Tuesday, March 06, 2007

By Their Fruits You Will Know Them

[Ed Note: I meant to cross-post this from AmFoot yesterday, but blogger was acting up. As the kids say, whatever...]

A reader at Josh Marshall's site makes the case for placing the recent Walter Reed/military hospital/VA scandal in its proper context:

What's really at issue here is the extent to which problems with the military, specifically, and the government, generally, are a result of policy. The common explanation for the catastrophic results of many of the Bush administration's initiatives (from Iraq to New Orleans and back again) is that they are the result of "incompetence."

Incompetence, the lack of capacity or skill, is ultimately an exculpating trope. It insinuates that the plan, or effort, was sound and could have succeeded had it been competently carried out. Moreover, the incompetent are in way less liable: their lack of ability lets them off the hook. Thus, "incompetence" insulates the actors from accountability and leaves the policy itself unscathed.

...the Bush disasters are a result of the administration's policies and not of some failure to effectively carry them out. [...]

The problem...is that as long as the government retains the same kind of policies, the nation will continue to suffer the same hardships. It is not until the beliefs that inform the ways in which the Bush administration runs the government are firmly linked to their consequences that the nation will stop voting for politicians who promulgate, and enact legislation based on, those creeds.

I'd like to take this analysis a little bit further in some respects by looking at the intentions behind the "policies" adopted and how the eventual outcomes have been remarkably consistent with those intentions.

First I'll turn to Hilzoy who argues, as I did in my prior post, that the breakdown of the health care system in place to aid our soldiers and veterans was, and is, largely about priorities. The policies themselves are logical extensions of those priorities. The Bush administration is not a victim undone, again, by cruel happenstance - first by "unforseen" hurricanes in the Gulf Coast region, and this time by an "unexpected" influx of casualties in the military hospital/VA system.

On the contrary, all along the Bush administration has been cleaving to a fairly consistent view of government's limited role in society and, where government must reluctantly be employed, to whose benefit that largesse should be directed. Hilzoy reminds us:

Remember: this is not about money. At the very same time that the Bush administration was sending troops off to fight two wars and underfunding the VA, at the very same time that it was charging wounded veterans for their meals, this administration somehow found a way to cut taxes for the wealthiest among us. It's too much, apparently, to ask the likes of Paris Hilton to pay taxes on any money they inherit, after the first few tax-free millions. But it's not too much to ask people who have given their health or their limbs or their minds fighting George W. Bush's misconceived war to pay for their meals, or to live in rooms with asbestos and mold and rodents and stray syringes lying about.

The fiscal policy has centered around the goal of redistributing money to the wealthiest Americans through a series of multi-trillion dollar tax cuts, and it has been wildly successful. Credit where due. There have been some unfortunate side effects necessitated by this massive diversion of resources, such as underfunding the VA/military hospital system, but this was anticipated and not the result of "incompetence." Similarly, we should recognize that the widespread problems with this health care system won't go away without a restructuring of fiscal priorities. Holding a certain number of military officials accountable, and working to streamline the bureacratic processes that are contributing to some of the problems, are worthwhile goals but not nearly sufficient to rectify the situation.

The question is the same as it has been for the past few years: which priority does the Bush administration value more, and where will it dedicate the resources. It has the means to deliver, quite competently, on its intentions in either direction.

Raw Story highlights another facet of the scandal: the "privatization" of traditional governmental functions undertaken by the Bush administration, and how this may have exacerbated the situation at Walter Reed and beyond. Congressman Henry Waxman will be looking into a part of this story llater this week. It really is a relief to have that subpoena power again. Paul Krugman offers a brief synopsis of the areas of concern:

We know from Hurricane Katrina postmortems that one of the factors degrading FEMA’s effectiveness was the Bush administration’s relentless push to outsource and privatize disaster management, which demoralized government employees and drove away many of the agency’s most experienced professionals. It appears that the same thing has been happening to veterans’ care.

The redoubtable Henry Waxman...points out that IAP Worldwide Services, a company run by two former Halliburton executives, received a large contract to run Walter Reed under suspicious circumstances: the Army reversed the results of an audit concluding that government employees could do the job more cheaply.

And Mr. Waxman, who will be holding a hearing on the issue today, appears to have solid evidence, including an internal Walter Reed memo from last year, that the prospect of privatization led to a FEMA-type exodus of skilled personnel.

Tim F at Balloon Juice contends that it's not privatization per se that is the problem, but the Bush administration's peculiar interpretation of privatization:

The main issue is not privatization, at least not in isolation. The problem is that the administration’s rigid fixation on privatization for privatization’s sake discards even free-market principles like competitive bidding. In cases where private competitors can’t turn in a credible bid, managers simply change the rules until the private sector wins....Leave out any oversight mechanism to make sure that the job is done right, stifle whistleblowers and you have a near-perfect system for incentivized failure. Lift the hood on any Bush disaster and you’ll find more or less the same thing.

Jim Henley sets forth some parameters to temper the wild privatization zealots:

Basically, if it’s a situation where the service has many buyers and the new private entity will have to sell to them, presume in favor of privatization. But if the new arrangement would have a private corporation selling to one buyer, the government, presume that the “prvatized” situation would suck much, much worse than good old fashioned bureaucracy.

I appreciate the insights of Tim F and Jim regarding the optimal use of privatization, and its perversion by the Bush administraiton. It should be emphasized that the selective use of privatization and/or reliance on market-based solutions should not be abandoned or indellibly tarnished simply because of how the Bush administration has utilized these tools. Here's the problem though: Are we really supposed to believe that the applicable Bush administration officials didn't know what means of privatization were likely to yield the best results? Could ignorance alone have led to these fundamental mistakes?

That is highly unlikely. It is not that the Bush administration failed to grasp the complexities of privatization, nor have they simply been incompetent in applying these principles. Neither is the problem a "rigid fixation on privatization for privatization’s sake" or some other misplaced ideological purity as Tim F suggests.

It's simply a case of matching up results with goals. In this regard, the Bush administration, again, does quite well. Matt Yglesias described the way the game works last month:

Then enter government contractors which, as The New York Times points out, have exploded to unprecedented levels under George W. Bush and the late unlamented Republican congress. Here you have private enterprises displacing government. Why? For the private sector efficiency, of course! But you don't actually get that efficiency....Funding is still being determined by political support. The cash doesn't go to companies that can do a really good job, it just goes to companies that have political clout -- i.e. ones that recycle a share of their profits into campaign contributions. It's essentially the worst of both worlds, since you get the inherent problems of the public sector plus the need for owners to be taking a slice off the top in profit margins. It is, however, a very good deal for politicians interested in union-busting and for politicians interested in raking money in from government contractors. Shockingly, the GOP loves it.

And again today:

You've got private profits, private corporations, privatization, and all sorts of other private stuff, but you don't have a market you have a patronage mill and you have suffering soldiers. The correct way to privatize government services if you don't think they should be provided by the government is to just have the government not perform the service. If it's something you think the government should provide -- medical care for injured soldiers would be, I think, an uncontroversial case -- then the government needs to provide it.

Those that argued that Bush's tax cuts would reduce the deficit knew, or should have known, that they were peddling a dishonest line to support a policy that would result in the hampering of fiscal flexibility. In this instance, we have the Bush administration and its allies supporting a perverted concept of "privatization" as a cover in order to establish a reinforcing loop of patronage and politcal support whereby wealthy benefactors are rewarded, all the while stripping the government of its responsibility and ability to provide essential services.

It all comes down to priorities. As I argued almost a year ago:

In general, the Bush administration has seemed wholly disinterested in most policy-related matters with few exceptions. And with respect to those exceptions, they have displayed an impressive level of acumen. They are, in no particular order: 1) shifting the tax burden from the wealthiest Americans to the middle and lower classes and generally pursuing an economic policy that rewards the top end/Bush supporters; 2) greatly enhancing the power of the unitary executive, while curtailing civil liberties of US citizens; 3) gutting the regulatory/administrative state in favor of industry provided wish lists (see, ie, here, here and here); and 4) winning elections. In these areas, the Bush administration has excelled quite admirably (regardless of whether you agree with the stated goals).

In almost every other respect (and even as a result of some of their "successes"), this administration has been an astonishing failure.

Credit where credit is due now. Neither the successes nor the failures have been accidental or the result of force majeures.

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