American Elephants


The Standoff At the Bundy Ranch Ends— For Now. by The Elephant's Child

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The Standoff at the O.K. Corral Bundy Ranch is standing off. The overarmed and overaggressive Bureau of Land Management has announced that because of the risk of violence, it is withdrawing its forces, some 200 armed agents, including snipers and guard dogs. The county sheriff negotiated the settlement.

It’s not at all clear what this was all about. The family settled in the area in the late 1800s and has ranched in the area ever since. The federal government has allowed Nevada ranchers to graze their cattle on tracts of adjacent public lands for generations. The federal government later created the Bureau of Land Management (BLM) to administer and “protect” the vast “federal lands”* including the land the Bundy family’s livelihood is and was dependent upon.

*These lands are frequently called “federal land.” This is inaccurate. They are public lands, owned by the people, and the government supposedly “manages” them for the American people. I don’t think anyone has challenged this frequently used terminology in court, but they should.

I don’t know about you, but I have a real objection to all these armed forces, SWAT teams, and snipers attached to agencies of the government. The Coast Guard, Border Patrol (we read that they were reduced to firing beanbags), and ICE,need to be armed, but this is really going too far. The federal agency did quite a few dumb things. It tasered Cliven Bundy’s son Ammon, rounded up a bunch of the Bundy cattle, and then fenced off a “First Amendment Area” in the middle of nowhere to demonstrate the protection of an “endangered” desert tortoise.

The federal government told the Bundy family that a tortoise existed on the land and therefore the land’s usage for cattle would have to decrease — attacking the Bundy family livelihood, which has led to a 20-year legal battle.The legal battle would seem to have gone against the Bundy family, but the Bundy family can in fact claim to have enjoyed generations of grazing rights on public land — with an arrangement originating in the 1870s when ranchers were offered those rights an enticement for settling the West.

I have no knowledge of the legal aspects of the case, and I suspect that you can’t fight city hall or the federal government. I am deeply suspicious of any claim of “endangered species,” because those so designated usually aren’t actually endangered, and are only used as a tool to accomplish some other purpose. I don’t believe that the Endangered Species Act has ever “saved” a species. The problem is often a simple increase in the number of predators.

Breitbart has done a fine job of outlining the case, the rumors, the law, and the problems involved. I would suggest that the American people are troubled by our imperialistic government and the increased militarization of so many federal agencies who have no business with SWAT teams and armed attacks on ordinary citizens. The Bureau of Land Management brought the angry resistance on themselves, with overreaction.



The Social-Engineering Approach to Health Care by The Elephant's Child

John Goodman offers two fundamental ways of thinking about complex social systems: the economic approach and the engineering approach.

The social engineer sees society as disorganized, unplanned and inefficient. Wherever he looks, he sees underperforming people in flawed organizations producing imperfect goods and services. The solution? Let experts study the problem, discover what should be produced and how to produce it, and then follow their advice.

Goodman, the father of the health savings account, calls this “cookbook medicine” which gives doctors rules and protocols for treating patients with various symptoms, and they must record each step along the way. Cookbook medicine does not bother with the differences among people, and is the opposite of personalized medicine which aims to tailor the therapy to the characteristics of the patient.

While it is useful to consider the standard protocols, people are not all the same. Medicine adapted to the genetic makeup of a person is in its infancy, but shows promise. When the cookbook becomes a rulebook to be followed slavishly, we’re in trouble. When complying with endless checklists takes valuable time away from patient care — that’s what’s happening in American medicine. A recent study of emergency room physicians found that they spend more time interacting with screens than patients, clicking the mouse 4,000 times in a 10-hour shift.

The Affordable Care Act was heavily influenced by the engineering model. After all, our bureaucrats are certified experts, and what are experts for if not to tell everybody else what to do and how to do it. Only social engineers would think of running “pilot programs” to control health care costs. What is the purpose of a pilot program if not to find something that appears to work, so you can order everyone else to copy it. Therefore you have the mess of digitizing all medical records and the result that hospitals have different systems that cannot talk to each other?

Dr. Virginia McIvor, a pediatric physician at Harvard Medical School explains the problem:

When a healthy child visits, I must complete these tasks while reviewing more than 300 other preventative care measures such as safe storage of a gun, domestic violence, child-proofing the home, nutrition, exercise, school performance, safe sex, bullying, smoking, drinking, drugs, behavior problems, family health issues, sleep, development and whatever else is on a patient’s or parent’s mind. While primary-care providers are good at prioritizing and staying on time — patient satisfaction scores are another quality metric — the endless box checking and scoring takes precious time away from doctor-patient communication.

If you have been to a doctor recently, you have probably noticed the multiplication of forms you must fill out, questions you must answer. I have noticed that the form now contains a line for “refuses to answer,” which may indicate progress of a sort.

John Goodman is the father of the “health savings account” which works precisely as promised and has been a great favorite. He is president of the National Center for Policy Analysis (NCPA) and he blogs regularly on health care matters (you can sign up to receive his columns), and his book Priceless takes on the health care problem.

There are great things happening in medicine that are promising for the future. The engineering rulebook is not interested in other people’s expertise or innovation.

The social engineer sees society as disorganized, unplanned and inefficient. Wherever he looks, he sees underperforming people in flawed organizations producing imperfect goods and services. The solution? Let experts study the problem, discover what should be produced and how to produce it, and then follow their advice. – See more at: http://healthblog.ncpa.org/cookbook-medicine-2/?utm_source=newsletter&utm_medium=email&utm_campaign=HA#more-36412
The social engineer sees society as disorganized, unplanned and inefficient. Wherever he looks, he sees underperforming people in flawed organizations producing imperfect goods and services. The solution? Let experts study the problem, discover what should be produced and how to produce it, and then follow their advice. – See more at: http://healthblog.ncpa.org/cookbook-medicine-2/?utm_source=newsletter&utm_medium=email&utm_campaign=HA#more-36412
The social engineer sees society as disorganized, unplanned and inefficient. Wherever he looks, he sees underperforming people in flawed organizations producing imperfect goods and services. The solution? Let experts study the problem, discover what should be produced and how to produce it, and then follow their advice. – See more at: http://healthblog.ncpa.org/cookbook-medicine-2/?utm_source=newsletter&utm_medium=email&utm_campaign=HA#more-36412


The Unaffordable Care Act Becomes More Unaffordable by The Elephant's Child

The health insurance policy rate hikes in excess of 6% in December were the largest reported since Morgan Stanley’s research team first started conducting quarterly surveys of insurance brokers in 2010. The April survey shows the largest rise in small and individual groups perhaps ever. The average increases are in excess of 11% in the small group market and 12% in the individual market. Some state increases are 10 to 50 times that amount. The analysts conclude that the “increases are largely due to changes under the ACA.”

The analysts conducting the survey attribute the rate increases largely to a combination of four factors set in motion by Obamacare:  Commercial underwriting restrictions, the age bands that don’t allow insurers to vary premiums between young and old beneficiaries based on the actual costs of providing the coverage, the new excise taxes being levied on insurance plans, and new benefit designs.

For the individual insurance market (plans sold directly to consumers); among the ten states seeing some of the sharpest average increases are: Delaware at 100%, New Hampshire 90%, Indiana 54%, California 53%, Connecticut 45%, Michigan 36%, Florida 37%, Georgia 29%, Kentucky 29%, and Pennsylvania 28%.

For the small group market, among the ten states seeing the biggest increases are: Washington 588%, Pennsylvania 66%, California 37%, Indiana 34%, Kentucky 30%, Colorado 29%, Michigan 27%, Maryland 25%, Missouri 25%, and Nevada 23%.

Think of the bride whose intimate garden wedding grows into a society-page extravaganza as the guest list keeps growing. The simple two-tier wedding cake turns into a multi-storied  edifice with elaborate floral icing on each layer. Not going to cost the same, and all those unneeded flowers and loops add to the cost, just as pediatric dentistry for 60 year-olds adds to the cost on an insurance policy. The massage therapy and acupuncture make a nice selling point, but it really isn’t free.

Since these hikes aren’t coming from HHS, but from the insurance companies, where it cannot be put off till “after the election,” it’s going to get interesting. Affordable Care indeed!



Shining a Light on the Dark Corners of Big Bloated Government by The Elephant's Child

Coburn

How many bureaucrats does it take to screw in a lightbulb? According to USA today, It takes 10 different offices at the HHS to tun programs addressing AIDS in minority communities. Autism research is spread out over 11 separate agencies. Eight agencies at the DOD are looking for prisoners of war and those missing in action. Schriever Air Force Base in Colorado has 8 different satellite control centers to control 10 satellite programs.

These are simply 26 new areas pointed out by the Government Accountability Office, where federal government programs are overlapping, duplicative, fragmented or just inefficient. There are 162 areas so identified in part reports. This gives Congress a clear map for saving tens of billion of dollars a year.

We owe this list to Senator Tom Coburn (R-OK), who wrote the legislation requiring this annual report, which is now in its fourth year.  “Turning this ready-made list of cuts into savings is one of the best ways Congress can regain the trust and confidence of the American people”, he said. “At the end of the day there are no short cuts around the hard work of oversight and identifying and eliminating waste.” The prepared testimony said:

It is impossible to account for how much money is wasted through duplication, in part because the government doesn’t keep track of which programs each agency is responsible for.

“One of the most troubling things in GAO’s report is the number of agencies that have no idea just how much taxpayer money they are spending on their programs,” said House Oversight Committee Chairman Darrell Issa (R-CA). He has sponsored legislation , the Digital Accountability and Transparency Act, that would require the government to better track spending data from Congress to an agency to its ultimate recipient. The bill has passed the House 388-1 last year and waiting for a vote from the Senate.

The agencies in question will object. Every agency in question will feel their slice of the pie is more important, and losing budget and personnel diminishes the agency. Bureaucracies always have empire-builders in their ranks. They just are not often recognized, because they have been good at telling their superiors how necessary that budget and that staff are to the good of the nation.

Many of GAO’s recommendations deal with some of the most complex and challenging areas across the federal government,” said Beth Cobert, the deputy director for management at the Office of Management and Budget, in a statement. “Fully addressing them is a long-term process that in many cases will take years to implement.”

Uh huh. Shine a spotlight on them and see what happens to the dark corners. Last year, the GAO reported that the two main groups responsible for POW/MIA issues were “unable to resolve disputes”  about who was responsible for what. When last month, National Public Radio detailed how bureaucratic and slow the search for remains was, DOD Sec. Chuck Hagel ordered that POW/MIA efforts be streamlined into a single office.

This is what transparency and sunlight are all about. A media that is too lazy,  uninterested, or partisan to do their traditional job as governmental watchdog, actually costs taxpayers money. A bloated, expansive government that is more interested in being important and powerful than in freedom and thrift harms everyone.




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