Sunday, June 01, 2014
The VA fiasco and the "let's pretend facade."
Turns out that the VA scheduling problems and long waits were reported numerous time in the past. Presidents and Congresses did little or nothing while pretending to care about medical care for veterans. This is an example of what I call the pernicious but widespread "let's pretend façade." Let's pretend we really care about X."" Let's pretend we really know how to fix X and will do so." Politicans need to pretend to get elected/re-elected. Public officials need to look good. The problem is related to the difficulty of measuring the quality of human services. How do we measure and evaluate rates of successful medical treatment? Without a good, "reasonably priced," measure, or fear of using a real measure which will make politicians and public figures look bad, faulty proxy measures are used. For example, how many vets are seen within so many days of asking for an appointment? This is no doubt, an important measure, but not really what we are interested in. The next problem is that in order to get raises, bonuses and promotions, people will cook the books as the VA did. An additional problem is that concern about quality care disappears as officials become obsessed with the appointment date figures. A similar problem occurs in higher education. How do we measure the quality of education? Complex measures are expensive and cut into budgets, esp. budgets for administrators' perks, salaries, bonuses, etc. So we look for an easy to measure and one that is easy to manipulate. We go with retention and graduation rates. If these figures are "too low" programs and courses will be dumbed down to bring rates up. Ultimately, quality education suffers but the numbers look good. Politicians and officials pretend they really care. The "victims" are taxpayers, veterans, clients, students and employers. The public obsession with having government fix everything and create a heaven on earth exacerbate the problems. Other examples are "let's pretend that more gun laws will reduce violence," and "let's pretend that public prayer in public school will make us a more decent and honest country." Of course, politicians and officials are the only ones who use this façade. All human being are too readily able to delude themselves and try to delude others. Festinger's theory of cognitive dissonance and the solutions thereto seem to be appropriate here