My point is that we should not be surprised by the VA operators’ behavior. Nor should we expect that the solution to the problem lies in hiring more “honest” schedulers, or in replacing the recently fired VA Secretary Eric Shinseki with a more competent executive. Operators, such as the VA schedulers, define their tasks in response to situational imperatives, and not the well-meaning directives of reformers. Calls for “clearer standards” or “more transparency” are unlikely to have much impact as long as there remains a disjunction between what schedulers are asked to do – and how they are evaluated – and what it is possible to do, given limited time and resources. Like most bureaucratic scandals, the fault lies less with the failing of individuals than it does in systemic factors that govern how those individuals behave within a particular bureaucratic context.Dan Munro:
Similarly, it is easy to blame Shinseki for his failure to “manage” the VA, but the truth is that Shinseki was not hired by President Obama because of his working knowledge of the situational imperatives that dictate how VA schedulers do their jobs. Instead, he was appointed for his symbolic value as a former military officer who served two tours of duty in Vietnam and earned a Purple Heart.
Fellow Forbes Contributor (and physician) Paul Hsieh cited three factors underlying the most recent allegations of corruption at the VA (here). Referencing a New York Times article, Dr. Hsieh summarized the three factors as:Philip Longman:
1) Doctor Shortage
2) Perverse Incentives
3) Culture of Dishonesty
He’s absolutely right – on all three counts.
Well, yes, as the author of the title Best Care Anywhere, Why VA Health Care would be Better for Everyone, it’s been dispiriting to have it confirmed by a preliminary inspector general’s report that some frontline VA employees in Phoenix and elsewhere have been gaming a key performance metric regarding wait times. But what’s really has me enervated is how the dominate media narrative of the VA “scandal” has become so essentially misleading and damaging to the cause of the health care delivery system reform.More politics and policy below the fold.
I don’t mean just the fulminations of the right wing press. It’s nothing new when Fox rolls out Ollie North to proclaim that any real or reported failure of the VA is proof of the case against socialized medicine.
I’m also talking about the work of hard-working and earnest reporters, who due to a combination insufficient background knowledge and the conventions of Washington scandal coverage, wind up giving the public a fundamentally false idea of how well the VA is performing as an institution. Over the next several days, I plan to make a series of posts here at Political Animal that I hope will be helpful to those covering the story, or for those who are just trying to get the full context for forming an opinion.
The number of companies offering health plans in New Hampshire under the Affordable Care Act will increase from one to five next year, the state insurance department said Monday.Ta-Nehesi Coates:
I wanted to take moment to reply to Kevin Williamson's Case Against Reparations. I wanted to do that, primarily, because his piece covers many of the most common objections to my piece, but also because I've always been an admirer of Williamson's writing, if not his ideas. Among those ideas is a kind of historical creationism which holds that "race" is a fixed thing. The problems with this approach are many, and duly apparent from the outset.More on this important topic in this forum presented by Black Kos.
Williamson says he is opposed to "converting the liberal Anglo-American tradition of justice into a system of racial apportionment." He then observes that, in fact, that tradition, itself, has always been deeply concerned with "racial apportionment." Thus within the second paragraph, Williamson is undermining his own thesis—if the Anglo-American tradition is what he concedes it to be, no "converting" is required. We reverse polarity for a time, and then we all live happily ever after.
Or probably not. That is because Williamson's entire framing is wrong. Reparations are not due because black people are black, but because black people have been injured. And the Anglo-American tradition has never been a system of "racial apportionment," but of racist apportionment.
We no longer have news. We have springboards for commentary. We have cues for Tweets.Simon Maloy:
Something happens, and before the facts are even settled, the morals are deduced and the lessons drawn. The story is absorbed into agendas. Everyone has a preferred take on it, a particular use for it. And as one person after another posits its real significance, the discussion travels so far from what set it in motion that the truth — the knowable, verifiable truth — is left in the dust.
The economy of contemporary journalism encourages this. It favors riffing over reportage, and it’s lousy with opinions, including the one expressed here. I sin whereof I speak. I also present this as a confession and a penance.
If you go back and search for that era of journalism in which facts were nailed down concretely before interested parties co-opted the story for their own purposes, you’ll find that it doesn’t exist except in the gauzy reminiscences of mid- to late-career pundits.Ron Fournier:
This culture of reverence for The Good Old Days that never were is particularly strong at legacy media outfits like the New York Times, which long enjoyed the capability to dominate news coverage — both in terms of what was covered and how it was covered – before people started writing things on the internet. The loss of control over the narrative is what Bruni is really upset about, which becomes clear as his column transitions to critiquing the coverage of the firing of New York Times executive editor Jill Abramson.
What Your Opinion on the Bergdahl Swap Says About Your Views Toward ObamaTPM:
We know next to nothing about Bergdahl or the president's plan to monitor the terrorists he freed. So unless you're partisan, it's too soon to form an opinion.
Republican operatives apparently believe there's something to be gained by painting Sgt. Bowe Bergdahl as a deserter.Kathleen Parker:
The New York Times ran one of the manifold articles Monday focused on resentment toward Bergdahl among some of the soldiers in his unit, and the paper disclosed the interviews were arranged by GOP strategists.
Obama critics naturally saw the president’s mouth tip in a smile, though it could be interpreted as a grimace. What was he to do, grab the microphone? Stare grimly at a father announcing the release of his boy after five years in captivity?If you don't remember what it was like right after 9/11, just watch the GOP on Bergdahl: it was like that. Reflexive jingoism, pressure to conform, false patriotism. It's all there on display.
There is nothing trivial about these events, but the questions raised are, nonetheless, “Homeland”-ishly intriguing: Did Bob Bergdahl convert to Islam? Did his son? Did Bowe Bergdahl abandon his post, as fellow soldiers claim? Is he a traitor?
Until the Army provides answers, we’ll have to make do with speculation. Meanwhile, the only question that required an immediate response was, did the United States want Bergdahl back and what were we willing to trade?
This was indeed a hard choice — and the answer had to be yes.