Friday, March 16, 2007



I have written a couple of times about the issue of government provided... as opposed to funded... health care at Veterans Administration facilities. The issues there as well as at Walter Reed army hospital revolve around the mind-numbing, Soviet-like process required to obtain outpatient care. What I have written can be boiled down to just a few things:

  • The health care professionals are doing the best they can with what they have as resources
  • The budget process comes before the health care demand levels
  • The health care professionals are not responsible for the budget process or the level of resources available to them
Now the government has taken action at one of their government-provided health care facilities:
The commander of Walter Reed Army Medical Center was fired yesterday after the Army said it had lost trust and confidence in his leadership in the wake of a scandal over outpatient treatment of wounded troops at the Northwest Washington hospital complex.
Washington Post Staff Writers
Friday, March 2, 2007; Page A01
And exactly what did that action accomplish:
  • The army general takes a bullet for the politicians who provide the funding
  • The politicians, like Sen. Charles Schumer, get to stand up and take credit for taking care of our soldiers while really only taking care of their publicity shots
  • There is a flurry of highly visible activity
  • The budget process stays the same
  • The health care process stays the same
  • Everyone waits until the dust settles
  • The soldiers still have the same problem
Of course, this is the same process that takes place in the V.A. The staffs are understaffed; the patients just have to have patience; the budget is whatever the politicians decide. While there is not much that can be done inside the military except C.Y.A., the V.A. can do this (from my last post):
I have argued on other discussion forums that the VA could be improved by providing eligible veterans with a "VA Health Card" that allowed them to seek treatment from any available hospital, clinic, or family doctor for minor or emergency needs. If longer term care is needed, the veteran would receive that at a VA facility if it is within a reasonable distance (to be defined) or continue receiving treatment locally.

This would accomplish two things:
  • Provide quicker care for the veteran while reducing the workload at the VA for short term care
  • Ensure the veteran receives long term care for chronic problems while focusing VA resources toward ensuring long term care is available.
The problem continues to be that VA health care is budget based rather than demand based. Private sector health care systems compete for patients by improving their systems to raise demand. They are limited by the constraints of insurance coverage and the requirement to provide emergency care for those without insurance. Bad systems eventually fail and get replaced by better ones.

With government-provided health care, you get what the government decides is appropriate in the manner it decides is appropriate.
Or, the VA can cover theirs... just like the army and the politicians... and wait for the public interest to be focused elsewhere. I know, how about focusing on the increase in hot air around Washington a.k.a. "global warming?"

By the way, it wasn't the general's fault. He didn't get the time, the money, or the staff to do what was necessary; but he did get the shaft.

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There is always an easy solution to every human problem—neat, plausible, and wrong.
Henry Louis Mencken (1880–1956)
“The Divine Afflatus,” A Mencken Chrestomathy, chapter 25, p. 443 (1949)
... and one could add "not all human problems really are."
It was beautiful and simple, as truly great swindles are.
- O. Henry
... The Government is on course for an embarrassing showdown with the European Union, business groups and environmental charities after refusing to guarantee that billions of pounds of revenue it stands to earn from carbon-permit trading will be spent on combating climate change.
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Tracking Interest Rates

Tracking Interest Rates


SEARCH BLOG: FEDERAL RESERVE for full versions... or use the Blog Archive pulldown menu.

February 3, 2006
Go back to 1999-2000 and see what the Fed did. They are following the same pattern for 2005-06. If it ain't broke, the Fed will fix it... and good!
August 29, 2006 The Federal Reserve always acts on old information... and is the only cause of U.S. recessions.
December 5, 2006 Last spring I wrote about what I saw to be a sharp downturn in the economy in the "rustbelt" states, particularly Michigan.
March 28, 2007
The Federal Reserve sees no need to cut interest rates in the light of adverse recent economic data, Ben Bernanke said on Wednesday.
The Fed chairman said ”to date, the incoming data have supported the view that the current stance of policy is likely to foster sustainable economic growth and a gradual ebbing in core inflation”.

July 21, 2007 My guess is that if there is an interest rate change, a cut is more likely than an increase. The key variables to be watching at this point are real estate prices and the inventory of unsold homes.
August 11, 2007 I suspect that within 6 months the Federal Reserve will be forced to lower interest rates before housing becomes a black hole.
September 11, 2007 It only means that the overall process has flaws guaranteeing it will be slow in responding to changes in the economy... and tend to over-react as a result.
September 18, 2007 I think a 4% rate is really what is needed to turn the economy back on the right course. The rate may not get there, but more cuts will be needed with employment rates down and foreclosure rates up.
October 25, 2007 How long will it be before I will be able to write: "The Federal Reserve lowered its lending rate to 4% in response to the collapse of the U.S. housing market and massive numbers of foreclosures that threaten the banking and mortgage sectors."
"Should the elevated turbulence persist, it would increase the possibility of further tightening in financial conditions for households and businesses," he said.

"Uncertainties about the economic outlook are unusually high right now," he said. "These uncertainties require flexible and pragmatic policymaking -- nimble is the adjective I used a few weeks ago."

December 11, 2007 Somehow the Fed misses the obvious.
[Image from:]
December 13, 2007 [from The Christian Science Monitor]
"The odds of a recession are now above 50 percent," says Mark Zandi, chief economist at Moody's "We are right on the edge of a recession in part because of the Fed's reluctance to reduce interest rates more aggressively." [see my comments of September 11]
January 7, 2008 The real problem now is that consumers can't rescue the economy and manufacturing, which is already weakening, will continue to weaken. We've gutted the forces that could avoid a downturn. The question is not whether there will be a recession, but can it be dampened sufficiently so that it is very short.
January 11, 2008 This is death by a thousand cuts.
January 13, 2008 [N.Y. Times]
“The question is not whether we will have a recession, but how deep and prolonged it will be,” said David Rosenberg, the chief North American economist at Merrill Lynch. “Even if the Fed’s moves are going to work, it will not show up until the later part of 2008 or 2009.
January 17, 2008 A few days ago, Anna Schwartz, nonagenarian economist, implicated the Federal Reserve as the cause of the present lending crisis [from the Telegraph - UK]:
The high priestess of US monetarism - a revered figure at the Fed - says the central bank is itself the chief cause of the credit bubble, and now seems stunned as the consequences of its own actions engulf the financial system. "The new group at the Fed is not equal to the problem that faces it," she says, daring to utter a thought that fellow critics mostly utter sotto voce.
January 22, 2008 The cut has become infected and a limb is in danger. Ben Bernanke is panicking and the Fed has its emergency triage team cutting rates... this time by 3/4%. ...

What should the Federal Reserve do now? Step back... and don't be so anxious to raise rates at the first sign of economic improvement.
Individuals and businesses need stability in their financial cost structures so that they can plan effectively and keep their ships afloat. Wildly fluctuating rates... regardless of what the absolute levels are... create problems. Either too much spending or too much fear. It's just not that difficult to comprehend. Why has it been so difficult for the Fed?

About Me

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Michigan, United States
Air Force (SAC) captain 1968-72. Retired after 35 years of business and logistical planning, including running a small business. Two sons with advanced degrees; one with a business and pre-law degree. Beautiful wife who has put up with me for 4 decades. Education: B.A. (Sociology major; minors in philosopy, English literature, and German) M.S. Operations Management (like a mixture of an MBA with logistical planning)