Bureaucracy; Governmental service, what thing can Government NEVER do well?
Professions, or the “practice” or “art of”.
Why? Because Bureaucracy MUST emphasize NUMBERS, not persons, NOT INDIVIDUALS.
Doctors and lawyers deal with INDIVIDUALS.
What kind of person enters Professions such as Doctors or Attorneys?
I suggest to you many Doctors and Attorneys are similar in one important way. Many care about what I call, “doing the right thing” when dealing with people’s lives. What follows are my real world observations over a lifetime of service, and my hypothesis of how that will transfer to the future of the Medical Profession under Governmentally controlled mandates.
Bureaucracy creates and keeps a certain personality, a kind of person who can be taught or trained to be satisfied with the status quo or system. A person who can be indoctrinated not to ask WHY, taught not to evaluate “the system” and suggest improvements.
A place everyone agrees is a great training ground for new lawyers is a governmental prosecutorial office. Young lawyers learn their art and trade in the crucible of the courtroom where experienced “old hands” literally hand their ass to them with juries of American citizens.
One learns more from their defeats than their victories. Starting with traffic tickets, DWI/DUI’s and Assaults, and consummating their experience with Sexual Assaults, Robberies, and Murders. This is truly INVALUABLE experience, in the proper environment. An environment where the CULTURE emphasizes what I’ll call “doing the right thing”.
In Texas all Attorneys take an oath to uphold the U.S.Constitution and the Texas Constitution. Additionally, Assistant District Attorneys take an oath to “seek justice“.
Texas Code of Criminal Procedure, Article 2.01, Duties of District Attorneys
… It shall be the primary duty of all prosecuting attorneys, …, not to convict, but to see that justice is done. They shall not suppress facts or secrete witnesses capable of establishing the innocence of the accused.
2 kinds of governmental organizations I have experienced are:
1) the Organization that keeps “justice” or “doing the right thing” at the forefront of their duties to their community and instills it in her culture (Folks, there aren’t many of these.), and
2) the Organization that concentrates on numbers.
What is NUMBERS? Disposing of the most cases. Having the highest conviction rate. As the community’s population grows, NUMBERS becomes the “holy grail”. No longer does anyone have the time to consider Justice. Doing the right thing takes time. Because “doing the right thing” requires time, only those persons who hold an inner, innate sense, that doing an exemplary job is most important, are going to take the additional time to “do the right thing”.
Why does “doing the right thing” take extra time?
One cannot discern JUSTICE from computers, paper, and reports.
“Doing the right thing” can only be learned from the INDIVIDUAL, and thus requires time.
- One on one interviews with crime victims.
- One on one interviews with law enforcement personnel.
- One on one interviews with attorneys and maybe the accused.
- Additionally, doing the right thing, will require legal research.
- After all that “extra” effort, the prosecutor has to “sell” doing the right thing to his superiors. And IF the superior agrees,
- then more work of DOCUMENTING the file for later use, just in case someone changes their mind and complains to the media….
It is much easier to just “tee up” the case before a Judge or Jury, try the case, and obtain a guilty or not guilty. The prosecutor’s office can say to the media, we didn’t do it, the idiotic judge or idiotic jury did it…..
What happens in the office that is concerned with NUMBERS ?
Attorneys who care about doing the right thing, get handed the difficult cases. These attorneys get more and more cases that require more and more work, as compared to the average attorney’s workload, WITH NO EXTRA PAY. So their numbers go down, even though they are doing more actual work (I suggest more valuable work too).
Doing the right thing, causes the attorney to encounter new ethical issues or problems in his/her caseload. These new ethical issues cause the attorney to tell his supervisors:
“NO, I won’t do that, it’s not the correct, or ethical, course of action”.
The supervisor, who is concentrating on numbers, because “the job” depends on it, has a problem. The supervisor can support the subordinate attorney, or not. The course of least resistance is to fall on the side of NUMBERS. Supervisors set by example, that NUMBERS are more important than PERSONS. Those attorneys that are happy to concentrate merely on numbers do what it takes to obtain numbers for promotion.
So what happens to the attorneys that care about Justice and doing the right thing?
They resign from Governmental service.
Those lawyers no longer trust their supervisors or the system. Maybe those attorneys are touched by the victims of the system. INDIVIDUALS.
- Sometimes the INDIVIDUAL is the victim of the crime.
- Sometimes the INDIVIDUAL is a child who has to re-live over several years the abuse they endured. And YES,
- sometimes the INDIVIDUAL is someone who is WRONGFULLY ACCUSED, and whose life is forever altered because “the system” let him/her down.
The common denominator in all these fact patterns is the person who cares about “doing the right thing” for the INDIVIDUAL . That person, this attorney, is victimized in every one of these cases of injustice. The rates of alcoholism, depression and mental illness are well known.
The person who cares about “doing the right thing” leaves the governmental bureaucracy. WHY?
Bureaucracy is concerned with NUMBERS, not INDIVIDUALS.
If the person continues to practice law, he/she attempts to practice where he/she is not prevented from attempting to “do the right thing” for the INDIVIDUAL .
What happens to the BUREAUCRACY, the governmental office?
- Those persons that concern themselves with numbers are promoted.
- Those who concern themselves with numbers are placed in charge.
- Those who concern themselves with numbers begin to train the “new recruits”.
- Those who concern themselves with numbers learn to identify persons who will be happy with the emphasis on NUMBERS, and not an emphasis on PEOPLE.
And then the cycle is complete. The SYSTEM concerns itself with NUMBERS of dispositions, not PERSONS and “doing the right thing”.
All is truly lost.
The Constitution no longer matters,
- dispose of that case, take care of the NUMBERS.
- No we can’t do the right thing because the Media will make us look bad for dismissing it.
- ETHICS falls by the wayside.
- Those who care about doing the right thing leave the bureaucracy because there is no time, only dis-incentive, to do the right thing.
what is their motivation, their incentive to become doctors and practice medicine?
Why and what do medical professionals do? From my own patient viewpoint, observations, and discussions with personal friends who are doctors. They care about “doing the right thing”. They care about PERSONS, INDIVIDUALS. The healthcare system’s priority has been about giving the best care possible to INDIVIDUALS. With Doctors, nurses, and their staff, the emphasis is on PERSONS, NOT NUMBERS. Every person is different, with infinite possibilities of complications.
One cannot dispense medical advice and healthcare from computers, paper, and reports.
TIME is required. Multiple interviews. Tests and documentation are required. TIME, TIME, AND MORE TIME.
Time is the enemy of NUMBERS !
FEDERAL BUREAUCRACY; EMPHASIS is on the NUMBERS !
Numbers will control and kill “THE SPIRIT” of HUMANITY.
Governmental bureaucracy will KILL healthcare as we know it.
The federal Government is taking control of 1/6 of the economy. CHEAPER CARE? Not after all.
4 million (as opposed to 30 million that were promised) to be covered with “cheaper” costs…..
The new costs appear to be at least 4 times greater than promised.
The GOVERNMENT’S emphasis on NUMBERS is why tens of thousands of IRS agents are going to NOT TOLERATE disobediance.
Emphasis is on costs and numbers. Not on treatment and improving care.
- No new emphasis on new training hospitals.
- No new emphasis on research centers.
- No new emphasis on thousands of doctors, nurses, etc. that will be required to treat the millions of new persons.
- No new emphasis on new medicines and new procedures.
The Government bureaucrats who supervise the Doctors will tell the Doctors, “No that procedure is not on our list of available treatments”.
- Doctor, you haven’t been seeing enough people (NUMBERS) to justify paying you, you must “treat” more people or we will penalize you.
- “I need this test done ASAP. Sorry, the line is 6 months long.”
- “I need this operating room in 3 days” Sorry, the line is 9 months for that procedure.
- Then the IRS will send the doctor’s bill back to him/her cut to almost nothing. Sorry, our manual doesn’t allow for that treatment in this case.
Quality persons, who care about “doing the right thing” for INDIVIDUALS, will find something else to do.
It won’t be long before DOCTORS who are prevented from doing the right thing for INDIVIDUALS, will resign and refuse to practice in America. DOCTORS will say to themselves, “NUMBERS isn’t WHY I became a doctor.”
The doctor (like the exodus from Canada to America 30 years ago) will go somewhere else to practice, or just retire.
When the gifted young people learn what has happened to the Medical profession, the “best and brightest” will no longer enter Medicine, they will choose a profession where they can control their own destiny and make a difference in their chosen way.
LADIES AND GENTLEMEN, governmental bureaucracy cannot provide healthcare.
- INDIVIDUALS provide HEALTHCARE to INDIVIDUALS.
- Healthcare is not a cookie cutter manufacturing process.
- Healthcare, is an infinitely changing, personal experience, to each and every INDIVIDUAL treatment.
THEIR IS NO WAY a bureaucrat can design a process to cover 300 million different INDIVIDUALS and each of their UNIQUE health problems.
?Do any of you really want your life, or your loved one’s life, in the hands of a bureaucrat that is content working for the Numbers?