The Power of No

What happens when you have the power to deny, to say “no”?  Then you are in control.  The person denied has no control, no power, no other option.  The power to say “no” is like being an umpire in a baseball game.  You can complain all you want, yell, kick some dirt (if you’re a

When good people hear the word "No". OK, marginally good people.

When good people hear the word “No”. OK, marginally good people.

former Yankee manager), or throw second base, but 99.9% of the time, you will not get what you want.  You’ll go back to the dugout (and like it), or you’ll get ejected.

Those are your two options.  That’s it.  Neither option satisfies the complaint.

In markets, competition means choices for the buyer, of whatever product or service they’re interested in acquiring.  With competition comes incentives for the business to provide a better service at a lower price, in order to gain more market share.  Choice erases the power to say “no”, because if you don’t like what you’re offered, you can take your business elsewhere.  Now the customer has the power to say “No”.

But what if you’re the only game in town?  A monopoly?  Those are generally illegal, which is why the government spends so much time enforcing antitrust laws.  In fact, they helpfully define them:

Many consumers have never heard of antitrust laws, but enforcement of these laws saves consumers millions and even billions of dollars a year. The Federal Government enforces three major Federal antitrust laws, and most states also have their own. Essentially, these laws prohibit business practices that unreasonably deprive consumers of the benefits of competition, resulting in higher prices for products and services.

But what the DoJ does not do is enforce antitrust laws against the US government, which has the market cornered (so to speak) on cornered markets, especially for health care, in Medicare and Medicaid, and other recipients of federal…care.

In fact, for some on the receiving end of the government’s monopoly on health care for their particular demographic, not being able to shop for better coverage means you’re stuck with whatever the government gives you.

In some cases, that means much more than sub-standard care.  It means catastrophically bad care, which is why only the US government could be the entity providing “care” to veterans, and have them die on their watch.  In the very place that’s been created and funded specifically for their needs.

Who has had the responsibility and oversight for this organization, the Veterans Administration?  Politicians.  More specifically, a politician who sat as the Chair of the Veterans Affairs committee from January 3, 2013, through January 3, 2015, and still sits as a member today?

Bernie celebrating his victory over Hillary Clinton.

Bernie celebrating his victory over Hillary Clinton.  (Ahem)

Bernie Sanders.  The politician that wants to expand the size of government, in order to expand its power – its power to say “no” to the people it’s supposed to represent.  The same politician who failed to oversee his own agency’s power to deny care.

But it’s not just veterans that fall before the power of “No”.  Medicaid and Medicare, both bright, shining examples of your government working for you (sort of), has a long and distinguished history of saying “no” to applicants, to people appealing decisions, and have gotten pretty good at saying “no”.

In fact, let’s take a look at the sweet KPIs HHS is compiling on appeals.  Looks like there might be one or two people out there unhappy with the one, single choice they have for health care, in Medicare (below).  For example, through FY2015, the average processing time for appeals decided (both for or against the person appealing) was 547.1 days.

That's a hot new trend in government service.

That’s a hot new trend in government service.

Now I’m no rocket surgeon, but a year and a half or so of waiting for the lumbering apparatus of those entrusted with tax dollars to disburse them to those who need them seems like, maybe, just a bit longer than is reasonable?  Especially if death is a more probable outcome if an issue goes untreated, thanks to your friends at HHS?  Especially considering those people on Medicare are typically retirees and the elderly?

So how does HHS measure itself against these appeals to power?  What do the results of these appeals look like – what are the outcomes? From the chart below, more than half are Unfavorable or Dismissed.  The power of “no” in action.

Kind of a "read 'em and weep" chart here.

Kind of a “read ’em and weep” chart here.

Even if one does receive a favorable appeal, there is one final, telling stat, the Average Processing Time.  A stat that if it was shown at a high enough leadership level internally in an organization other than one run by the USG, would result in one of the following:

  1. Firings of leadership.
  2. Money thrown at the problem to alleviate the downward trend and mediate loss of market share.
  3. Both #1 and #2.

Even if a favorable outcome is decided, the person appealing might have have outcomes other than favorable already.

As far as trends go, this is Not A Good One.

As far as trends go, this is Not A Good One.

Bernie Sanders, in order to fix what he thinks is wrong, wants the government to increase spending by 2X the current debt of the United States, or another 18 trillion in entitlements of one kind or another, but specifically in single-payer.  Given the examples above, and the power ceded to a government agency that can then tell you what you can’t have, how can Bernie argue on one hand that this is good for all Americans, while on the other, he’s removing choice from the equation?  How are people empowered when they have no choice?

Were veterans empowered while they sat on secret waiting lists for the care they deserved more than anyone else?  Or were they trapped in a

The Power of Choice - you're free to choose the one option.

The Power of Choice – you’re free to choose the one option.

system, one with no options, and left to suffer the consequences?

No.  If you can say no, that’s when you know you’re in charge.  Bernie wanted to be in charge of the biggest government apparatus in history, one with the largest and most expansive power, ever, to say “no”, and he effectively sold this idea to tens of millions of people.  The same politician who decided, on his own, that there are too many types of deodorant for sale, was telling everyone exactly what he thought of their power to choose.

Which begs the question:  Why let anyone make choices for you?

 

 

 

 

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