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Notes -
Two case studies in government waste:
As you can likely imagine right now a lot of people in medicine are sharing tales and taking sides in the great DOGE debate. Two that popped up on my radar and stuck out to me:
Some problems: -As an emergency room most of their patients have no insurance or Medicare or Medicaid, meaning the facility often get paid less than cost. They only stay open at all because of their state grants.
-Many of the patients are drug addicts or malingering (because of homelessness for example). Every day you’ll hear something like “you’ve been here every day for the last three weeks” or “have you considered stopping using PCP? You always seem to fight with the police when you do” and “here’s your follow-up appointment, will you go? No? Fuck me? Okay thank you have a nice day.”
-Many of the patients who do actually have mental illness are in denial about it, or have some sort of limitation that prevents them from attending aftercare appointments.
-The “best” solution is probably to violate patient rights and involuntarily commit them to make someone else be on the hook for making sure they go to their aftercare.
-In the meantime, the hospital has hired several additional staff to manage some of the administrative complexities associated with this change (for example hammer calling the patients to remind them to come to the appointment). They have also hired night staff whose job is to sit in an office overnight purely to schedule appointments with an outpatient program (otherwise no patient could be discharged overnight because they wouldn’t have an appointment to go to…).
Anyway, he dutifully completed his requirements in a timely fashion (which were all pointless! Ex: what is the motto of the VA???). So, months later his rotation is starting soon. He begins the process of emailing the education team once every 2-4 business days. You have to email them multiple times before they respond. The conversation goes something like this over the course of multiple weeks, “I think I’ve completed my onboarding do I have to do anything else?” “no” “okay is my onboarding done” “no” “okay when can I pick up my ID card” “when your onboarding is done” “I thought my onboarding was done” “yes” “okay what I am waiting on” “nothing.” I have seen the emails; it really looks like this.
At this point his program tells him to CC the chief of medicine at the VA hospital, at which point the person responds with “okay we put in a ticket for this a month ago, your training is complete but your training is marked as incomplete.” A screenshot has been attached that shows the request and an automatic response that says something about high ticket volume and that they will get to it at some point. The chief of medicine replies “….does the trainee need to do anything?” (we are here).
The resident will be able to rotate but will not be able to do any work without computer access.
It’s worth noting that the VA is paying for this resident to be there, despite the fact he will in fact not be able to do anything. At his last VA rotation (yes they go through this for every resident every time) he was six weeks into an eight week rotation before he got access.
We have gotten to an odd place where people can nonchalantly talk about fighting police weekly and utilizing millions of dollars of public resources as "rights". This seems like yet another example of why the left and Democrats are so alienated from "the working class", as far as such a thing exists. Relaying a story like this to an Amazon delivery guy, a stay at home mom of 3+, a legal secretary, or a midlevel real estate agent and they'd very likely be seething with rage, thinking about how they just got a $3000 bill from a hospital because their kid had an asthma attack, which came just after finished paying off the bill for their other kid's birth.
Why didn't they just pretend to be homeless again? That is the question they ask. Why is the violent drug user getting better treatment from the state?
Get on our level. British Columbia got into a bit of a kerfuffle when it tried to ban people from injecting drugs in playgrounds. Apparently it would cause "irreparable harm" if they had to shoot up elsewhere, so the BC Supreme Court filed an injunction against that amendment.
(They eventually got it banned, eight months after their first attempt. Having Health Canada do it instead of the BC government was the secret sauce to make it stick, because it matters which government is violating the Canadian Charter of Rights and Freedoms, or something.)
Well, you've got to give them points for intellectual consistency and being willing to bite bullets! If a the Parks department wants to do something to improve general community wellbeing and make parks enjoyable for normal people, we have to think carefully about the rights of junkies to shoot up in parks. If the Health department says that it's about health, there is absolutely nothing that will counterbalance that and they have an arbitrary level of power to dictate who goes where when.
In Canada, as with the rest of the Western world, 3 Goddesses are worshipped: Safety, Equality, and Consent.
The Parks department's approach contradicted Equality, so what they wanted was bad and denied.
But the Health department are Safety's priests, so what they wanted was good and applied.
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