True, and though increased oversight is no magic bullet (I say that mostly because I do not believe in magic bullets) you (by which I mean “me”) have to wonder if the government isn’t somehow willfully part of the fraud if no reasonable effort in the area of oversight is being made.Originally Posted by Uboat509
I would feel remiss if I did not mention that this sort of thing comes in an American flavor that most of us are unaware of.
If you don’t read the newspaper, you are uninformed; if you do read the newspaper, you are misinformed. – Mark Twain (attributed)
It is never out of the realm of possibility but Ken White has a great quote that I cannot find now that says something to the effect of "Never attribute to malice what can be easily attributed to incompetence." Lack of oversight can be caused by a number of different things. It can be a regulator who is complicit with illegal activities at the local level. It can be a lazy and/or overworked regulator. It can be a regulator that lacks an effective regulatory mandate to actually be effective. It can also be an incompetent regulator. It can also be a lack of funding to have enough regulators to cover all the locations. It can also be a combination of several of these things together.
There is absolutely no doubt that our bloated social programs have problems.
“Build a man a fire, and he'll be warm for a day. Set a man on fire, and he'll be warm for the rest of his life.”
Terry Pratchett
I don’t know about malicious, but when your job is to stem fraud and the best you (as an institution, and the higher-ups within it) can do is throw up your hands and say, “What else can we do?!?” I kind of think you yourself are acting fraudulently. But that’s a discussion for a dedicated Ethics thread.
If you don’t read the newspaper, you are uninformed; if you do read the newspaper, you are misinformed. – Mark Twain (attributed)
Speaking as one who foolishly reported a couple of such episodes...
Only to have the Health Insurance bureaucracy come down on me like a ton of bricks, in essence telling me to sue, bring criminal charges or shut up in order for them to justify their over priced premiums...
Calling the Guvmint's Fraud Waste and Abuse hotline resulted in more of the same. No one flat said "we know and we like it that way..." but it was rather apparent that was the attitude.
One complaint was over an orthotic brace for my wife, an item that can be purchased for about $50.00 in most Medical Supply Stores or on the internet-- we paid about $85, the insurance company over $300...
Hanlon's razor, "Never attribute to malice that which is adequately explained by stupidity" doesn't apply -- the health care industry isn't stupid and, while not truly malicious, they sure aren't straight arrows...
Was yesteryear better?
Medicine is not a speciality I am familiar with, but reading this thread and mindful of the history that supplying medical care in COIN is often described as a "win, win" option two thoughts came to mind:
a) traditionally IIRC medical care was given on an individual basis, with the host community being aware of what that meant and with very rarely was care given beyond the "village" or local community
b) today there is an emphasis on public health, e.g. clean water and on somewhat sophisticated medical care, way beyond local comprehension, local affordability and out of community sight, e.g. helicopter evacuation to Camp bastion's hospital for an IED injured child
It seems to me that in 'stability operations' we have adapted the traditional approach, which was kept small and in view, added the far more effective public health option - which may not be locally seen as benign and offered medical care that is simply too much.
This issue also appears in civil / NGO provision in medical emergencies, notably after disasters and natural failures, drought comes to mind.
Now back to my "armchair".
davidbfpo
Leaving aside for a moment the relationship to counterinsurgency and allowing me to oversimplify a bit: with public health-related projects greater avoided costs over the long term are associated with greater upfront costs. Rational planning of a public health-related project should begin by asking whether avoiding cost over time is the raison d'être. If the answer is “yes,” the next question should be whether meeting the upfront costs is feasible (not a purely financial matter, as there are political and social realities to take into consideration).
Returning to the issue of counterinsurgency, is there real evidence that providing healthcare is a successful means of winning hearts and minds?* I’m not trying to be a troll here but rather am seriously asking whether the concept can truly be said to rise above the level of assertion.
*Note that my question is not whether providing access to healthcare improves quality of life. I am taking that for granted.
If you don’t read the newspaper, you are uninformed; if you do read the newspaper, you are misinformed. – Mark Twain (attributed)
Healthcare is a successful means of winning H&M?
Ganulv posted:Certainly in my reading on the campaign in Malaya and especially Oman there are references to the impact of providing basic medical aid in locations that had none.Returning to the issue of counterinsurgency, is there real evidence that providing healthcare is a successful means of winning hearts and minds?* I’m not trying to be a troll here but rather am seriously asking whether the concept can truly be said to rise above the level of assertion.
My impression is that basic medical aid - in Oman - helped secure the loyalty of local people as proof the new Sultan cared before more extensive and expensive options arrived, such as building roads.
davidbfpo
I don’t know the first thing about that conflict, can you recommend a reading or viewing for beginners? It would be interesting to see whether the initial medical aid was meant to be—or at least to be perceived as—the first step towards a long term medical infrastructure (as opposed to medics periodically showing up to pull teeth and hand out quinine).
If you don’t read the newspaper, you are uninformed; if you do read the newspaper, you are misinformed. – Mark Twain (attributed)
Ganulv,
You asked two questions:If you search SWC on Dhofar (the province) and Oman there are many posts, but for a reading list - not on medicine - there is this now merged thread:I don’t know the first thing about that conflict, can you recommend a reading or viewing for beginners?
My recollection is that medicine appears as a phrase, maybe a sentence and not in detail. It is a long time since I've done any reading on the campaign, so perhaps a Google search might find new sources.It would be interesting to see whether the initial medical aid was meant to be—or at least to be perceived as—the first step towards a long term medical infrastructure (as opposed to medics periodically showing up to pull teeth and hand out quinine).
davidbfpo
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