One of the things that has always been prominent in American politics is that efficiency is a secondary concern. The primary concern is getting re-elected and to do that you have to help the people who can help you.
All else being equal they politicians are of course OK with efficiency but not if it hurts a major donor or important constituent.
Even some of our most vocal fiscal conservatives find ways to play this game, often developing convoluted arguments explaining why a specific program that happens t help your donors is essential.
It is often so convoluted in practice that millions or billions can be save if a few essential reforms are pushed through.
Today we see a proposal designed to rationalize much of the donation process. Just a few common sense changes related to kidney disease could lead to significant health advantages as well as significant savings.
Dialysis is the worst form of treatment, even though it does save lives. Much better treatment is a Kidney transplant or adopting in home dialysis like many of our European friends do.
The latest proposals are outlined in the following article.
Organ Transplant
Its a product of the current administration but much of what is proposed is simply common sense solutions. It is likely to be opposed by many for that reason, but it seems to actually address some real issues. It should be considered on its merits no matter the source.
Showing posts with label cost. Show all posts
Showing posts with label cost. Show all posts
Wednesday, July 10, 2019
Wednesday, December 12, 2018
Border Security
Border security is something that we obviously need to be somewhat concerned about but with two coastlines and thousands of miles of actual borders it is never going to be 100% guarded, it would be both unaffordable and technologically and personnel nearly impossible.
The concern currently is the number of illegal immigrants coming across our Southern Border, because the comprise the majority.
They certainly don't comprise the greatest threat, at least not in any real sense of that word.
They do however create something of cultural threat, speaking a different language, influencing certain programming, and generally being a different type of American, than our European roots.
Of course, they also have European roots, but for various reasons, those roots were Spanish and ours don't include Spanish roots, since they would have obviously emigrated to the Spanish speaking countries.
The people coming here, and they have been coming here for a very long time, come for better economic or because we are generally a safer country than some of our southern neighbors.
Current claims to the contrary they do not consist of gang members and/or terrorists, at least not to any great extent. Terrorists might tag along but they have many other means and the idea that they would first travel to a Latin country to then try to enter this country illegally is both convoluted and a bit silly. If they aren't already a known terrorist, they could probably just get a tourist visa and come here.
The current argument concerns whether we need a hugely expensive border wall to reduce illegal immigration along our southern border. If the reason to do this has to do with keeping out terrorists or gang members, it is extremely silly and almost certainly useless.
I've never seen an analysis that would indicate a wall along the southern border would accomplish anything. We already have created barriers in the areas with the easiest overland access only to have them bypassed or tunneled under. Will a multi-billion dollar wall stop some immigration, certainly, but so would many other more effective measures.
It is a project that would take many years to complete, cost many billions of dollars, and require significant maintenance and manning to accomplish very little.
Its not the way to get effective border security.
The concern currently is the number of illegal immigrants coming across our Southern Border, because the comprise the majority.
They certainly don't comprise the greatest threat, at least not in any real sense of that word.
They do however create something of cultural threat, speaking a different language, influencing certain programming, and generally being a different type of American, than our European roots.
Of course, they also have European roots, but for various reasons, those roots were Spanish and ours don't include Spanish roots, since they would have obviously emigrated to the Spanish speaking countries.
The people coming here, and they have been coming here for a very long time, come for better economic or because we are generally a safer country than some of our southern neighbors.
Current claims to the contrary they do not consist of gang members and/or terrorists, at least not to any great extent. Terrorists might tag along but they have many other means and the idea that they would first travel to a Latin country to then try to enter this country illegally is both convoluted and a bit silly. If they aren't already a known terrorist, they could probably just get a tourist visa and come here.
The current argument concerns whether we need a hugely expensive border wall to reduce illegal immigration along our southern border. If the reason to do this has to do with keeping out terrorists or gang members, it is extremely silly and almost certainly useless.
I've never seen an analysis that would indicate a wall along the southern border would accomplish anything. We already have created barriers in the areas with the easiest overland access only to have them bypassed or tunneled under. Will a multi-billion dollar wall stop some immigration, certainly, but so would many other more effective measures.
It is a project that would take many years to complete, cost many billions of dollars, and require significant maintenance and manning to accomplish very little.
Its not the way to get effective border security.
Sunday, January 14, 2018
Risk vs Cost
One of the things that is different between the Government and private industry is profit motivation.
Private industry in order to exist must make money and in order to make money they have to sell a product at a profit.
This tends to make cost the most important factor in many decisions.
Government on the other hand is really about risk.
The risk to human lives, the risk to the environment, the risk to our national security.
Risk is a factor in private industry and cost is a factor in Government but facing the same decision about trading risk for cost (less risk more cost), private industry will opt for more cost in cases where Government will opt for less risk.
Of course the vast majority of decisions are probably decided the same by both, but in a few crucial one, one will accept a risk which the other will not.
Its hard to say what the better approach actually is, there is a risk of being too risk averse and never quite finishing and of course the other side risk is that we have breakdowns and human lives at risk.
I've read quite a few examples where certain industries determined that the cost of paying settlements would be less than the cost of eliminating a problem.
Of course the gamble is with us, the consumer, and the unlucky few that suffer the consequences will often never recover.
We are in a period where the current administration wants to eliminate as much Government as it can and rely upon private industry. It probably will be cheaper but not necessarily better.
What is the risk of the banks regulating themselves?
I think 2008 might be the answer.
Private industry in order to exist must make money and in order to make money they have to sell a product at a profit.
This tends to make cost the most important factor in many decisions.
Government on the other hand is really about risk.
The risk to human lives, the risk to the environment, the risk to our national security.
Risk is a factor in private industry and cost is a factor in Government but facing the same decision about trading risk for cost (less risk more cost), private industry will opt for more cost in cases where Government will opt for less risk.
Of course the vast majority of decisions are probably decided the same by both, but in a few crucial one, one will accept a risk which the other will not.
Its hard to say what the better approach actually is, there is a risk of being too risk averse and never quite finishing and of course the other side risk is that we have breakdowns and human lives at risk.
I've read quite a few examples where certain industries determined that the cost of paying settlements would be less than the cost of eliminating a problem.
Of course the gamble is with us, the consumer, and the unlucky few that suffer the consequences will often never recover.
We are in a period where the current administration wants to eliminate as much Government as it can and rely upon private industry. It probably will be cheaper but not necessarily better.
What is the risk of the banks regulating themselves?
I think 2008 might be the answer.
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