A G K Y R A

The title of the report from last night’s episode of The News Hour with Jim Lehrer on PBS was “After Delays and Criticism, Pentagon Shifts Priorities to Protect Soldiers.” I hope you’ll take the time to read it (or listen or watch). The story it tells is familiar: flashlights without batteries, a shortage of basic medical supplies such as bandages and tourniquets, and long delays before body armor is issued show that in some cases, U.S. troops aren’t getting the equipment they need to survive let alone perform effectively in the field. Those examples lead in to the report’s main topic: why the Pentagon is only just now making a priority of buying mine-resistant vehicles in large quantities when they’ve been asked for repeatedly for a number of years.

The Pentagon official and whistle-blower behind the story had this to say: “I realized that the people around me had a completely different sense of urgency than the people that I was dealing with back here. I was able to see that the warfighter was being hurt directly by decisions being made within the bureaucracy back in the rear.”

What was the problem? Money and red tape. They already had contracts with the manufacturers of Humvees. Congress is well familiar with and has approved the use of Humvees. Troops know how to use them, how to repair them, and what their abilities and limitations are. Their reliability is well established. The manufacturing process for Humvees is already set up and humming along. Government agencies have already done the background checks to make sure that the Humvee manufacturing companies aren’t secretly owned by terrorist groups, hostile foreign governments, white men to the exclusion of women and minorities, or Dick Cheney and Haliburton. And the demands for equipment are more than the government can meet, so better to give more of our troops a modest Humvee than a very small number of troops the newer, better equipment. If the Pentagon had chosen to shift its priority away from the Humvee and to the MRAP (as this armored vehicle is called), any one of those things I just mentioned could have been built up into a spectacle of blame and accusation by politicians, and dutifully reported by the media.

So it’s easy to understand why the government behaved as it did in the case of deciding between Humvees and MRAPs, and I’m not in a position to say that it behaved wrongly or even unwisely. What slows down and complicates the process is nothing more than the mess of laws that control how government contracts are awarded, the risk that the media and public opinion could be manipulated by politicians for their own personal political advantage rather than the benefit of the troops or our country, and the need to allocate scarce resources — tax dollars as well as manufacturing and logistics capacities — to unlimited demands.

The question for us is how this is any different than a government health care system? When physicians in the community clinic are urgently requesting more bandages, needles, anesthetic, or MRIs, how will the Department of Health Security, let’s call it, respond?

If every community needs more MRIs, what will they do? Will they give out just a few state-of-the-art models? If a white suburb gets one, will inner-city blacks raise an outcry? If they dole them out 1:1, will the city dwellers make a stink that they still only have one MRI for every million people, but the suburbanites get one for every 250,000? Or if they concentrate them in the cities, will the suburbanites cry that they have to drive 400 miles just to get an MRI in the nearest city (and the price of gas)? Or maybe, just to be fair and avoid a political nightmare, the government will just give every community an older model — or maybe no MRI at all but CT scanners or the imaging equipment of a previous generation.

You see, this is just how government works. Government ought to be perfect, but it’s not. It ought to be fair and above reproach. But being above reproach in the era of mass media politics means moving very slowly, doing lots of research, lots of background checks, lots of consulting with politicians, lots of fulfilling the letter of the law, all while trying to keep as many people as happy as possible with very limited resources. Usually that means that most people are hardly happy and some people are angry. Isn’t that exactly your experience with the government?

And Barack Obama’s website still touts his plan as guaranteed, comprehensive, affordable, simplified, easy to enroll in, portable, efficient (with “reined in health costs” no less!), high quality, and offering choice. And this is supposed to be change we can believe in!

I’ve asked this question before: what government agency would you like to see take over our national health care “system”? FEMA? The Pentagon? Social Security? Homeland Security? TSA? IRS? What government program in our history can boast “reined in” costs of any kind?

The same problems we’ve seen with the Pentagon will be the same problems you will experience under a national health care system. It’s just basic economics.