UC system spends big dollars for….. what?

August 28th, 2014

The gist of this article points out how ridiculous it is for someone who has already proven themselves unable to create jobs to teach a class on creating jobs.

That much is obvious, but to me the real crime here is that – according to this article -between her $84K salary and her husband’s $180K, a combined $264K is going to be spent teaching two classes at UC Berkeley.

And, two classes that likely are not the kind that lead their students to particularly lucrative careers, either. I don’t know what her husband teaches, but I doubt graduates with a degree in “public policy” make substantial dollars in general.

Now… when we hear about how we can’t do ANYTHING about the rising cost of college, and how the only answer is to raise taxes so we can feed more tax dollars into the UC system to subsidize it, are you going to remember that?

I will.

Your government tax dollars at work.

http://eagnews.org/governor-who-oversaw-loss-of-630000-jobs-to-teach-course-on-job-creation/

 

California chooses not to post standardized test results – to escape accountability?

September 16th, 2013

For those who have not been following along, the quick summary is this:

To this point a set of standardized tests – called “STAR” tests – have been used in CA to satisfy the federal requirements for evaluating student performance.

Starting soon, the federal requirements are shifting to a process called “Common Core.”  There are a number of reasons for this, who knows if they’re valid or not, but it’s going to happen.  This transition will require a new set of tests that supposedly test different things.

It’s likely that the initial rounds of tests under the Common Core system will result in overall lower test scores.  That has already happened in New York, and is projected to happen pretty much everywhere – in theory because the Common Core standards are higher and therefore kids educated in ways that make them test well under the old standards may not fare so well under the new ones.

http://www.ajc.com/weblogs/get-schooled/2013/aug/12/common-core-may-create-common-problem-lower-test-s/

Again, in theory, at some point as the entire “Common Core” curriculum ramps up, test scores should also catch up.

We could debate whether this is all true or not, whether Common Core is even the way to go, etc, etc, but the real point of this post is to discuss the state of California’s decision to not publicize it’s test scores for the first couple years of this transition process.

Now, to me it seems obvious there must be an ulterior motive to that.  The idea that we’re simply not going to do this because it makes us look bad certainly makes sense – looked at from a perspective where how things look is all-important (not how things actually work..), but given the publicity this has gotten I would think if the only impact is that every test score in the country is going to be downgraded a bit, we’d all be on the same playing field and it would make little difference.

NOW, thanks to the San Diego Union Tribune (link below) we find out the real reason behind this – because teacher evaluations are tied to test scores, and having those test scores go down may impact them.

Of course in a smart world we would just say “of COURSE teacher evaluations should be tied to results (their student’s test scores)” and design a system that took into account the possibility that the tests might change – and set the proper bar based on those new tests.

We can’t do that, though, because we’re intent on pursuing only STUPID solutions in our government, so the solution to this one is just ignore it and hide the test results.

Stupid government at it’s best.

http://www.utsandiego.com/news/2013/sep/14/teachers-unions-demonstrate-again-who-controls/

 

Army says no to more tanks, but Congress insists

April 29th, 2013

Obviously stupid.

Summary of this article below is that the Army says it does not need any more Abrams tanks, but Congress has decided it knows better and is going to force them to buy them.

With all the angst going around regarding the sequester, particularly the recent silliness surrounding the FAA’s furlough of air traffic controllers and all the doom-and-gloom articles on how our military readiness is going to be affected by cuts to repair and maintenance budget, we’re going to continue on a path to spend $436 million on something the Army says they don’t even need?

This is pork-barrel politics at it’s finest.  Write your Congressman to urge them to grow a spine and vote this one down!

http://news.yahoo.com/army-says-no-more-tanks-115434897.html

Bonuses stop for state disability doctors

April 23rd, 2013

So… once again we find the government doing dumb things with our money with no oversight.

The upshot of this one is that the CA government apparently decided to incentivize doctors to review disability claim cases quickly by giving them a flat-fee payment for each case reviewed (what is called a “spiff” in the retail world…) on top of their normal salaries.

San Diego Union-Tribune Story – “Bonuses stop for state disability doctors” – April 22nd, 2013

Actually a great idea, I think one of the dysfunctional aspects of our government is we have no performance-based incentive programs involved in it, wish we could do things like this more often.  However in typical government fashion they put this in place with apparently no mechanism for monitoring it and making sure it’s working correctly.

As anyone who’s ever managed incentive based plans knows, it’s critical that you build the plan to create as few openings for abuse as possible in the beginning, then monitor it on an ongoing basis because we know no plan is perfect, and there will always be people looking for ways to game the system.  And finding them, no matter how well you think you planned it from the beginning.

Apparently in this case this has been on auto-pilot since 1996.

Also apparently they have no internal reporting that would have flagged particular consultants for review, likely Dr. Paxton (the subject of this article.)…

How would I have done it?  Easy – set up a periodic audit system, where someone in a supervisory position picked random samples of the consultants work to review.  Then set up reporting so if one consultant were billing at rates outside the norms, the audit process kicked in a little more frequently for them.

If this consultant truly was managing such exceptionally efficient performance and maintaining the same accuracy level as the other consultants while doing many times their caseload, more power to him.  He may deserve every penny he got.  But we don’t know that – or at least nothing in this article indicates any audit process exists.

One issue not brought up in this article.  If we make an assumption that Dr. Paxton is not giving sufficient time to review each case, then he could have either have denied valid claims or approved invalid claims.  If he denied valid claims, I’m sure that would have shown on someone’s radar.  Many people with denied claims may just go away, but I suspect a significant portion would have fought the denial.

On the other hand, if his default behavior was to approve unjustified claims, no one would have complained, would they?  Everyone feels their claim is justified, so the approval would just be seen as validation of what they already knew.

The end result, however, is more financial drain to the state, in the form of disability payments to people who did not truly qualify…

Another thing to build into the oversight reporting – a comparison of claim approval/denial rates between consultants.  If someone deviates from the normal averages, again – increase the audit frequency.

Missing from this Watchdog article is the name of the person responsible for managing this program, and the name of that person’s boss.

In private industry, if my job was to manage a program like this and it was found I had let it run with such loose controls for 17 years, I would likely be fired.  In government, I’m sure nothing will happen.  There is no consequence to incompetence in government.

Matter of fact, I’m sure next we’ll hear how we need to pay above average wages and benefits “so we can get the best and brightest into government.”  Sure.  I’m sure the guy in charge of this program is one of those.

Truly stupid government.

The Sequester

March 4th, 2013

OK, so I couldn’t resist.  Pretty much everything that needs to be said has already been said about it, but just to put my opinion out there I thought I’d post.

Charles Krauthammer says – again – what needs to be said.

http://www.utsandiego.com/news/2013/mar/02/tp-charles-krauthammer-hail-armageddon/

The most salient points are the fact that the “cut” really is not a cut – it’s a reduction in growth.  The “cut” is also only barely over 2%, as Krauthammer says, about equal to the amount you and I were forced to cut our own budgets with the expiration of the payroll tax reduction earlier this year.

In our home budget, if a cut of that magnitude required a change in spending habits (i.e. it did not just reduce the money available for savings, IRA contributions, college education funds, etc – as likely happened in most prudent households) we most certainly would have cut our household budget starting with “frills”, not with groceries.  That HBO subscription has got to go.  No more going out to the movies on Friday nights.  Let’s pack a sandwich for lunch.  Etc, etc.  We would not go straight to “sorry kids, we don’t have money for essentials like dinner on the table.”

But then, this is government, and we’re dealing with this more as theater than as a rational, thought-through plan.

Of course, our government could have just addressed this a year or two ago and made the cuts in areas that the country could easily survive.  Anyone think that we’d be talking about the economic impact of these cuts if we perhaps cut oil subsidies, farm subsidies to farms over a certain income threshold, scaled back the F-35 program a bit, or looked at any one of the myriad of ways we could have cut overlapping, wasteful, or bloated programs without having to furlough actual working people?  

Would not have made good theater, though – would it? 

 

San Francisco plans to provide transgender surgeries for uninsured residents

November 9th, 2012

Summary

The City of San Francisco apparently provides some form of “universal healthcare coverage” for residents – the “Healthy San Francisco” plan.  Today the city’s Health Commission decided to “drop sex reassignment surgery from the list of procedures specifically excluded” from this plan.

http://www.mercurynews.com/breaking-news/ci_21960300/san-francisco-plans-provide-transgender-surgeries-uninsured-residents

Conclusion

What can I say?

We could debate the merits of universal healthcare, we could debate whether preventative procedures should be covered, we could debate if elective procedures should be covered, but can anyone really make a case for the idea that sex reassignment surgery is truly necessary for anyone’s health?

Yes, yes, yes, I know there are people who will say they’re very, very unhappy because they were “born in the wrong gender body”.  Sorry about that.  There are lots of things in life to be unhappy about, unfortunately.

Hmmm….. I’ve had a bump in the middle of my nose all my life.  It makes it hard to wear normal glasses (the bridge is almost never wide enough) and of course I would be much more handsome without it.  My mental health has likely suffered because of this all my life.

Without that bump, I’d likely have had a career in film, gotten rich, married a supermodel, and perhaps bought myself a trip to the Space Station at some point.  It has REALLY messed up my life.

Can I get reconstructive nose surgery – and of course have you pay for it – because I’d be happier with a new nose?

This is, like everything in this blog, truly stupid.

U.S. Ties Hospital Payments to Making Patients Happy

October 15th, 2012

Summary

Apparently some provisions of the ACA involve tying a small portion of hospital’s Medicare reimbursement to patient survey results.  No details are given on this survey, but the implication is that it will focus on “patient satisfaction.”  The WSJ article cited below says this involves about $1B in money, of a projected $586B in Medicare payments in 2012.

http://online.wsj.com/article/SB10000872396390443890304578010264156073132.html

Commentary

This one’s just too easy to pick apart…

First, does anyone think whether a patient is HAPPY when they come out of the hospital is truly the most critical measure of a hospital’s effectiveness?  Aren’t they supposed to….. er……. cure people?

Yes, I do think that a hospital should pay attention to customer service, certainly.  As one whose career has been spent managing customer service organizations all I can say is….duuuh!  On the other hand, that should be a free market thing.  Publish the darned survey results in a way a patient can use to make a decision in a situation where they have the freedom to do that, but what the government is PAYING FOR is not to make you happy but to make you well again.

Also, $1B out of $586B is  0.17%.  Now, if someone came up to you and asked you to change the way you do your job – even in a well meaning way – and told you the penalty for NOT doing that was a reduction in pay of 0.17%, would you really take them seriously?  Any pay cut is not good, but is 0.17% ($170 if you made $100,000/year) really an incentive to do anything, especially if you for some reason did not WANT to do it?

Sure, they may have a point, and making that change may be recognizably a good thing, but this is a truly dumb way to create incentives for hospitals to do a better job at what they’re designed to do.

How about a program that put some SERIOUS money (10%?  20%?  50%?) on measuring patient OUTCOMES, so a hospital that did a better job of getting their patients HEALTHY made bonus money?

Naaaawwww… too obviously intelligent.

Let’s stretch for a bit.  What if the government used it’s vast database of Medicare data – showing exactly how many patients with any given malady were cured and how much it cost – to publish that on the web, so a patient could see that Doctor X at Hospital Y were just plain more effective at curing whatever they have (and maybe even cheaper) than others in the area?

Nope, that would lead to informed consumer decisions and marketplace competition by doctors and hospitals to get better at their jobs, to attract more patients.  Wouldn’t want to do that…

California Teacher’s Pension fund – the stupidity continues…

September 10th, 2012

Summary

Apparently we’ve now discovered 29 managers or administrators  received significant raises, without what the auditors consider proper documentation, in the period immediately preceding retirement.

This is an issue because the pension amounts paid after retirement are based on a calculation that includes their final pay rates – whether their last year or some other calculation involving their last few years of pay.

In prior investigations in this we’ve seen issues where employees who are about to retire are given significant pay raises, either overt raises or increases in overtime, with the implied intent of “spiking” their pension rate upward.

The article below does not say this is true in this case, but is simply raising the red flag on this issue as discovered.

http://www.utsandiego.com/news/2012/sep/10/tp-paperwork-lacking-on-administrator-pay-hikes/

Commentary

Yet another example of the problems caused by lack of accountability in our governmental systems.

Even the examples they give of special situations that SHOULD trigger investigation are ridiculous – only if they earn more than $147K/year and/or receive a raise exceeding 15% (!!!)  Are there so many employees that meet this criteria that it would be burdensome to do a quick audit of the rest, and WHO in the private sector gets even close to 15% raises in one year these days – without a significant promotion involved?

As with most of these problems, what should happen here is the people who approved these raises should be fired.  We the people hired them to be the stewards of our money, and they’re giving away enormous raises that exacerbate the pension cost problem we all know we have while at the same time as they’re telling us they need to cut teachers, increase class sizes, reduce the length of the school year, etc.

In any normal company a manager who demonstrated his incompetence and inability to  understand basic budgeting in this way, particularly in a manner that seems like obvious collusion to increase a “buddies” retirement pay, would be a firing offense.  Why is it not in government?

Keep your eyes peeled for news stories indicating who’s been fired as a result of this.  I predict here, now, that you won’t see any.

California Teacher’s Pension fund audits – once every 48 years?

September 6th, 2012

Summary

A new report released Wednesday by the state controller’s office found that the nation’s largest teacher pension fund has been so lax about detecting pension spiking at California school districts that it is on pace to audit each district once every 48 years.

The office found that the California State Teachers’ Retirement System failed to adequately audit school districts, missed opportunities to stop unjustified salary increases, and failed to use its own electronic system to detect possible abuses.

http://www.utsandiego.com/news/2012/sep/05/report-teacher-fund-lax-on-anti-spiking-efforts/?print&page=all

Commentary

We all know that gold-plated pensions, granted without regard to funding, and the abuse of those pensions is big news these days.  It’s been big news for several years, going back at least as far as the mid 2000’s.

So….. the people in charge of auditing those programs at a state level don’t read the paper?

In keeping with the theme of this blog we don’t make any judgements about whether the people involved should be getting a certain level of pension or not, all we can say is whatever plan you’re going to put in place, having no mechanism for effectively audting that plan is just plain stupid.

You and I may not check our 401K or IRA statements monthly, perhaps, but anyone with any kind of brain reconciles the account at least once in a while.

According to this article

http://www.bloomberg.com/news/2012-04-09/california-teacher-pension-unfunded-gap-widens-to-31-.html

The California Teacher’s pension plan has $152 billion in assets.  Think maybe that justifies the occasional audit?

Apparently the people who are supposed to do that audit don’t think so.

Does anyone think we’ll see any news about the management of the  California State Teacher’s Retirement System being disciplined in any way over this?  Maybe someone in charge of this process losing their job, perhaps?

Unlikely.  The root cause of most of these issues is total lack of responsibility and accountability, and I’m sure this will be no different.  This will blow over, and the next time we hear about CalSTRS chief Jack Ehnes, it will be in a story regarding some gigantic salary or raise he was given for doing such a good job, at which point some official will justify that salary or raise by saying “we need to attract the best and brightest to manage such a large portfolio….”

We will all have forgotten by then, of course.

Palomar Medical Center’s New Hospital – we just don’t get what “affordable” means, do we?

August 20th, 2012

Summary

In November 2004 local voters approved a $496M bond measure to replace the 54-year-old Palomar Memorial Hospital with a new modern building.

As with most public construction projects, by the time it was done the cost had almost doubled, to $956M.

http://www.utsandiego.com/news/2012/aug/20/tp-palomar-completes-transfer-of-patients-to-new/

Commentary

Whether we really needed to replace the old hospital is beyond my ability to judge.  Certainly seems worthwhile on the surface, I know it’s often pretty difficult to retro-fit old buildings with the accoutrements needed for new technology (the things you need built into the walls just aren’t there), but how much of the cost involved was to do that, and how much was to make this a much more gold-plated Medical Mecca?

As the article says,“staffers Sunday raved about the large private rooms, the airy lobby, the state-of-the-art emergency room, the parklike 52-acre site with ample room for expansion” and goes on to say “… doctors and nurses will have larger operating and treatment rooms, and the latest technology (robots that mix intravenous solutions, say). But the patients will all receive private rooms, each 320 square feet and looking out onto gardens — native grasses and plants are featured on the north side, bamboo on the south. Each floor has outdoor terraces for visitors and patients. Windows are everywhere; there are even skylights over the basement, where some of the laboratories are located.”

Of those reasons, certainly a state-of-the-art emergency room may be a valid expense, larger operating rooms might be good, but what did having a “parklike 52 acre site” have to do with the money spent?  Before they put together the plan and projected costs, did they not know how big a lot they were going to build on, and if not how did they even put together a proposal?

On the “large private rooms”, I can tell you it is certainly wonderful to have a nice, plush room all to yourself if you’re in the hospital.  I’ve never had the misfortune myself, but I’ve been there several times for others – on the birth of our children, on the death of my grandparents, during surgeries for relatives, etc.  Just being in a hospital (even for the birth of a child) is not a fun experience, but to add to that by being in a small room with someone who is also seriously ill on the other side of a curtain from you does not make it any better.

On the other hand, anyone would tell you that the critical issue we’re facing in healthcare is the cost.  Everything else this country is wrestling with regarding this issue revolves around the ever-increasing cost of healthcare.  If healthcare costs were reasonable and insurance cost $10/month instead of $1000, very few people in this country would even think about it.  Instead, we know the cost of insurance is sky high, driven by the cost of care.

With one side of our mouth we talk about keeping costs down, and pass laws with titles like the “Affordable Care Act” that purport to address that.  No political comment on the ACA here, except to point out – as many have – that very little of the ACA actually addresses the cost of healthcare in any direct manner.  Under the ACA, although there are provisions dealing with making care more effective (and perhaps cheaper as a result), the only part that makes it more “affordable” is the fact that it spreads the cost over a larger pool of payees, not that the cost of care is actually driven down in any way.  If healthcare becomes more affordable for some, it’s only because a portion of the cost of their care is being picked up by others.  Done with that.

When it comes to “acting locally”, however, to do our part in containing the costs, rather than saying to ourselves “hey, our first priority in healthcare is to make sure we keep the costs down so that everyone can afford top quality care”, we instead decide rather than build an exceptionally well functioning building (out of cinder blocks?) designed to provide a large number of technologically advanced beds in an affordable manner, we’re going to build a palace on a prime piece of land – and damn the cost, because it’s for healthcare, right, and nothing’s too good for us in that.

I’m not advocating that we build giant warehouses and put patients on pallet racking, I’m just saying if we’re truly interested in focusing on how to keep healthcare “affordable”, we need to think through every expense, and – as with any budget – clearly separate the “I wants” from the “I needs.”

There are 288 private, single patient rooms in this hospital, which translates into $3.319 MILLION dollars per room.  Do we really feel we could not have provided a nice environment for patients without spending the equivalent of ten of my entire houses on each patient slot?

Think about that next time you pay your healthcare insurance bill or look at your portion of the cost for a hospital stay, and then think about how much  you might be willing to stay in a state-of-the-art bed with a curtain between you and the person next to you, if it saved you tens (hundreds?) of thousands of dollars in insurance premiums over the rest of your life…