Should We Give Kaiser Permanente a Chance with the VA?

Is Kaiser the Solution for the VA? General Eric Shinseki resigned today as Secretary of the Department of Veterans Affairs. His resignation was inevitable, but it is not a panacea for the VA. General Shinseki is not totally at fault. The VA problems have been festering for decades, but Senator Obama made a campaign issue of the VA in 2008. General Shinseki has been in office for 5½ years, but claimed today he was unaware of the problems. New leadership is a necessity, but more is needed. The culture must be changed The VA is a bureaucratic morass unresponsive to competitive pressures. Nor do the 200,000 public sector union employees fear discipline for poor performance. It is hard to change an institutionalized culture. It is a challenge to change a fossilized bureaucracy. It has to be done. Democrats are crying out for more funding, their solution to every problem - more funding for the 200,000 public sector union workers at the VA. Insufficient funding? Congress has been throwing money at the VA for a decade. The VA has the fifth largest budget of government agencies. Its funding raised 235% from 2001 to 2013. The budget was $45 billion in FY 2001 and $150.7 billion in FY2014. The medical budget rose 193% during this period. Insufficient funding? The VA has been returning hundreds of millions of dollars annually in recent years of unspent medical funding. Insufficient funding? The VA has scores of unfilled medical positions, 400 alone in primary care. Insufficient funding? The VA has 19,000 physicians. Insufficient funding? The VA’s per patient spending increased 27% between 2008 and 2012. The VA has 8.8 million patients, up 1.7 million in a decade. The government appropriations have more than kept even with the rising patient total. Insufficient funding? Redistribute the $190 million in bonuses the VA employees gave themselves last year for outstanding performance in the medical centers. The VA has received bipartisan support in recent years with an ever increasing budget. It was not subject to the sequester. Funding without accountability is a disaster. More funding without a change in culture, without accountability, will accomplish nothing. The closest counterpart to the VA in the private sector is Kaiser Permanente, the largest managed care operator in America. Kaiser operates in 9 states and the District of Columbia. It has 8.9 million members, 167,000 employees, 14,600 physicians, 37 medical centers and 611 medical offices. It has $1.6 billion in profits on $47.9 billion in revenues. Kaiser serves 100,000 more patients than the VA, but with 4,500 fewer physicians and a much smaller bureaucracy. The Kaiser computer system allows physicians in any Kaiser office to pull up the records, including lab tests and X-rays of any patient. The VA cannot upgrade its antiquated computer system. Patients will often be unable to make an appointment with their personal care physician on short notice, but the Kaiser facilities have two daily alternatives available. A same day appointment can be made with the available physicians or the patient can walk into an urgent care facility. The patient may have to wait awhile in the waiting room before being seen in urgent care, depending on the severity of the problem, but the patient will be seen that day or evening. Lab tests and X-rays are performed the same day, but special tests have to be scheduled, but to the best of my experience usually within a week. In a county, such as Orange County where Kaiser has several facilities we have several options available. Kaiser has to compete with other healthcare providers. The VA has a monopoly. The unions are as opposed to letting veterans seek care outside the VA, such as with vouchers, as they are with vouchers in education. Their know their VA facilities and public schools cannot compete private facilities. If the government cannot provide adequate medical to our veterans, then how can a “single provider,” the goal of liberals, provide medical care to 340 million Americans? It cannot. Give the private sector a chance. Give the vets vouchers. Contract out some operations with Kaiser. Bring in Kaiser execs as consultants to meaningfully reform the VA delivery of healthcare services.

Jay Carney, the Carny, Resigned Today

“Carny,” also called a “carney,” is one who works in a carnival. Think of the barker at a carnival or the midway of a circus or carnival, the hawker of a carny game, think of a huckster offering snake oil, and you get the idea. President Press Secretary Jay Carney announced today his resignation after three years as the spokesman for the Obama Administration. He couldn’t shovel it fast enough as it kept piling up: ObamaCare, NSA, Benghazi, Fast and Furious, Veterans Administration. He mirrored Baghdad Bob in recent months. Even the Obama loving media in the pressroom had trouble keeping a straight face when Jay Carney tried to spin the unspinable. They alternatively tuned him out or asked confrontational questions. The usually unflappable, glib Carney face looked pained. His predecessor, Robert Gibbs, also had trouble with the spin. He often seemed dizzy. Jay Carney just kept spinning, except when he pled ignorance. The Yale graduate was counted saying “I don’t know” 1900 times, which averaged a little less than twice a day. One of the questions Jay Carney could not respond to was the most critical to the White House reporters: “Candidate Obama promised the most transparent Administration. Why is it that the Obama Administration has become the least transparent in the memory of the White House Press Corps?” He also couldn’t explain how the popularity of the reelected President with the spin spinning out of the Daily Press Briefing has plummeted to below 50%. You can only shovel so much. The carny's job is to draw you in. Carney was tuned out. The White House Press Secretary has a challenging task. Reporters expect spin, but even the best carny reaches a limit. President Obama kept digging Jay Carney deeper and deeper in an increasingly bottomless pit. You cannot defend the unindefensible. Jay Carney became a living caricature of Jay Carney.

The Post-Memorial Day Assessment of the United States Military

President Obama spoke earlier today at the West Point Commencement. He purportedly laid out his foreign policy. I have no idea what he said because what matters is what his Administration is doing. I have no idea what he said because after 5½ years in office a President who has to explain his foreign policy has no foreign policy. A strong foreign policy depends upon a strong military. A strong foreign policy depends upon a military, which can project force, and a President willing to project force. We have neither. Don't judge the President by his words, but by his acts. President Obama has been carrying out one of the most important goals of America’s left – the decline of America’s military. They believe that America’s military has been used to secure oil and other natural resources (“Bush invaded Iraq for oil”), to prop up petty dictators, and to enslave third world nations. Sadly, the Congressional Republicans played into President Obama’s hands through the sequestration, half of which would be Pentagon cuts. The United States projects power through the Navy’s aircraft carriers. The Navy is now down to 10 active carriers, several of which are always being refitted at base in the United States. The Navy now has fewer ships than any time since pre-World War I. China is now asserting control over the South China Sea, and pushing Japan, the Philippines, and Vietnam around. The Russian Bear has emerged from hibernation. The Mideast is a tinderbox of Islamic militants fueled by Iran. Regardless of what happened in Benghazi on 9/11, 2012 the military claimed it had no assets available to come to the rescue of the besieged Americans. The Pentagon is asserting that neither the Army, the Navy, the Marines, nor the Air Force were able to come to the assistance of American diplomats under military attack. The once powerful Mediterranean Sixth Fleet had no vessel, which could have come to the assistance of the Americans. No ship, no plane, no helicopter was available! That is the true tragedy of Benghazi. Secretary of Defense Hagel said the Army will downsize to 440,00 – 450,000, it’s smallest size since 1940. The Pentagon, which never liked the A10 Warthog, wants to scrap the plane eventhough it is the best ground support plane in the world. No other plane comes close to its effectiveness and durability. The ugly plane can fly low and slow unlike the jet fighters. Remember the devastation the improvised explosive devices early brought to American and allied soldiers? The Pentagon came up with MRAPs (Mine Resistant Ambush Protected) vehicles to protect the troops at roughly $500,000 each. The Pentagon plans to scrap about 20% of its equipment ($7 billion) in Afghanistan, including thousands of MRAPs. It claims it would be too difficult and expensive to bring the equipment back to the States. The President announced in 2013 that he ensure the security of America and its allies by reducing the strategic nuclear weapon by a third below the level set in the START Treaty. 50 ICBM's were recently removed from their North Dakota silos and placed in storage. The Air Force will see its force of strategic bombers reduced to 60 from 93. The Navy’s nuclear subs will carry 54 fewer nuclear bombs. Many of the existing nuclear weapons are degrading, but the President is not spending funds to maintain or upgrade them. The United States can still claim the strongest military in the world, but the President lacks the will to project or sustain it.

The Commencement Disinvitation Season is Almost Over

I blogged on May 3 about the fervent opposition to some commencement speakers. The first was when President Frederick Lawrence and trustees of Brandeis revoked the honorary degree to be bestowed upon Ayaan Hirsi Ali and withdrew her invitation as the commencement speaker. The Brandeis Administration showed a lack of intestinal fortitude. Next came Secretary Condoleezza Rice voluntarily withdrawing as the commencement speaker at Rutgers University. She withdrew with grace, which is more than can be said about the protestors. Rutgers’ Administration, to its credit, stood by their invitation to Secretary Rice until she withdrew. I referred to these wannabe thought police as academic Neanderthals. We understand that young adults can be very doctrinaire because they know all the answers. We were there once. They are quick to take offense. That doesn’t explain though the professors aiding and abetting the students. Faculty are supposed to open the minds of students – not close them. Sadly, these militants were emboldened by their earlier successes. Robert Birgeneau withdrew as Commencement Speaker at Haverford College. 46 students and a few faculty members protested because he was Chancellor of the University of California Berkeley in 2011 when campus police allegedly used excessive force in breaking up an Occupy Protest. These campus militants, like the French revolution, are beginning to devour their own. Chancellor Birgeneau is liberal. As Berkeley’s Chancellor he publicly supported affirmative action, gay marriage, and the Dream Act. That’s not enough for these academic pygmies. The replacement speaker was William Bowen, former President of Princeton, President Emeritus of the Andrew W. Mellon Foundation, and one of the most highly regarded academic leaders in America. His speech was a cry for academic freedom and a condemnation of the militants. He called them “immature” and “arrogant.” He said Chancellor’s Birganeau’s withdrawal was a “defeat” for Haverford and its ideals. The students, families, friends, and faculty in attendance at the commencement gave President Bowen a standing ovation for his remarks, which is a tribute to the Haverford community. It also reinforces the reality that these academic Neanderthals are but a small minority. They do not warrant the attention or response they have been receiving. A few of the militants were upset. It detracted from the ceremony in their eyes in such a way that they could not speak up. They don’t object when President Obama in the State of the Union Addresses does that to the Supreme Court Justices, who cannot speak back. These academic Neanderthals act like schoolyard bullies. The next to back out was Christine Lagarde, the first woman named to head the managing director of the International monetary Fund. That should her attractive to Smith College. It was to the administration and trustees, but not to the 500 who signed a petition against her. They had no direct fault with Ms. Lagarde, but to the policies of the IMF. The radical left views the IMF as one of the chief villains in globalization and a means by which the ruch nations impoverish the poor countries. They don’t understand that only nations with severe problems come to the IMF for assistance and that they are not forced to obtain IMF funds and the attached conditions. She withdrew with the grace similar to Condoleezza Rice. That may not be the end of the disinvitation crusade. The graduation for the Harvard School of education is scheduled for May 28. The invited speaker is Colorado State Senator Michael Johnson, who is a graduate of Yale and the Harvard School of education. Dean James Ryan called him “a nationally recognized advocate for school finance reform, fair teacher evaluations, and education equity.” Senator Johnson joined Teach for America in Mississippi. He served as a teacher and a principle in Colorado. He was a cofounder of New Leaders for New Schools. That’s not good enough for some academic Neanderthals at Harvard. An on-line petition is available, asking the University to disinvite Senator Johnson because he “embraces a vision of education reform that relies heavily on test-based accountability while weakening the due process protections of teachers.” His crime is that he wants accountability from teachers. Senator Johnson supported in 2010 a Colorado law that would base 50% of the assessment of a teacher’s performance on standardized test scores. Senator Johnson realizes the current assessment methodology is failing our students. My view on the teachers and prospective teachers signing the petition is that they are too closed minded to be teaching our children and grandchildren. Senator Johnson’s commencement address at Harvard on May 28 is still scheduled, as far as I can determine from the internet. Let the commencements proceed.

Yesterday Was a Special Day for the Dale E. Fowler School of Law at Chapman University Commencement

Yesterday was a special day for the Dale E. Fowler School of Law at Chapman University. It was graduation day for the law students. Every graduation is special for the graduates, and every student is special. 42 years of teaching law. 42 special classes of graduates. 42 years of incredible students and incredible persons. Every commencement is a joyous occasion. I watch the graduates walk across the stage in what is annually the happiest day of the year for me, but also the saddest. I see these wonderful young adults happily receiving their diplomas and looking forward to tomorrow with a beautiful smile. It is their day. Their families and friends are elated. It is also their day. I bask in their reflected glory. We have done our job. We have played our role in their maturation. We hope we have done something to make them better lawyers and better persons. And yet, as they walk across the stage, I am sad because I know I will never again see many of these wonderful young people as they proceed into the world. That is the lot of us teachers. We impart knowledge and values in each class of special students, and then they move on, as they must. I can tell stories about some of the special students, but that would be a disservice to the ones not mentioned. The cycle begins again each August Yesterday was special for the law school, which was founded in 1995. Yesterday was the 16th graduation for the Law School, but the first for the Dale E. Fowler School of Law. We unveiled a bust of Mr. Fowler in the Law School in front of him and his family prior to the commencement ceremony. Mr. Fowler, a graduate of Chapman College, made a fortune in commercial real estate in southern California, and is giving some of it back to Chapman University. He and his wife Sarah donated $55 million to the Law School last August with the dedication on September 10, 2013. The law building always had a name, Kennedy Hall, for Donald Kennedy who gave a major gift at the law school’s birth. The name of the school was reserved for a transformative gift. Yesterday’s graduates know Dale and Sarah have ensured the future of their law school and the value of their degrees. The students received their J.D.’s and LL.M.’s. Mr. Fowler an honorary degree. They all earned their degrees. Most commencements are not memorable in terms of who the speakers were or what they said. Most probably don’t appear on Youtube. A $55 naming gift is memorable. The graduates knew it. Dale and Sarah Fowler made the first graduation of the Dale E. Fowler School of Law at Chapman University special for a special class of graduates.

May 22, 1964; Five Decades Ago Yesterday, President Johnson Unveiled the Great Society

President Lyndon Johnson delivered the commencement address at the University of Michigan 5 decades ago on May 22, 1964. He unveiled the Great Society to graduates, who like almost all graduates at commencement probably failed to understand what the speaker was talking about, if they were even listening. “Your imagination, your initiative, and your indignation will determine whether we will build a society where progress is the servant of our needs, or a society where old values and new visions are buried under unbridled growth. For in your time we have the opportunity to move not only to the rich society and the powerful society, but upward to the Great Society. The Great Society rests on abundance and liberty for all. It demands an end to poverty and racial injustice, to which we are totally committed in our time. But that is just the beginning. The Great Society is a place where every child can find knowledge to enrich his mind and enlarge his talents. It is a place where leisure is a welcome chance to build and reflect, not a feared cause of boredom and restlessness. It is a place where the city of man serves not only the needs of the body and the demands of commerce but the desire for beauty and the hunger for community.” He challenged the audience:” Will you join in the battle to build the Great Society, to prove that our material progress is only the foundation on which we will build a richer life of mind and spirit?” He appealed to the eternal optimism of the American people 50 years ago – the belief that the people working with the government could solve all problems, including poverty. A disillusioned American public now knows better with little faith in government. Why the University of Michigan? As President Johnson alluded in his speech, four years earlier during the primary campaign for President, then Senator John F. Kennedy stood on the steps of the Michigan Union at 1:00AM and unveiled the Peace Corps. America was soon to witness the transformation of American Society. The young LBJ emerged out of the Texas Hill Country as an ardent supporter of FDR and the New Deal. He never forgot his poverty roots. President Johnson was in a position to expand the New Deal. President Roosevelt’s goal was to save capitalism, create jobs, and expand the rights of workers. President Johnson’s goals were to expand the New Deal, eradicate poverty, and the civil rights of Americans, especially African Americans. His support for African Americans was a shocker to those who knew him as a segregationist in his years as a Congressman and Senator, but he never forgot his roots. (Didn’t I just say that?) He unleashed a flurry of legislation not seen since the early days of the New Deal, and not emulated since. President Johnson obtained passage of the Civil Rights Act of 1964, which forbad discrimination in employment and places of public accommodations on the basis of race, religion, ethnicity and sex. The Voting Rights Act of 1965 brought the vote in the South to African Americans. Southern politics were changed forever. The Civil Rights Act of 1968 prohibited discrimination in housing on the basis of race. The Elementary and Secondary Act of 1965 committed federal funds to our schools while other measures provided scholarships, grants and work study money for higher education. President Roosevelt gave us one major entitlement program, social security. President Johnson created two, Medicare and Medicaid. The Great Society brought us Head Start, Vista, Upward Bound, legal assistance for the poor and food stamps, as well as aid to public transit. He created funding for the National Endowment for the Arts and Humanities and the Corporation for Public Broadcasting. Some of his programs did not work. Others were eliminated or consolidated over time. The vast majority of the Great Society forms the foundation of modern American society. LBJ would go down as one of the greatest presidents in American history, except for the quagmire of Vietnam. That was his war and his continuing legacy. The Great Society and the accompanying War on Poverty did not end poverty in America, but it did raise the living standards of the lower classes. Think of how many poor have cars, cellphones, and HD TV’s today. And yet, we easily forget the first major act of President Johnson. He knew that while America was affluent in the early 1960’s he would be unable to finance the Great Society without growing the American economy. Therefore his first priority was the enactment of President Kennedy’s proposed tax cuts. The resulting Kennedy-Johnson Tax Cut of the highest marginal rate from 91% to 70%, coupled with reductions in the lower marginal rates and the corporate income tax rate set off an explosion in the American economy, just as the subsequent Reagan tax cuts and Bush Tax cuts. Tax cuts increase tax revenues by expanding the economy – a lesson that politicians such as President Obama never understand.

Marjorie Margolis, aka Marjorie Margolis-Mezvinsky, Paid a Political Price Yesterday for a Vote Two Decades Ago

The media is concentrating on the political triumph yesterday of the “Republican establishment” over the insurgent Tea Party. They are also pointing out that eventhough Senate Minority Leader Mitch O’Connell of Kentucky won handily yesterday he is so heavily disfavored by Kentucky voters that he may lose reelection in November. We’ll see. The big loser yesterday was not the Tea Party, but Marjorie Margolies who was seeking election to an open House seat, a seat she held two decades ago. President Clinton and Secretary Clinton campaigned for Marjorie. Their luster was expected to rub off onto Marjorie. The Clintons have great loyalty to Marjorie. Her son, Marc Mezvinsky, is married to Chelsea Clinton, who is about to make her parents grandparents. The loyalty though is twofold. President Clinton owes Marjorie Margolis big time. President Clinton’s massive tax increase bill was one vote short of passage in 1994 in the House of Representatives. The only Representative left that could vote for it was the first term Congresswoman Marjorie Margolis-Mezvinsky of Philadelphia. She opposed tax increases in her election campaign. And yet, the Big Dog needed her vote. She caved. Unfortunately I could not find the video on Youtube, but national TV two decades ago showed an ashen faced, wobbly Congresswoman Marjorie Margolis-Mezvinsky being led down the floor to pass the tax increase, as if she was being led to her execution. The voters outrage voted her out of office and turned the House and Senate over to the Republicans. Her political travails were just beginning. She was married to Congressman Edward Mezvinsky of Iowa. “Fast Eddie” was a fraud, a multi-million cheat, who pled guilty to fraud. He was headed to 80 months in jail. They were divorced in 2007 with Marjorie reclaiming her maiden name. They also ran out of money. She was chair and chief executive officer of the non-profit Women’s Campaign International (WCI) in December 2001 when she participated in, but may or may not have formally voted, on the doubling of her salary from $1,000/week to $114,000 annually. The board minutes are silent on if she abstained. Only two other board members were present at the vote. They also paid her car lease for several years. WCI is a charity top-heavy with administrative expenses. Most of its funds come from taxpayers. Its purpose is to provide advocacy training for women around the world. She lost the 1998 election to be Lieutenant Governor of Pennsylvania, and dropped out of the 2000 election for the Senate, but just couldn’t give up on politics. Marjorie Margolis saw her opportunity this year, and was anointed the frontrunner. She could change her name, but not her vote. Marjorie Margolis is still paying for her vote to increase taxes 20 years ago. So too is the American public.