It Turns Out That Firing Nobody and Giving the Agency More Money is a Really Poor Way to Fix Things

Working in the world of privatization, one objection I get all the time to privately operating in a here-to-for public space is that government officials are somehow more "accountable" to the public than are private companies.

This strikes me as an utter disconnect with reality.  If I screw up, I make less money or even go out of business.  When government agencies or officials screw up, they generally remain unchanged and unpunished forever.  There are no market competitive forces just waiting to shove a government agency aside -- they have a monopoly enforced at the point of government guns.  As I wrote a week ago about a conversation between myself and a government official about my operating public parks:

I understand that my margins are so narrow, if even 5% of those visitors don't come back next year -- because they had a bad time or they saw a bad review online -- I will make no money.  Those 2 million people vote with their feet every year on whether they think I am adequately serving the public, and their votes directly affect how much money I make.

Government agencies have nothing like this sort of accountability for public service.

One reason government agencies seldom change is that the typical response to even overt malfeasance is 1) to give the agency more money, as the agency will blame all incompetence on lack of budget (just think "public schools" and teachers unions) and 2) the agency will fire nobody.

Take the Phoenix VA.  Congress eventually rewarded the VA with more money, almost no one was fired, and the one of the worst managers in the VA system, a serial failure in multiple VA offices who would have been fired from any private company I can think of, was put in charge of the struggling Phoenix VA.

Well, it turns out that firing nobody and giving the agency more money is really a poor way to fix things.

Patients in the Phoenix VA Health Care System are still unable to get timely specialist appointments after massive reform efforts, and delayed care may be to blame for at least one more veteran's death, according to a new Office of the Inspector General probe.

The VA watchdog's latest report, issued Tuesday, says more than two years after Phoenix became the hub of a nationwide VA scandal, inspectors identified 215 deceased patients who were awaiting specialist consultations on the date of death. That included one veteran who "never received an appointment for a cardiology exam that could have prompted further definitive testing and interventions that could have forestalled his death."

The report portrays Phoenix VA clerks, clinicians and administrators as confused and in conflict about scheduling policies despite more than two years of reform and retraining.

"Unexpectedly" as a famous blogger would say.

 

 

19 Comments

  1. Dan Wendlick:

    Imagine how far you'd get with the IRS if you told a supervisor "Because of your employee's attitude, I'm never going to pay my taxes again."

  2. John O.:

    The reason why nothing changes is the apathy of the voters and general lack of any attempt of reforms that would hold government actors accountable. I've seen many reforms to hold government departments accountable, but they never go anywhere because they are hostile to the established political players (irrespective of party).

    The only real alternative right now is to just sue the crap out of these departments and agencies but that's far more expensive and difficult due to the many obstacles the state has put in the way.

  3. John Moore:

    This is correct.

    I use the Phoenix VA. I find that it varies from good to bad. This is because government tends to prevent the sort of quality control that happens naturally with businesses. And the good part is because even government has trouble driving the good out of good people.

  4. Matthew Slyfield:

    Fixing voter apathy wouldn't make as much difference as you think. Voting the current bastards out won't fix anything, because real reform will still be against the personal best interests of the new bastards.

  5. mlhouse:

    While there are other names for it, I call the process the "Barney Effect". If a bureaucracy is threatened with budget cuts their response is to make public that "if you cut our budget" then the most valuable aspect of our service is going to be eliminated. If the Corporation for Public Broadcasting is threatened by even a modest budget cut, they will claim that means they have to cut Barney and Sesame Street. This effectively changes the political argument from a reasonable and necessary budget cut that can be done by eliminating waste and inefficiencies in these bureaucracies to whether we should keep Barney and Sesame Street on the air "for the children". That is always a losing battle, but the CPB never says they also have the option of cutting "Victory Garden".

    The public is gullible and they do not see the mechanisms at play. The political leadership is either feckless or at times powerless to change the entity.

    A bold president would come into office and demand a real 3% budget cut in all of his agencies and departments. If the head of the agency argued that their budget cuts were "Barney", then that person would be fired immediately and a new person put in charge that will find the legitimate cuts.

  6. Northern Eye:

    Amen, Amen, Amen. As a 30-year Federal employee (now retired, thank the lord), I can vouch that the surest way to create a small-government libertarian (and cynic) is to spend 30 years working in a system which rewards ALL the behavior it claims NOT to want!

  7. TruthisaPeskyThing:

    "government agencies or officials . . . have a monopoly enforced at the point of government guns." No student should be allowed to graduate from high school -- even middle school! -- without being able to articulate this point. The problem often is not who is in charge at the government; the problem is the system where government has so much power and control. This problem is exasperated when the media feel that government should be the avenue to solve problems.

  8. marque2:

    Which is why the establishment bastards all seem to really really hate Trump.

  9. marque2:

    Government officials never have problems demanding private companies fire people, even when those people are probably the best to solve the discovered problem that probably didn't even reach the CEO. Elizabeth Warren demands the firing of Wells Fargo CEO for what some underlings did, that the CEO wasn't fully aware of, but won't fire herself for the VA problem, which she is totally aware of and hasn't helped fix.

    Probably should just give the vets vouchers for private care.

  10. SR:

    The VA situation has everything to do with money, but not in the way most government types think.
    Make anything free, and there will follow shortages. Medical care is no different. Free medical care always results in waiting, lack of supplies, and withholding of care. The VA hospital where I work occasionally gives veterens the very best of care, but delivers it slowly and bureaucratically.

  11. Matthew Slyfield:

    Nope, not even Trump would make any real reforms.

  12. mesaeconoguy:

    The VA episode is a litmus test for those who reflexively defer to government and government agencies.

    Tellingly, very few people I have encountered who fall into this bucket actually view this disaster as a real problem, explaining it away with a variety of unsupportable rationalizations and false comparisons with private, non-governmental healthcare delivery.

    The blindness to overt incompetence is shocking.

    It is also why the VA, those involved in Obamascare, and all of the other now openly corrupt and dangerous federal agencies know they can get away with nearly anything.

    It’s also why most of those people need their franchise revoked (different topic).

    We are headed in a very, very dangerous direction not seen before in this country.

  13. MJ:

    There actually is a formal name for the bureaucratic behavior you describe. It is popularly known as the Washington Monument strategy.

  14. John O.:

    Voter apathy comes from lack of wanting to be part of the solution to our problems. Its easier for a voter to take the candidate that promises the easiest life trade offs to live with. The only way I know how to get voter apathy to change is to randomly start throwing them into jury pools designed to conduct not just trials or indictments but also be part of the enforcement mechanism for these government problems. Right now the only power a citizen really has is to be randomly selected to partake in a jury (grand/trial) and vote in elections. The education on those two basic functions is often just total crap in public schools that only continues the decline of citizen participation in government.

    I agree with the statement that bold president needs to come in and just way waste to those who think their job is to always request more money.

  15. John O.:

    I started picking up really bad vibes that Trump is playing the Reagan of the 21st Century and knowing the lack of progress on reforming the government Reagan had, I can't see how Trump could possibly accomplish it either. In fact I can't see Trump actually wanting to reform anything, I think he's in it for the prestige and power.

  16. Matthew Slyfield:

    "Voter apathy comes from lack of wanting to be part of the solution to our problems."

    Or from realizing that there are no viable solutions short of burning the entire system to the ground and starting over from scratch.

    It doesn't matter who you vote for, There are few truly qualitative differences between the Republicans and the Democrats. Neither party shows any interest in the best interests of their constituents. It won't change a damn thing.

    I still vote, most of the time, but it's getting harder and harder to care enough.

    "The only way I know how to get voter apathy to change is to randomly
    start throwing them into jury pools designed to conduct not just trials
    or indictments but also be part of the mechanism to correct these
    problems created by more government action."

    There is nothing a grand jury can do to fix these problems. Your idea might work if the grand jury as the founders envisioned itself still existed, able to open it's own cases and conduct it's own investigations free from control by any government official. That kind of grand jury died 50 years ago. The grand jury of today is a pet of the prosecutor. They can hear only cases presented by a government appointed prosecutor, they can consider only the evidence that the prosecutor chooses to present to them.

    It's a nice idea, but short of violent revolution there is no chance of bringing back the kind of grand jury that might make a difference.

  17. marque2:

    We hear of the VA doctors who take 3 patients a week for full salary when similar doctors in the private sector would average 4- 8 a day. It is more than bureaucracy, it is sloth on the part of many VA workers, who look at the VA as some kind of personal welfare program.

  18. SR:

    What is your evidence for that?

  19. Agamamon:

    Warren aside, let's be real here - there's no way the CEO didn't know and if he *didn't* know then he certainly wasn't on top of what his company was doing or how the policies he set were being implemented and working at the customer level. This wasn't something that happened in one branch, or even one *state*. It was widespread and endemic throughout the bank's offices.

    He should have been fired. Probably should be jailed.

    Of course, its not the government's and certainly not Warren's place to fire the dude - that's the privilege of Wells Fargo's shareholders.