In today’s Wall Street Journal there are two articles that seem to be completely disconnected but are really linked at the core. One is titled “Health System Reflects Greece’s Ills” which summarizes Greece’s public sector health policy:
Like nearly all Greeks, Mr. Gianakouras was covered by a state social security fund, which provided $13,6000 for the hospital bill. There was just one more thing: Mr. Gianakouras said he gave his surgeon “black money” – $5000 Euros in cash – to perform the operation.
‘If you don’t pay’, he said, ‘you don’t get anything done’.
While we might be surprised by this type of situation in the United States and a few other western countries, it is the way the world operates elsewhere when the government or constitution gives “rights” to citizens without the means to pay nor proper incentives to get work done in an organized and systematic (market-based) fashion. This system was brought to a fine art in the former Soviet Bloc countries where the free-market was squeezed almost entirely into niches; a vast, parallel system of bribes, favors, and illicit goods and services ran alongside the “official” system which got little or nothing done.
Alongside the uselessness of utilizing the official channels is the general impunity of the government workers that run the sham system. Periodically there are calls to remove “corruption” but that implies that corruption is a deviation from the system when in fact corruption is the system itself. There is little or no motivation for the government workers to follow rules and bribes and favors are commonplace, so what is the point in going after them in the first place for participating in a system that can’t work?
A different article discusses the “penalty” faced by SEC workers for their failure to spot the Bernie Madoff fraud, titled “SEC Discipline over Madoff” which can be easily summarized in the first paragraph:
The SEC admitted Friday that it has disciplined eight employees over their handling of the $50 billion Bernard Madoff Ponzi scheme without firing any of the workers.
In one of the most obvious cases of gross governmental negligence (there are entire documentaries about individuals that tried to bring Madoff’s scam to light and were ignored by the SEC employees so I won’t summarize them here), there is NO CONSEQUENCE for these workers for their failures.
The core concepts of moving away from the free-market to a governmental run system are 1) bribes , corruption and favors being built in to the system to make it work 2) general impunity of workers for participating in this sham “rights based’ process.
My advice is to befriend governmental workers and medical care professionals in the future as our system moves more towards the “Greek” model of over-promising care to everyone and under-funding and not incenting the hard work necessary for quality care to occur. And be prepared for a wall of government workers who can rule with impunity based on arcane processes and standards not tied to the free market or any sort of accountability based system as our “investment” in government increases; the first thing these workers will do is build a system where they are put “first” before the mission that they are trying to accomplish.
I never thought that my classes on “command economies” would ever come in so useful, but it shows the long-term arc of our creeping end game in the West.
Cross posted at LITGM