Problems in the VA health care system have prompted some to blame them on the inherent incompetency of big government. Get rid of big government and things like this wouldn’t happen. A few of the most rabid anti-big government voices in our area consider state, county, and city governments to be big government as well, so it’s a little hard to know where they are willing to draw the line. In an odd contradiction, they believe the nation owes good medical care to veterans but don’t trust the government to provide it.
They are not far from those who blame the General Motors ignition switch problems on the inherent incompetency of big corporations. We should do away with big corporations but keep the economies of scale they bring to the market place. I wonder how that would work? It’s a little weird how the anti-Socialists and anti-Capitalists meet on the common ground of their imaginations.
Imagine it. A nation of small governments and small businesses that, nonetheless, enjoys all the benefits of economies of scale, nationwide access to goods and services meeting high standards of health, safety, and value, and dependable infrastructure systems built and maintained without intrusive planning or oversight from big brother, whether governmental or corporate.
The problems at the VA are problems of the VA, not of big government. They need to be addressed at that level. In like manner, problems at General Motors are problems of General Motors, not of big corporations. In both cases the problems have something to do with the efficacy of policy and procedures, and with organizational culture run amok. One cannot be fixed without addressing the other, and neither can be fixed by blaming the existence of the generic institutions of government and business.
On the other hand, and being Episcopalian there is always another hand, all human organizations, regardless of size, tend to fall into habits of performance in which people do what they can to insulate themselves against criticism and liability. The larger the organization, the greater the opportunity and incentive to do so. It’s a function of collective human nature. Laws, rules and regulations help establish boundaries that mitigate against abuses. An impartial legal system helps to resolve disputes. Intentional management of organizational culture helps to promote more ethical behavior through the general acceptance of higher standards. It’s never foolproof. Conditions are always changing. What is acceptable and what is not is always debatable. Agents of misfeasance and malfeasance will always find a way to corrupt whatever system is in place. Human greed, laziness, and incompetence will always fall into whatever cracks those agents open up. That’s life. It’s pretty well laid out in Genesis, Exodus, and Numbers, and it hasn’t changed much since then.
Perfection is not ours to have, at least not in this life. But we can do better, and doing better begins not with blaming straw men or chasing after red herrings. Nor does it begin with better managers. It begins with better management. I might suggest the Sermon on the Mount as a good place to begin the search for better management. The problem with that is that too many competitive types would rather play “screw your neighbor” than do the hard work of managing well.