have not served aren't given the option to be interred in a National VA cemetery.

~OGD~

Why should vets have access

Anonymous PS — Sun, 01 Jun 2014 12:00:02 +0000

In reply to A consultant could be states

Why should vets have access to specialists and consults that ordinary people do not?

Two good reasons, one moral and one practical.

The moral reason is that vets agreed to die and/or become maimed for life to defend the country. We owe them.

The practical reason is that, because they do put themselves in extreme harm's way, their medical needs are, on average, more extreme.

Hey, nice to see ya. Hope

Anonymous PS — Sun, 01 Jun 2014 00:14:07 +0000

In reply to A consultant could be states

Hey, nice to see ya. Hope you're doing well.

A consultant could be states

artappraiser — Sat, 31 May 2014 18:57:25 +0000

In reply to I wonder if this is like the

A consultant could be states away but freely able to review imaging and laboratory studies.

I'd just like to point out that that's not at all the planned ~~Obamacare~~ Romneycare model of the future,quite the opposite. Limited local networks are the foreseeable future for this country, by design, to cut down costs. If you're real lucky, you might have access across your state. In most cases and definitely in the case of larger states, not even that. Why should vets have access to specialists and consults that ordinary people do not?

Neither does a national health model, which the VA resembles, and which I actually dream of and would prefer, allow everyone to go everywhere and get everything they want. That's for the rich and/or powerful, no matter what system you have. Everyone in Cuba does not get to see Fidel's gatroenterologist, nor are they probably allowed to have the same operations he gets for the same condition.

I noted with interest in the this NYTimes article from today's print that a major part of the cost problem is the one that is bedeviling all health care systems everywhere:

...Most of the veterans now seeking treatment at department facilities are aging Vietnam-era service members, many with chronic illnesses like diabetes that require long-term care or with cancer and cardiovascular disease that require complicated and expensive treatment...

To change the subject. As regards, the title of this post, "Why Firing Shinseki is Counterproductive," from this analysis piece also from the NYTimes. Basically from the horse's mouth via his mouthpiece; this came from the top, nobody made Obama do it:, he wanted the resignation and is not happy with how things are being run:

“To make this change, he felt that staying the course would actually be harmful to the fixes that need to happen, as opposed to changing the press narrative, which is something he would never do,” said David Plouffe, the president’s longtime adviser.

Still, Mr. Obama struggled to explain the different approaches. Keeping Mr. Shinseki, he explained, would have been “a distraction” from the important work of fixing the problems at the department. But getting rid of Ms. Sebelius right away, he said, would have been “a distraction” from the important work of fixing the problems with the health care website.

The difference was particular to the two situations, advisers said. With health care, the open enrollment period was rapidly closing, and switching leaders at that time would have complicated it. With Veterans Affairs, the issues are so systemic that it will take a long time to address and there was no sense in waiting.

At the same time, it is clear the White House views the veterans issue with more alarm than some of the other controversies of the last couple years, like how it publicly characterized the attack in Benghazi. “There’s a feeling, and I share it, that these were manufactured crises mainly by Republicans and pumped up by cable news and Twitter,” Mr. Plouffe said. “This one’s got some reality to it.”

Yes. They are talking about

Peter Schwartz — Sat, 31 May 2014 18:17:24 +0000

In reply to I wonder if this is like the

Yes. They are talking about sending backed up vets to private hospitals, etc., for which there's some precedent. Vets who've been waiting like that, but they don't like the idea of dismantling the VA (which might be the next step).

Vets, as you might expect, have unique health issues, and the VA has a lot of expertise with those issues, which private hospitals do not.

But on the other point, Congressmen from, say, Virginia don't want Washington State shrinks stealing basket cases from Virginia shrinks. Or something.

I wonder if this is like the

rmrd0000 — Sat, 31 May 2014 14:54:32 +0000

In reply to Yes, sadly. From what I hear,

I wonder if this is like the post office. Congress cuts funding and puts limitations on operations to force a "free market" solution. The idea that a consult could not be done over the phone anywhere in the country seems ludicrous in the age of telemedicine. A consultant could be states away but freely able to review imaging and laboratory studies. Phone calls may be the wave of the future, saving patient time spent sitting in the doctor's office.

Yes, sadly. From what I hear,

Peter Schwartz — Sat, 31 May 2014 14:44:38 +0000

In reply to From what I read, his one

Yes, sadly. From what I hear, though, he opened up eligibility for care and benefits on a massive scale. So, if a vet had PTSD or exposure to Agent Orange, he was automatically deemed eligible without having to go through a lot of red tape. This ballooned the rolls, which ES then worked to reduce, successfully.

If you read the article, you'll see there were systemic flaws that almost guaranteed system gaming. She doesn't mention a lack of sufficient funds, which is almost always a non-starter with the GOP these days, but I would wager that a cut back in funds for doctors and shrinks was part of it.

Interestingly...the shrink I see had a regular gig doing phone consultations with vets through some kind of contract. He just learned that shrinks can now only do phone consults with vets if they are physically located in the same state, even if they're on the other side of the state from the patient. Sounds like Congress to me and keeping the jobs in the state.