Friday, August 03, 2007

Bridges to Governance - Richardson - Wellmark Bullying

August 3, 2007, 1:30 p.m.

Managing Infrastructure

The collapsing Minneapolis bridge is a sad tragedy, and at least from some reports was an accident that could have been neither accurately predicted nor prevented.

Governor Culver responded by ordering an inspection of Iowa's bridges.
William Petroski, "Culver assigns DOT to report on bridge safety; Iowa officials will speak with Minnesota engineers on why the major structure collapsed," Des Moines Register, August 3, 2007; Paula Lavigne, Lee Rood and Tom Barton, "10 Iowa I-80 bridges may need replacing," Des Moines Register, August 3, 2007.

We look to our officials to "do something" following such disasters, and sending out folks to look at bridges is certainly better than just appointing another task force. Moreover, as a "political" reaction -- in the best sense of "political" -- there's no harm in an official using the media to communicate to constituents that he's on top of things. Making citizens "feel better" is a useful thing for officials to do.

But the phenomenon of "locking the barn door after the horse is stolen" is a human foible that has not disappeared with horses and barn doors. There are techniques for remedying it, and our failure to use them is a significant tragedy in its own right.

There was another example in this morning's Register: "
Local emergency management officials in Polk County used the explosion Wednesday to highlight the need for hazardous materials training involving ethanol." Tom Barton, "Electricity sparked blast, officials say;Gasoline was being loaded into a tanker when the explosion occurred," Des Moines Register, August 2, 2007. Why does it take an explosion to "highlight the need" for such training? Shouldn't that be obvious even before such explosions?

Earlier, the reaction of Governor Culver, and the Board of Regents, to the Virginia Tech shootings was to launch a study of security on our campuses; their reaction to the Wellmark naming controversy mess is a review (and creation) of policies on naming university colleges and buildings.

Recently, there was an explosion in downtown Manhattan from a corroded, underground steam pipe. The response was that, "Hey, maybe we ought to be checking out those steam pipes."

I've written at length here about governance models in general, and the Board of Regents need for one in particular. As but one example see, Nicholas Johnson, "An Open Letter to Regents on 'Governance,'" in "UI Held Hostage Day 451 - Open Letter to Regents," April 17, 2007. (Similar considerations apply, with modest modifications, to single-headed units -- such as the Governor's office.)

What John Carver calls "ends policies" and most would call "measurable goals" are distinguished from the means to be used by administrators for achieving those "ends" -- the achievement of which is also the administrator's "job description." The board sets the goals, and the administrator's job is to design and execute the means for reaching them. Accomplishment of mileposts along the administrator's (e.g., "CEO's") timelines can then be reported to the board (or governor) with a "management information reporting system" -- without the board's involvement in micromanaging of the details of the administrator's "means."

In fairness, a part of the responsibility for the failure of government, corporations and other institutions to do this job in a rational and effective way falls on the media. "If it bleeds it leads" is TV's motto. "Infrastructure" is neither very visual or very sexy. Most Iowans would probably rather use a Webcam to watch corn growing than watch a TV news report of inspectors looking at bridges. "A bridge collapsed and killed people? Now that's something we have to get on the evening news." And, once it receives media focus officials have to respond -- with an investigation, task force, a fly-over inspection, or promises of how things are going to change.

But the fact is that so many of these disasters are predictable -- not necessarily precisely what's going to go wrong and when, but that something will. Hurricanes, tornadoes and floods. Deteriorating (and exploding) underground pipelines for natural gas, gasoline -- and steam. Toxic waste dumps and hazardous chemical spills at work sites. Aging bridges. Fire hazards and improperly functioning sprinkler systems and smoke detectors. Inadequately maintained railroad tracks. Outbreaks of disease -- possibly as the result of a contaminated food supply. (And I won't even start down the list of potential "terrorist" attacks.)

Management by media coverage of disasters hasn't worked for us very well. Governance models aren't, alone, enough to solve all our problems. But they sure would be a lot better than what we're doing now with our after-the-fact barn-door-locking programs.

Governor Bill Richardson

I attended another Richardson event last evening (where I had the honor of introducing him to a packed Richey Auditorium in the IMU). It was vintage Richardson, and the crowd stayed with him though it all.

This was the second time I've seen him create a collection of questions at the end of the evening -- and then address them all. A staffer says, "Just one more, Governor." And then he says something to the effect of, "Well, I'll just respond once, but let's see if we can't get the questions from these folks with their hands up." Whereupon a staffer makes a list of a dozen or more additional questions which he then puts to the Governor in rapid-fire order.

The guy has had such a range of responsibilities and experiences over the past 35 years (e.g., House Intelligence Committee as Congressman; multiple successful hostage negotiations; UN Ambassador; Secretary of Energy; education, health care and environmental accomplishments as New Mexico's governor; etc., etc.) that these final Q&A sessions turn into a real tour de force display of his wide-ranging knowledge, experience, analysis, policy orientation and proposals. It's very impressive.

Afterwards we had a chance to visit with him informally for an hour or so. "What you see is what you get," on stage and off. He's as friendly, informal, funny, relaxed, considerate of others, and intellectually stimulating as your favorite uncle. (Actually, depending on who your favorite uncle is, that may not be doing Richardson justice -- but you get the idea. He's fun to be with.)

Add to that, as I commented in the introduction, that he's visited more Iowa counties in the last three weeks (five more major stops today) than Senator Grassley visits in a year, and no wonder he's picking up those poll percentages that Clinton and Obama have been losing.

Interested in more? See http://www.RichardsonForPresident.com.

Wellmark the Bully

This is not, necessarily, a critical story about Wellmark -- on the merits. The company has involved itself in decisions about "how many hospitals does it take to screw over the public"?

So, in a way, we should be grateful it cares about controlling costs -- costs that ultimately get passed along to us in the form of higher hospital bills and insurance premiums.

But the story is just one more example of what's wrong with providing a service that should be everyone's moral right -- namely, health care -- as yet one more product distributed by profit-maximizing, benefit-cutting private businesses called "hospitals" and "insurance companies."

If you're interested, read Tony Leys, "Insurer questions new hospital plan; Wellmark says Iowa Health's proposal is not economical," Des Moines Register, August 3, 2007.

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4 comments:

Roy L. Fuchs said...

I agree about Richardson. He clearly is the person most ready to be President.

Yet, I do not hear ANYONE addressing the coming Social Security and Medicare/Medicaid Crises in the campaign. People may not have liked Bush's proposal, but at least he approached the issue. I am a Generation X member having been born in the late 60's, and I expect to get little, if any Social Security benefit, and when I do get it, I will be 75.

Anonymous said...

I find it interesting that a hospital needs to be approved by a state board controlling health care delivery.

On one hand people don't want socialized medicine, because 'the market' or 'free enterprise' is better than a Gov't program.

On the other hand, a quasi-Gov't organization approves or disapproves private firms hospital building plans. Talk about conflicts of interest? Talk about distortion of market forces.

If there really was a free market, there should be little control of what provider builds what medical facility. Does Gov't have rules against how many law firms can relocate to Des Moines? Rules on how many accountants are needed for Polk county? No. Rules on how many auto companies decide to make cars? No. The market generally decides.

I understand some people believe that health care is a different market (mainly because it seems so gerrymandered). That each new facility increases the costs of health care. (and each new hospital is very costly) Thus it needs this 'regulation'.

It is obvious this regulation isn't working very well. Every prediction involving health care has been mostly wrong.

So why do we reject 'socialized medicine' but accept a sort of communistic 'collectivization' with central planning of the distribution of health care? And why allow Wellmark to bully the central planning committee. Isn't that like letting Kirk Ferentz determine where Iowa State can recruit football players because 'there aren't enough good football players in Iowa to fill up 2 D-1 teams'?

John Barleykorn said...

Re: Bridge Collapse

You give the people a free ride...You blame the people in government, blame the media...anyone but the public. People get the government they deserve. Bridges are inspected every year, we don't need the empty suit result of nepotism Chet Culver making some public declaration of what's done anyway.

"Free men will remain free as long as they are aware of their responsibilities"

Anonymous said...

Des Moines Register News
IMMEDIATE RELEASE
August 5, 2007

Hansen Column Renamed for Wellmark Blue Cross-Blue Shield

DES MOINES – Marc Hansen’s column in The Des Moines Register today was renamed The Wellmark Blue Cross-Blue Shield Marc Hansen Column, Register Publisher Mary P. Stier and columnist Hansen announced.

“This new name will allow me to dispense with the fiction that I have any commitment to those pointless journalistic principles like independence and fairness,” Hansen said.

Publisher Stier approved the naming because she said it fits with the Register’s strategic plan of pulling back from being “The newspaper that all of Iowa depends upon,” to being “The newspaper that depends on Des Moines’ insurance industry.”

Hansen got the idea for the naming, he explained, after going to coffee at Starbucks recently with Wellmark public relations director Cliff Gold. “Cliff gave me two great columns ideas. First, he explained how I could criticize the University of Iowa College of Public Health, and then he explained why we don’t need any hospitals in West Des Moines. Both ideas made sense to me, and they allowed me to get out on the tennis court a lot earlier in the day.”

The naming involves no exchange of money. “Cliff explained that insurance companies don’t work that way,” Hansen said. “It was really funny in a way. After we ordered coffee and I paid, I showed him my debit card receipt and asked him to reimburse me. He took a big rubber stamp out of his pocket and marked the receipt ‘Claim Rejected.’ The whole place was in stitches over that one!”

Hansen is not the first Register employee to take a name associated with Wellmark. For several years David Elbert has held the Wellmark CEO John Forsyth Is A God That Should Be Constantly Praised columnist chair. Several Register staffers hold Wellmark CEO John Forsyth Is A God To Be Feared And Not Criticized editorships.