Senator Mike Lee has the best article yet about what the new, GOP-majority congress ought to do. It is entitled “Five Steps To Restore Trust, Transparency, And Empowerment.” Please RTWT.
Senator Lee makes several observations which are highly consistent with the picture Jim Bennett and I painted in America 3.0.
America’s health care, energy, higher education, telecommunications, security, and criminal justice needs (to name just a few) appear to be in the midst of transitions, nearing tipping points that will help define our nation in decades to come.
Most systems we use to provide government services were designed decades ago, before the tech and telecom revolutions that have changed the way Americans do almost everything else. In 20 years, will we need, say, a Government Printing Office or Internal Revenue Service in anything like their current forms? If disruptive innovations continue to personalize and localize the economy, will centralized, monolithic bureaucracies be the right instruments to regulate it? Or is government just as badly in need of some disruptive innovations that would enable market forces, public desires, and longstanding constitutional principles to once again show us the way and make our institutions more accountable?
… we know that our society and our economy have rocketed out in front of our government, and that the bureaucracy in its current form is unlikely ever to catch up.
Everything about American life today is becoming more decentralized, open-source, localized and personalized. Everything, that is, except government. An increasingly customizable economy and diverse social networks of mini-communities will not long tolerate the innate incompetence of clumsy, self-serving, Big Government.
Let Congress operate less like a nineteenth-century industrial mill, and more like a twenty-first-century open-source network.
In today’s world, individual and community empowerment are strengths for organizations who know how to use them.
This is all good stuff.
Yes, America is in the “midst of transitions”, and many sectors are indeed “nearing tipping points”.
Yes, America’s governmental legacy systems were designed before the contemporary “tech and telecom revolutions” occurred and should be fundamentally re-thought.
Yes, “disruptive innovations” will “continue to personalize and localize the economy” and this presents an opportunity to remake government in a more transparent and cost effective way.
Yes, the “bureaucracy in its current form” is doomed to fall behind the revolutionary pace being set by the American people and the innovations they are creating, which is making “everything about American life … more decentralized, open-source, localized and personalized.”
Yes, the old system has to be replaced, to become compatible with an “increasingly customizable economy and diverse social networks of mini-communities.” (That last phrase, a “diverse social networks of mini-communities” is particularly nice.)
Yes, Congress itself has to change from an America 2.0 model, ” a nineteenth-century industrial mill”, and move into America 3.0 as “a twenty-first-century open-source network.” (That will be cool, actually. It can be done.)
Senator Lee is being a visionary realist, the best kind.
Let’s hope his approach will be adopted by the incoming GOP Congress.
Remember: America’s greatest days are yet to come!
I certainly hope that the people who design those systems understand them better than the EMR programmers understood medicine.
While the adoption of electronic health record (EHR) systems promises a number of substantial benefits, including better care and decreased healthcare costs, serious unintended consequences from the implementation of these systems have emerged. Poor EHR system design and improper use can cause EHR-related errors that jeopardize the integrity of the information in the EHR, leading to errors that endanger patient safety or decrease the quality of care. These unintended consequences also may increase fraud and abuse and can have serious legal implications. This literature review examines the impact of unintended consequences of the use of EHR systems on the quality of care and proposed solutions to address EHR-related errors. This analysis of the literature on EHR risks is intended to serve as an impetus for further research on the prevalence of these risks, their impact on quality and safety of patient care, and strategies for reducing them.
It has been a disaster. I liken it to taking off while bolting parts on the plane.
Adoption of HIT (Health Information Technology) has failed to achieve projected benefits and cost savings because of shortcomings in the design and implementation of HIT systems, including safe and effective use of these systems.4 Despite the promise of EHRs’ improving quality of care and patient safety, a growing body of evidence has found potential safety hazards associated with their use, sometimes referred to as “e-iatrogenesis.”5 The emergence of EHR-related errors results in data being lost or incorrectly entered, displayed, or transmitted, leading to loss of information integrity.6 Although little published evidence quantifying the magnitude of HIT-associated risks exists,7 as HIT products have become more intimately involved in the delivery of care, the potential for HIT-induced medical error, harm, or death has increased significantly.8
That is not from a right wing blog. I just hope the quality of design improves before we have a complete system-wide meltdown.
Mother Jones is still deep in the weeds.
2014: The Year of Koch
The Making of the Kochtopus
How the Billionaire Brothers Spread Their Web of Influence Across Every Sector of Society
What’s the old legend of the fox and the hedgehog ? Mother Jones still has its one thought.
>How the Billionaire Brothers Spread Their Web of Influence Across Every Sector of Society<
no mention of soros, tides foundation, or the coal baron et al. good allan i hate these creeps.
Two points that obliquely support Lex’s argument, for they both signal the usefulness of moving authority and responsibility closer to home:
1) The Republicans are faulted for not having offered an alternative, even though winning the Senate and House big. They have – all those bills are sitting in the Senate. But the rigor of argument was not required. Much like the Tea Party energy dissipated in filling out forms, the House’s energy blew away in bills that never came to the Senate floor.
But, look at the election: it wasn’t an anti-incumbent election – the Republicans who had gone to work and cleaned up their states were elected, with considerably healthier margins than predicted. This was a wave across the country and, while it brought some new governors in, they were modeling their proposals on other Republicans.
2) The obnoxious clip of Gruber explaining the importance of passing the health care bill by fooling the public had an underlying argument, I suspect, in his shallow brain pan. The left and academia generally think the masses are selfish and unwilling to pay for another’s pain. This doesn’t lead the left to charity – rather the opposite. They somewhat uncharitably decide that others should pay for others’ pain – and give the elites a cut as well.
The assumption isn’t true, of course. The right are far more generous, for instance. And insurance has been bought for centuries as a back-up – a gamble you don’t want to win (you hope your ship doesn’t go down, you live long and provide for your wife and children). But if you lose, what you bet is going to someone suffering from the bad luck you escaped. It is at once a prudent and a charitable gamble.
The federal government is not going to manage this prudently nor economically. We understand that; we like to insure our own. That’s part of the pitch of the new “Christian” insurance plan. Ethnic, fraternal, religious groups often formed insurance companies. I can’t find it, so maybe I’m misremembering, but I think one of Murray’s points in Coming Apart was the high level of insurance among African American men who worked together or were in the same fraternal in the 1890’s. Linking insurance to jobs in WWII had the unfortunate consequence of undercutting the vitality of the social groups Murray praises, and the sense of community they instilled.
But we rightly suspect taking from the healthy to give to the unhealthy by a government and such deep thinkers as Gruber is not a great idea. Our government at its best is lumbering and sclerotic. And that’s at its best. In this group, we see hands out for graft; that doesn’t make us uncharitable. It makes us prudent, a virtue not much in demand in today’s Washington but on display in several statehouses.