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It's Not a Business, Stupid

4/17/2015

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It is frustrating when yet another misguided politician insists that government should be run like a business. Aren’t you tired of that?

On Wednesday evening, Secretary of Veterans Affairs, Robert McDonald, told Rachel Maddow that the VA health care system needed to function like a business. This should surprise no one; Mr. McDonald is the retired CEO of Proctor and Gamble and has limited experience leading anything but a business. And he is an Obama appointee, reflecting that Democrats have joined Republicans in acting out the fairy tale that successful business people make the best leaders of government and its agencies.

Here in crAZy we’re suffering from this on a large scale. Arizona’s buffoon for a governor, Doug Ducey, campaigned on his business experience (Cold Stone Creamery). He often repeats his pledge to manage the state like a business. Thus far, that approach has failed miserably. However, it will ensure that Arizona wins the Race to the Bottom, as we face a growing deficit and poorer measurable outcomes on all fronts. His policies center on transferring state budgetary funds to the hands of private industry. Charter schools and private, for-profit prisons are two of this favorites. Most recently, he suggested the state’s university system be (what else?) run like a business. Accordingly, he directed the University Regents to take a “businesslike” approach in solving the problem of our grossly underfunded higher education system. He’s enamored with for-profit “universities” like the fraud-ridden, under federal investigation, University of Phoenix. Interesting that the Arizona Constitution, which he swore to uphold, reads (Article 11, Section 6): “The university and all other state educational institutions shall be … as nearly free as possible.”

While government does need to function with higher efficiency and effectiveness, it should not do so “like a business.” It is not a business. It’s a government – for the people, by the people, and all that. But why listen to me when you can turn to Forbes, a business magazine for some perspective? In 2012, John Harvey offered a clear and convincing explanation of why government should not be run like a business. He reminds us -

…the key issue is this: not everything that is profitable is of social value and not everything of social value is profitable. The proper role of government is the latter. … Profit is the realm of business, while unprofitable but socially useful tasks is the responsibility of government. (Forbes, 10/5/2012)

Republicans, Democrats, and the rest of you confused public servants – please give up this madness! Your jobs involve running a government. Make it so.

And Mr. Ducey: The Grand Canyon State ain’t no ice cream stand. We deserve better than your foolishness. The time cannot come soon enough that you are Stone Cold Out of Office.

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Psycho Killer: Qu'est-ce que c'est?

4/6/2015

As French investigators pursued the recent Germanwings tragedy with clear determination, they likely pondered that more frequently as the days progressed. The co-pilot was, indeed, a mass murderer of horrific proportions. He was also a disturbed man who should not have been flying a plane. In this “post 9/11” era, how does such a thing happen? Have we forgotten about terrorist pilots?

Immediate Germanwings responses offered the simple “solution” that US airlines already practice: always have at least two people in the secured cockpit. But, would such a system have stopped this tragedy? Would the co-pilot not have simply subdued or otherwise restrained a flight attendant as he completed his evil deed? His premeditation and preparation was reportedly extensive.

The world has struggled for more than a decade to balance airline security with privacy and freedom. It hasn’t gone well, and was mostly farcical until March 24. Think about how many tubes of mascara and hand lotion were confiscated as underwear and shoe bombers boarded planes. Or how many of your emails were scanned by NSA to determine whether you could be offered “TSA –Pre.” (Ever wonder how that happens?!) I long for the “old days” every time I enter an airport.

Travel stress will be heightened now. Thanks to Andreas Lubitz’s terrorism, we’ll look carefully at our pilots and crew as we enter a plane - wondering whether they will get us there safely or take us on a terrifying final ride. Someone else should be concerned with that question. Not us.

Each day we learn more about Lubitz’s psychiatric history. A deadly imbalance of privacy over public safety in Germany has come to light. Lubitz should not have been driving a bus, a train, controlling air traffic, let alone manning an aircraft. There is overwhelming agreement that people with severe mental illnesses should be identified and treated – not quietly shepherded into positions that require integrity and reliability on a grand scale. People who choose such positions should understand that they are also choosing to be monitored carefully. It “comes with the job” of taking so many lives into one's hands each day. Privacy cannot be the primary driver.

Health care providers have a unique and essential role not only in caring for individual patients, but in protecting the public. The fate of Flight 9525 could have been altered by a physician with an enlightened perspective, perhaps one who paused to consider whether s/he would travel on a plane that Lubitz was piloting.

Louis Lasagna’s Modern Hippocratic Oath includes – “I will remember that I remain a member of society, with special obligations to all my fellow human beings, those sound of mind and body, as well as the infirm.”

In the future, may our clinicians, indeed, feel obligated to all their fellow human beings.

It's Not a Business, Stupid

Psycho Killer: Qu'est-ce que c'est?

Politics Writ Large
"Politics is public health in its most profound sense."
Adapted from Virchow.

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It's Not a Business, Stupid

Psycho Killer: Qu'est-ce que c'est?

Politics Writ Large"Politics is public health in its most profound sense."Adapted from Virchow.

Archives

Categories

Politics Writ Large
"Politics is public health in its most profound sense."
Adapted from Virchow.