I don’t think there’s any more divisive issue in the US right now that the war in Iraq – no one is left on the sidelines. That said, those opposed to the war, and those who still support it are united in at least one area: We should take care of wounded troops.
The debacle at Walter Reed has already claimed the job of one general. Now it appears to have cost the Secretary of the Army his job as well.
US Army Secretary Francis Harvey has resigned amid a row over the treatment of wounded US soldiers.
The move follows critical reports in the US media about the care of troops wounded in Afghanistan and Iraq at Washington’s Walter Reed hospital.
The reports said some the soldiers lived in buildings infested with rodents and cockroaches.
I’m actually surprised it went this high. Not displeased, but certainly surprised.
Update: The president intervenes.
President Bush has intervened in a scandal over the way wounded American soldiers were treated after they returned home from Iraq or Afghanistan.
In a radio address on Saturday, Mr Bush will say he is deeply troubled by the treatment of some military veterans in a Washington medical centre.
He is forming a cross-party commission to oversee how they have been handled.
Principal or politics? Your perspective on that issue is probably pre-determined by your politics, but it is a bi-partisan panel he’s convening and for my own part, I’m quite pleased not to have a presidentially appointed panel helping me solve my problems.
According to the NPR report this morning, a lot of insiders are saying, “they fired the wrong guy.” Not sure what that means since the report didn’t elaborate, but considering a Maj. Gen. lost his job because of this, I can only imagine the “right” guy is either WAY higher or WAY lower than an O-8.
From what I hear, “they” may be right. The MGEN that was relieved had been on the job since 2004 and had been trying to change the place. The LGEN that is replacing him is the guy that many blame for letting WR go to pot.
I just read somewhere that “unnamed defense officials” said that SecDef Gates asked for, and then received, Harvey’s resignation. Good on Gates to hold some high-up accountable for this.
Lex, yep, the LGEN should go down too from all reports.
They are still aiming too low-even with the axing of the SECARMY. I believe this problem is more systemic-it won’t really improve until DOD as a whole gets over this idea that proper healthcare is a “financial burden” that takes money away from the DOD “enterprise”. People have to believe it is a sacred obligation and it has to be funded accordingly. To fix THAT-someone a lot higher up needs to go. Like Dr David Chu, who has shown ZERO compassion for veterans throughout his time in the Pentagon.
Now that said, the Army has needed a new Service Secretary for a long time IMHO.
It BLOWS my mind!
I agree with everything in the comment’s that Skippy-san just posted.
!AMAZING!
Right on, Skippy-san, good one.
doorkeeper
(PS–haven’t mustered both the time and courage yet to join you on the dark side, but it’s coming!)
I don’t understand your point, Skippy.
Are you trying to deny that the escalating cost of healthcare is NOT a major issue? How can you possibly argue that it is NOT an “enterprise issue” when the pot of money is not infinite, and healthcare is a huge and escalating piece of the pie?
Hats off to Gates for making clear the priority for any dollars must go to wounded vets.
Escalating health care is an issue, to be sure. However the real issue is that it is an expense that must be paid. This is a part of the moral contract with Soldiers and cannot be dodged, simpy because the DOD needs to save money.
What I am trying to say is that this “people are expensive” mindset has to go. They are expensive because they are worth investing in.
I was surprised to hear about Harvey, too; I expected Lt Gen Kiley, the Army Surgeon General, to be next on the chopping block. His one or two press appearances that I caught on TV were not good — he seemed almost dismissive of the whole news report — didn’t seem to be very concerned.
I suspect that he still might get the axe.
Not to take on Skippy in this particular arena, but health care is not merely a financial burden, it’s a part of a whole cost of operations and has to be treated accordingly. It doesn’t do a lot of good to have the greatest hospitals and no ammunition, as an example, or good facilities and no bunker oil in the ships, but given your supply of money one needs to determine where spending it does the most good.
It’s long been said that the VA system is a bad joke, yet it seems only now that its become an issue. It’s also been said, generally by me, that the VA system is the future of universal health care in the USA and we will get what we pay for. I base that opinion upon the problem inherent in any socialist scheme of wanting the best but wanting somebody else to pay for it.
Given that, it’s understandable that Walter Reed has roaches in some buildings and POTUS in other areas that are probably nearly sterile. One simply cannot provide everything under a fixed budget, hence areas will be substandard. In these cases its up to the mangement to fight for increased funding or balance spending such that the showplaces get a little less and the Roach Hotels get a little more.
All that said, does anybody remember the polio wards of the early 20th century? Row upon row of beds, perhaps a small nightstand, in a room the size of a gym? *That* is the way to control costs in health care. It’s not the machine that goes ping or the million-dollar procedure that’s causing costs to rise, it’s medical care being taken not as a necessity but as a consumer choice.
Listen to the radio or look at billboards as you drive. How many ads do you see for hospitals? Best Heart Care Here. Your Cancer Center There. We Deliver Babies. We Know Your Heart is Bad and you Better Get In Here Now So We Can Fix It!
There was a time when a man went to the doctor not when he was sick, but when he didn’t get well after a few days of rest. There was a time when seeing the doctor was a thing to be done of necessity. Things you *have* to have else you die don’t need to advertise. You never see “Level 3 trauma center just in case you’re shot while delivering that 8-ball of crank!” in those ads? Why not? You also never see “Cheapest beds in town with nurses making rounds every two hours!” in those ads. Wonder why?
Like most things, it’s an economics problem and one that laws of supply and demand can fix. The greatest problem is not giving preference so that those in charge of supply can see the demand side of things.
– Max
Max,
We are not in disagreement however how does the military person really get into that free market you are talking about. He has to be released from the military system first or bear the cost himself-which in many cases is prohibitive. Most folks are not in the position to do that right away.
As I said over at the flight deck, when you dig a little, one will find the Army created a lot of structural barriers to getting that increased money for facilities. Plus was not Reed on the BRAC list? I wonder if that -as in the Navy-prompts and automatic OFF switch when it comes to new construction et al.
Me I think a total free market solution is not going to be equitable without some means to ensure fairness. Otherwise you have one set of options for the rich and quite another for the poor. That is simply wrong. Probably it will have to be something like they have in Asia which is a forced savings program combined with guaranteed access-such as they have in Singapore. Its not very democratic-but it works for them.
Now me, I still feel that employers have an obligation to provide health insurance. That gets in trouble with the free market types and small business advocates.
I think one should probably look at the Army budget numbers and one would probably see that Reed has had a down ward trend over the last few years.
The Army medical services, and the VA, to boot, have been in and out of this kind of scandal since The War (between the States) and I betcha similar arguments have gone on since gangs of guys first lined up with swords and chopped at each other, back in Sumeria or someplace.
That it still goes on at this late date implies to me that basic human nature is involved. Anybody familiar with the parable of The Good Samaritan? It is the natural behavior to shy away from a stranger who is messed up; you need to make a conscious moral effort to help the guy.
Lex, I’m sure you’re familiar with the story of the guy who ejected from a Crusader in a godawful thunderstorm back around 1960 and went up and down in the thing for an hour or so.
By the time he made it to the ground, he was so beaten up by the hailstones, and bloodyfaced, that when he stood by the road with thumb up, people sped up to display disdain and horror for a *long* time before somebody took pity on him.
And he was dressed as a Naval Aviator, too. Sometimes you just caint get no respect.
Max
Do yu have a healthcare “solution”, whether for military or otherwise?
Any large and successful enterprise has got to do two things to stay successful: take resource out of so-called support processes (ie, get more efficient at them over time), and fund innovations at the cutting edge of capability.
The faster you can do the former, the more you can afford of the latter. Balancing these two imperatives is not a trivial problem, of course.
You simply cannot afford to keep doing things the way they have always been done, when the cost of doing so is increasing faster than the budget, unless you are willing to sacrifice the future.
If Walter Redd were somewhere in Iowa (just an example y’all Hawkeyes) the problems might never have been addressed, despite being Brac’d.
This is unforgivable. The Army Secretary resigning, really is sort of an inspiration for everyone in between. This is the type of situation where I would expect ANY flag officer, any officer for that matter, to resign over or even lay down in the street over IF their concerns weren’t addressed- that disapoints me. Again.
All this within the beltway, too…makes it beyond egregious. SOBs need to get away from the powerpoints and blackberry’s and get out and check on the welfare of the most GD important service folks we have!
BTW, Walter Reed ain’t a VA hospital.
b2
Walter Reed is a hospital for Active Duty military. It (and the other military hospitals) are run by the military.
VA Hospitals are for those people no longer in the military, but did serve. They are run by the Department of Veterans Affairs… a completely civilian run organization.
They are completely different organizations, with separate budgets.
I am a former Army soldier, now a 100% disabled (wheelchair bound) veteran that lives in the greater Washington DC area.
I can assure you — from first hand experience — that the Department of Veterans Affairs (VA) itself and at least the service(s) at the Washington DC VA Hospital are 10 TIMES WORSE than that of Walter Reed. I’ve been treated at Walter Reed, the DC VA Hospital, and DeWitt Army Hospital — and when I say treated I mean lengthy inpatient stays. If I had my druthers I’d be seen at Walter Reed, or better yet DeWitt Army Hospital at Ft. Belvior, Virginia. Unfortunately I don’t get to choose.
I can tell you some true horror stories about the service that I received at the VA Hospital. Like being a quadriplegic and laying in my own urine for several hours and no one answering the call button. Then, when someone finally came, they just tried to re-dress me without cleaning me first. And that’s just for starters.
I can also tell you about how they have full time staffers that just play computer games and make personal phone calls for hours on end, and refusing to help the lone veteran in their office.
Or how about the staffers that really do care, but are so overworked because they have to pick up the slack for those that refuse to work, that they make critical mistakes with meds.
In addition to that I’ve been fighting for 20 months to get my status upgraded with the VA. I’ve also been in contact with many, many veterans in the same boat as me. Some have been trying to get their status upgraded to receive DESERVED services and compensation for over 40 months. Almost 4 YEARS!!! The VA website states that the average veteran’s claim takes 6 months to complete. What a crock of crap!!
As a civilian if you had to wait that long you’d get an attorney and sue. Well guess what!?! Veterans aren’t allowed to have an attorney when dealing with the VA. At best they’re allowed a service rep from the DAV or American Legion… or other similar organization.
Yes, things at Walter Reed are not what they should be, and that’s a terrible shame. But once you’re out of the active duty-military hospital system and dealing with the VA hospital system things go down hill… RAPIDLY!!
This is not how it should be, unfortunately it’s a fact of military and veteran life. The generals and NCOs that were fired aren’t the only people that should be losing jobs. How about Jim Nicholson, he’s the Secretary of Veterans Affairs. Nicholson and his upper echelon need to go as well. In fact, I can think of a couple of deparment heads at the DC VA hospital that are useless slugs that need to be fired as well.
*Note: I’ve been told that some VA Hospitals across America are really great places and the service is fantastic. To bad that’s not true everywhere. To bad that’s not true with the VA Claims Service section either.
If anyone thinks I’m exaggerating I have an appointment at the DC VA Hospital in under 30 days. You’re welcome to come with me and see it first hand.
~V5
Principal or politics? Your perspective on that issue is probably pre-determined by your politics, …”
Truer words were probably never written, Lex. Now that’s what I call hit-the-nail-on-the-head, insightful writing.
This unfortunate story is going to grow for some time. Having some experience in both military and VA hospitals, I can sympathize with the victims of war and bureaucracy.
But is it not unconscionable, that in a time of war, Walter Reed was on the BRAC list?
Is it not unconscionable, that in a time of war, the Administration proposes cutting VA benefits?
Is it not unconscionable, that in a time of war, Walter Reed’s professional staff was decimated because of its “privatization.”
In the coming weeks we will be hearing a lot about privatization, cronyism, John Snow, Halliburton, KBR, Al Neffgen, military contracts and congressional appropriations, Cerebus Capital . . . and IAP Worldwide ?
This unfortunate story is going to grow for some time. Having some experience in both military and VA hospitals, I can sympathize with the victims of war and bureaucracy.
But is it not unconscionable, that in a time of war, Walter Reed was on the BRAC list?
Is it not unconscionable, that in a time of war, the Administration proposes cutting VA benefits?
Is it not unconscionable, that in a time of war, Walter Reed’s professional staff was decimated because of its “privatization.”
In the coming weeks we will be hearing a lot about privatization, cronyism, John Snow, Halliburton, KBR, Al Neffgen, military contracts and congressional appropriations, Cerebus Capital . . . and IAP Worldwide – a small company that failed during Katrina, but ’surprisingly’ won a contentious and questionable, $120 million contract to provide Walter Reed support services.
From my perspective, I applaud Secretary Gates for his swift action. And I think Major General Weightman may be partially vindicated when the whole story comes out. But it is going to be ugly, and bitterly political.
Hopefully, the wounded and rehabilitating troops will not be overlooked in the fray, as so often is usually the case.
I strongly concur w/V5’s assessment of the DC area health care for active duty and vets. I’ve been to the VA hospital (fortunately not for long stays) and while have limited outpatient experience at WR, have extensive experience w/Bethesda in general and the neurosurgery and neurology departments in particular. The two are not just worlds, but light years apart. It rips at my heart every time I go to the DC VA hospital – to see the conditions, the overwhelmed staff and especially the vets seeking treatment – to see the frustration, anger, and resignation in their faces. The “is this all there is?” look…
I was “fortunate” (if you call spine surgery fortunate) to have entered the system at Bethesda while still on active duty and have been able to remain so with subsequent surgeries (times I feel I’ve got more titanium in me than an Alpha SSN), but there is no other place and no other group of surgeons I utterly and completely trust than the group at Bethesda.
Read that again — this is coming from an aviator to whom medical personnel in general and docs in particular are anathema.
Yes it too is packed and the wait is long, but I don’t mind because I’ve seen first hand the quality care our service men and women are receiving there and it shows in their faces, their spirits and in their recovery.
And for the civilian bean counters at OSD who continue to try and play budget games by forcing the Services to choose between health care or force structure because they won’t press for a larger budget in a time of war, I presume there is a special circle in, well, You Know Where reserved for them.
- SJS
fliterman:
*IF* the BRAC process goes as planned, Bethesda would see a huge expansion and Ft Belvoir a new/much larger hospital to account for closing WRAMC.
Mighty big ‘if’ if you ask me under current conditions…
- SJS
Michelle asks, “Do you have a healthcare ?
Michelle asks, “Do you have a healthcare “solution”, whether for military or otherwise?” I will respectfully answer “no” because 1) I would not want to be responsible for 16% of the national economy teetering on my opinions, and 2) I don’t think “health care” is a fixed asset that can be quantified, and any problem that cannot be defined cannot technically be fixed.
Now I’m going to get myself into trouble and explain how I’d fix the problem of health care in this country, both military and civilian. From my perspective, health care means check-ups (preventative maintainence) and Fixing Stuff. Fixing Stuff in the medical field involves pills with side effects or a knife penetrating my delicate innards. I consider both of these to be hazardous to my health and hence a last resort.
For the second definition, so we’re all arguing the same thing here, I define Health Care as a service performed. You eating a salad vs. fat-dripping bacon may be healthy, but it is not a part of the Health Care system. The value of that service rendered has to be balanced against the value added for the individual customer. Classic economics. We’ve all seen people with bad teeth or a painful limp who refuse to see a doctor (I’m one of them) because to them it’s not worth the cost. I disagree that there is any “right” to health care in the same way I disagree that there’s any “right” to food or an electrician or cable TV. Rights cannot oblidge another to act for you, else they take away his right to property, namely himself and the fruits of his efforts.
Having defined the terms, how would I make the present system better?
First, I’d put Wal Mart in charge rather than politicians, generals or Harvard lawyers. If health care is a service it must be responsive to the customer, and nowhere else in America can you find a company that has reacted to the wishes of the customer better than Wal-Mart. You may not get the best product from them, you may only go there for certain products you wish to get cheaply, but for supplying the basics you cannot beat their bunch of MBA’s. Checkups, colonoscopies, eye exams, mammograms, etc… would be under this model. Get them in, checked, and out with no frills. Let the insurance companies have a stake in any hospital they do business with too — if Acme Health Insurance underwrites my policy I want them to negotiate with the clinic the same way a union negotiates a contract. The insurer is a customer, they need to have a say in what service it is they’re buying.
Then I’d kill all the lawyers. Alright, that’s just a fantasy and made in jest. Actually, what I’d do is a little tort reform such that negligence has to be shown before a health care provider can be sued. That will eliminate a lot of back-end costs added to your bill as the cost of doing business. Also, performance reviews. I want every patient to fill out an exit form listing who worked with them and a spot to give them a grade on the service provided. Waiters get tips if they do well, I see no reason nurses and doctors shouldn’t get raises and pink slips based upon customer appreciation.
Finally, we get to the expensive health care and veterans health care. At this stage the problem is life is precious, so do I spend money to keep you alive one more day or spend it making another life better?
For Vets you signed a contract to give part of your life to your country and your country should oblidge. If you are active duty the cost of the care should be balanced against your value to the service. A pilot, like Lex, represents a quarter-million dollars of training and hence gets priority over an Air Force silo-sitter we can replace in an afternoon (joking there too). If fixing Lex costs more than a quarter-million, we pension him and add disability as might be appropriate. Further care is triaged, he gets that knee replaced after the folks who are staying in and before folks who are retired. Pure economics in that regard, are you worth more fixed up or pensioned? Triage to give priority to those who need it first.
On the civilian side, it’s a similar process, only the contract was with the insurance company rather than the nation.
Finally, we come down to expensive care. Triage. If it’s life-threatening it’s treated immediately. If not, get in line until it’s convenient for the provider. Can’t pay? Work it off. Can’t pay and it’s not life-threatening? Sit a while. Can pay and you want the Regal Suit in the penthouse? Pay a premium and enjoy it.
To sum, health care is a service. Service isn’t free, but unless your life is in danger you will pay a premium for better service and the people servicing you will be graded on their performance. If you cannot pay, we should work out options. If you can pay but want little, we should provide a care that meets your needs and your costs else we lose you as a customer. The best way I know of to meet these goals is to run the system as a business, not as a service.
That ought to be enough to get me smeared..
— Max
Thanks for answering my query, Max. And now that you did, I really don’t want to respond. Not here in a comment thread that’s a few days old which, if not already, will likely soon be forgotten by many.
and secondly, its not a very productive way to approach a discussion. So I hope you’re okay with me taking your post over to the Flight Deck and that you will join in the discussion when I open it up over there.
I have had an inkling for the past few days that I wanted to address the issue of healthcare on the Flight Deck. With your permission, I would like to copy your post over there and then respond to it. I am hoping that will open the discussion up to a few more participants. All right with you?
BTW after reading your post, I walked away from the computer for a while. A few minutes later, I thought to myself “Some people are just scary!” Then I realized that I didn’t want to go there because first of all, I don’t find you particularly scary (at least not outside this post
PS “That ought to be enough to get me smeared.”
I promise to do my best to keep the smearing to a minimum.
Re: First, I?
Re: First, I’d put Wal Mart in charge rather than politicians, generals or Harvard lawyers. If health care is a service it must be responsive to the customer, and nowhere else in America can you find a company that has reacted to the wishes of the customer better than Wal-Mart.
So this means you would out source all of the health care to the Chinese?
I mean if you are truly going to emulate Wal Mart and all?
Could not resist the slam of Wal-Mart.
The problem with your analogy is that you are making people into a dollar figure. If I follow your thinking since more was invested in Lex than say, Joe bag o Donuts, he should recieve more care. It would seem that is what you are implying by stating that it is merely a service dependent on the amount the customer is willing to pay.
I just cannot accept that. There has to be a mix between public and private insurance and a way to fund it that ensures equal access. There has to be-and there are examples where I’ve seen that work. 45 million unisured Americans is a national embarressment. It just is.
Also, your view that if folks cannot pay, they will be able to work something out. That more often then not results in something not good for the consumer.
I’ll get back to my original premise. DOD is an employer with an obligation to provide quality care. Yet over the last 6 years I have not seen its principle civilian leadership banging on the desks to provide. Actually just the opposite has taken place. They have continued on a path to transfer more and more of the cost to the customer-and or dodge their obligation entirely.
People in good health have the luxury of vaunting the values of the free market.
Michelle, go ahead and post it — I don’t read Flight Deck but I get the feeling I ought to start. You might preface the post by noting that it was after midnight on a lonely wind-and-snow-swept plain and Your Humble Pontificator indicated the problem could not be solved but he was going to spout off anyway. My “fix” is to make the product being offered more customer oriented and to do as much as possible before the expensive care is needed, and yes there is a dollar amount placed upon a person’s worth. Don’t believe me, look at the old Ford Pinto problem — engineering said it would add a few bucks to each car, Ford decided the costs of the lawsuits was less than fixing the gas tank. These are business decisions made every day, be it in the ER or when designing an assembly line or shoveling the sidewalk, how much risk is acceptable at what cost?
Actually I think you’ll find I’m a fairly nice guy, I just approach problems without empathy, and this is all mental wanking at most so there’s no human ramifications to be concerned about.
And Skippy, I realize the analogy isn’t perfect, but we’re already outsourcing a lot of our doctors from India and losing a lot of domestic interest precisely because the insurance costs of practicing medicine are so large, as are the educational costs, that we’re seeing fewer and fewer people consider it as a career. We’ve already outsourced a great deal of our engineering talent overseas, why not health care as well? Labor costs are a cost of doing business and will be minimized if possible, and there are so few that choose jobs with high expenses.
But I question your assumption that an employer is obligated to provide health insurance. An employer is obligated only to fill the terms of your employment contract. That’s between the employer and you, period. The issue here is that employee health insurance is tax deductable for your employer, but not for you. That creates an imbalance in the market, and I think it’s also part of the problem (and the one I admit is the most frustrating). This is killing non-profits, and causing for-profits to balance insurance offerings so as to not go above the tax benefits.
Also, I think insurance hides the costs of health care from the consumer, and that further imbalances the market and results in expensive decisions being made where they otherwise might not be. When you visit your neighborhood clinic or hospital, do you ask the retail price of the recommended procedure? Do you get the actual bill and then turn to your insurance company for assistance?
I take Prevacid to treat a serious acid reflux problem. Zantac would do the job, and a roll of Tums would do it to. I have no idea what Prevacid costs — all I know is it runs me $10 per script and that’s less than two packages of Zantac. If the actual cost is $500 I’d choose differently. What I know is *somebody* is still paying $490 every time I pick up that prescription, but it’s not me personally so what do I care if I increase the costs of your insurance to balance it out or it’s passed on to my employer? After all, he’s rich and he’ll probably fire the mail room clerk to reduce costs before he fires me for being such a costly employee.
Yet I remember growing up on the farm we’d trade meat and eggs to the doctor and dentist if we didn’t have cash, or chop firewood for him. Cash was great, but barter would do in a pinch. I still operate that way today, whenever possible, mainly because if it’s not cash it never hits my tax return.
I don’t believe health care can be fixed. I do believe it can be changed to better serve the customer and better reflect the costs to the customer. With that done I think we’ll start seeing the demand side of the equation become a factor and the supply side will follow.
– Max
Skippy, for a period of some years I was part of the national embarassment of uninsured people. I was also healthy, young, full of fire and vinegar and was earning $50/hr and what did I want to waste that contracted rate by buying health insurance?
The day I proposed that maverick viewpoint changed, but as a single man who could fit everything he owned in his automobile and had not a single worry on the planet, your crisis was my unnecessary cost.
Life changed a lot after I got married. It also changed a lot once I aquired wealth (a house and land) and discovered insurance was a means of protecting it. For one thing, I starting paying insurance companies regularly.
— Max
Here in Japan they have a combination of private and government health care. Its not perfect but it does provide a safety net. For example the S.O. has private insurance from when she was down sized by her heartless American employer ( part of her buy out package) and she is entitled to use Japanese National health care.
Personally I would rather pay a health insurance premium that allowed me to buy into the civil service health care plans, the kind that has been used by Congress than pay into SS. I don’t have that option and like TSP it would sure be nice if it came from my pre-tax income.
In Singapore they have a thing called the Central Provident fund. Its about 29% of your income and you have no choice-you have to pay into as does your employer. It funds health care, retirement savings and you are allowed to borrow against it to buy a house. (Apartment really-you have to be really rich to have a seperate house).
Like I said its not very democratic but it gets the job done.
Of course the Sings do their damndest to strictly control immigration-something the US probably needs to do.
Thanks Max. Will do in the next few days when I have a little more time. You probably should check out the Flight Deck, its a pretty cool place. And, if you don’t, how will you ever be able to respond to my point by point response?
The only comment I will make here is that I just don’t get how a peron can do this or even why they would want to:
“I just approach problems without empathy…
Seems to me that the only way to approach any problem is with a large dose of empathy. There should be no worry of the empathy clouding your judgment because I think real empathy just means recognizing that we’re all inter-connected. It isn’t about “handouts” or “something for nothing”, but it is about recognizing that to a point we all are “our brother’s keeper” and that there are certain basics we are all entitled to, again at least to a certain point. You’re not “worth more” than me just because you might have more money than I, no matter how hard you worked for it. And if I am wrong and you are, then our values are so screwed that we might as well just give up the game right now.
I hope I see you on the Flight Deck.
Michelle, I do believe I’ll take you up on that and see you on the flight deck. I hope you’ll put in a good word for me there. To answer your question, I’m an engineer by trade, and my job is to Solve Problems, so I tend to look at things a little differently than the average person might. How much I *care* about something doesn’t fix it, nor does money in and of itself. Eventually it takes action. That action has to be applied to something that can be changed and will provide results we want to achieve. Evaluating these choices, these points in the equation, requires ranking them in order of importance and assigning a value to them so I can spend my most effective work first, then spend my limited resources on the less effective. In the medical field it’s called triage, you handle the worst first and if you lose his leg but save another’s life you’ve done well. This ties in with economics in that you want the greatest possible good for the least cost, and then start working towards the lesser good for increased cost, until eventually you run out of your finite resources and can accomplish no more good.
I’m inherently worth no more than you, and you’re actually worth more than I since, as a female, you’re absolutely necessary to the continuance of the species. I and my group of males can be easily replaced in this regard by a single Eurostud with a tan. Please do not mention this to my wife.
We’re both chunks of carbon spinning around old Sol on this warm mudball, and if either of us cease to exist there’s three billion Chinese who won’t care less. Our ability to affect the lives of others adds value. The ditch-digger is no less a human being than the policeman or the doctor, but when you need a policeman or a doctor the ditch-digger is not a substitute, and when you need a ditch guess who is more valuable than the doctor? Value is relative to need.
Let me give you an thought to ponder. We all want to be safe while we motor around in our automobiles. We all want our kids to be safe, and we’ll spend nearly anything to do that. So why don’t school busses have seat belts?
The answer is purely economic. School busses are made to carry people, and to add the steel necessary to keep the chassis rigid enough to make seat belts effective would increase the weight and cost of the vehicle to the point nobody would purchase one and it would get 2mpg. It’s cheaper to add padding to the seats to protect against the most common traffic accidents and accept the fact that in case a bus falls off a bridge a few kids are going to die. We’ve saved most of the kids by making the school bus a viable means of getting them to and from school, but we’ve made that possible by not making it perfectly safe and accepting that statistically we’re going to have a few deaths that would have been prevented if cost were no object.
How I *feel* about designing a bus that I know will cost a few kids their lives is immaterial. My job is to make certain the most kids get to school and back while minimizing the number that die because safety was too costly. It’s an equation that must balance else I help fewer kids overall but save one or two extreme cases.
Ask Lex about ejection seats that would save a pilot, but only above the knees. That’s a harsh choice to make, re-design the airplane or admit the millions spent in re-design is less costly than a man’s legs. Yet those are the decisions we make every day. Empathy cannot enter into it, else we’ll squander time and treasure for the few and do so much less for the many.
And yes, at the end of the day many an engineer and doctor and medic has looked himself in the mirror, told himself he did the best he could and saved the most, then unscrewed the top of a bottle and flipped the lid away knowing it wasn’t going to be needed again. Empathy is for after the affair is done and you feel you could have done more. Somehow. Maybe…
– Max
Wow. Things to think about, indeed. Not necessarily to all agree with, but to think about. See you on the Flight Deck, my friend.
[...] in just one post. And since its been a little over two weeks since?Ǭ
[...] in just one post. And since its been a little over two weeks since I asked Max Damage, over in the Walter Reed thread at Lex’s, if he had a healthcare “solution”, whether it be for military or [...]