Privatizing Walter Reed

Ron Brynaert at Raw Story makes the convincing case about GOP passion for privatization of government services and the problems at Walter Reed. Jim Henley reminds me that I posted on the general problem here last month -- it's not as if there are dozens of United States Armies all competing against one another to run the best hospitals and choosing among a variety of suppliers of hospital services in a dynamic marketplace where the Army that runs a bad hospital goes out of business.

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.

Comments

Matt -

I'm a government contractor and I agree with you. There is simply no benefit to having contractors run government facilities. In theory, since we can be fired on the spot and bureaucrats generally can't, there's an extra incentive to perform. But in practice, as you say, there's a lot of patronage involved and those incentives are marginal.

Special projects, limited in duration, requiring special skills - these are excellent candidates for "privatization." Running hospitals isn't a special project. There's no reason to expect privatization to make any difference.

Posted by Slippery Pete | March 5, 2007 10:19 AM

I tend to view it this way: I can't think of any free markets in which customers can be guaranteed to find a product or service that meets their needs. And yet this is exactly what's needed in treating injured soldiers. There's some overlap here with arguments for universal health care, in which it's impractical to expect all hospitals and such to be run by the government, but veterans' care strikes me as a special case: their need for treatment is a result of policies and decisions made by the government.

Posted by RSA | March 5, 2007 10:32 AM

There's some overlap here with arguments for universal health care, in which it's impractical to expect all hospitals and such to be run by the government...

I'm not sure why the norm in most of the western world is "impractical", especially as universal health care seems to consistently provide better treatment at a lower cost.

Granted, the "single-payer" part of the equation is probably the most important, but still.

Posted by Kevin Brennan | March 5, 2007 11:15 AM

I'm not sure why the norm in most of the western world is "impractical",

Sorry, I wasn't writing (or perhaps thinking) clearly. When I wrote about the government running hospitals, what I was thinking of as being impractical was the idea that most doctors would be military or civil servants, the way I assume it's the case at places like Walter Reed. I shouldn't have even brought up such a strawman idea.

Posted by RSA | March 5, 2007 11:45 AM

Are you saying you are against every instance of government contracting out? Should the government manufacture its own paper clips and build its own buildings?

Privatization is no panacea, but doing everything in-house doesn't make sense either. The problem here is in detailed institutional design.

Posted by Pithlord | March 5, 2007 12:20 PM

Pithlord, it goes without syaing that if government is buying a product or service identical to one widely available in the private market, with many competing buyers and sellers, that's fine. Also RSA's point: contracting out requires a certain tolerance for bad outcomes, which is fine in the case of paper clips but not so fine in the case of medical treatment for wounded soldiers.

Posted by lemuel pitkin | March 5, 2007 12:33 PM

Pithlord: in the case of paper clips and building construction, the government is just one of many buyers for the service, and they buy much less than half the product. When there are many buyers and many sellers, markets work well.

However, when there is a good or service that there is only one buyer for, like providing logistics for the army in Iraq, we aren't talking about a market, we're talking about a recipe for patronage and corruption. You don't save money by replacing supply sergeants and military construction units with Halliburton, just the reverse.

Posted by Joe Buck | March 5, 2007 12:36 PM

Another vastly overlooked failure in military privatization is in the arena of instruction. In all of the reporting on interrogators and intelligence over the past few years, how often did you see a mention of how those soldiers were trained? It was done by contractors--too many of which were and still are not qualified--and a minimum of "green suiters", they have other places to be. -- There's a story to be had here.

Posted by anon | March 5, 2007 1:27 PM

Don't enlist. Just don't join the U.S. Armed Forces. Caveat Emptor. If I was searching for a job I wouldn't apply at a corporation getting written up daily in the papers detailing their mistreatment of their workers. Why is the military any different? Do people sign up not for job and education opportunities but because of patriotism and a family history of military service? Yes they do. Is this country currently an institution that merits laying your life on the line? No, it isn't. Whoa you say, it's still a great country, it's just the current leadership that has led it astray. Well, roughly half the voting electorate put that leadership in office TWICE. At a minimum half the populace is undeserving of protection provided by the armed forces. It really is too bad veterans are treated as they are. However, most of them knew going in the mendacious nature of their commander in chief. THEY ASKED FOR IT! If you'd have stayed in the goddamn factory or mine or Walmart you'd still have your legs. Screw the military. Bunch of goddamn murdering xenophobes.

Posted by steve duncan | March 5, 2007 1:45 PM

steve,
You can't be so sure they new the "mendacious nature of the C-I-C." All the news networks were gung ho for the Iraq war. I saw one thing on C-SPAN that tried to show some reason. Even Obermann was subdued. I have sympathy for them.

Posted by Russ | March 5, 2007 2:05 PM

Russ, during both prez elections Bush "won" there were ample reportings of his deliberate avoidance of service during Nam. Even a charitable inspection of his military records would fail to deliver anything but a verdict of AWOL. How does a prospective soldier decide to serve an army headed by a deserter? Would you work in a daycare center supervised by a pedophile? A women's health center chaired by a wife beater? And you knew BEFORE applying for either job your superiors had these backgrounds? I hope your answer would be no.

Posted by steve duncan | March 5, 2007 2:23 PM

My rule for privatization of existing services is pretty simple,and as a union organizer I've won with this is a simple question to publicly ask. The contractor will want 10% profit, the government agency will want to save 10% for a total of 20% minimum. So unless there is demonstrably 20% waste in an agency, there should not be any privatization given the risks (3 in 4 new business fail in three years)and social disruptions, loss of jobs, lost health plans etc.

Posted by Bob D. | March 5, 2007 2:44 PM

I have been doing management consulting for the VA for years now, as a practicing Anthropologist. My take for some time is that the Bush Administration and other conservatives are nearly desperate that the VA and Walter Reed fail. They cannot square the great success that the VA has acheived in the past decade with their privatization schemes. They continually attempt to cut VA funding and make everyone dance through outrageous hoops to get their great work done. Their latest attempt to sabotage the VA includes appointing people like Jim Nicholson, who is simply not experienced enough to carry forward the renaissance of the VA that his predecessors accomplished in the mid-1990s (before my time with the VA).

Posted by Chris Darrouzet | March 5, 2007 7:18 PM

But hey, let's privatize teachers and public school education so that the same people involved in these shady military contracts can "branch in" to public education!! Smashing idea!!

Honestly, other than people who love pain, why does anybody vote for Republicans? All they do is irresponsibly spread misery...

Posted by Father Figure | March 5, 2007 11:29 PM