And you thought government was bad!

[For brief reaction to pundits’ various suggestions as to what the President should do, click here.]

Business in General
Private Medicine
Government
Conclusion

Many things amaze me about the media and politics today. Most striking is the ubiquitous belief that government is incompetent and unresponsive.

The source of this belief is a relentless thirty-year program of right-wing propaganda designed to get common people to distrust their government and turn power over to our ruling class’ business wing.

What amazes me is not the program’s effectiveness. Modern admen, PR people and “spin doctors” are good at what they do. What amazes me is how this propaganda has gotten people to ignore their own everyday experience.

Before you can call any institution incompetent and unresponsive, you have to ask “compared to what?” The whole thrust of the right-wing’s propaganda is that business is like Annie Oakley: anything government can do, it can do better.

Really? My own personal experience is so different that I think those who espouse this view must live on a different planet. Here are some examples:

Business in General

1. Bank Predation and High-Handedness. I have written a post about how modern banking and finance have degenerated into sophisticated swindling. My views are not entirely abstract. I’ve been a victim, too. And the predators include two of the most prestigious names in American banking:

A. Wells Fargo Bank charged me $277 to deposit a check from France in euros, in the amount of approximately $3,600. The check was hardly a risky instrument; it was drawn on the account of a French provincial government. The bank advertised only a tiny currency-transaction fee but hid this exorbitant charge in a sub-market currency exchange rate.

B. Without my knowledge, JP Morgan Chase “automatically” rolled over a $60,000 certificate of deposit paying a reasonable interest rate into a new one paying 0.25% interest. It then charged me a penalty of $600 to extricate my money. (The bank had tried try to notify me during a transition period, but the calls were indistinguishable from telemarketing, and I did not take them. I had heard the recorded refrain “This call is important!” too many times before.) I am no longer a customer of Chase.

C. MetLife Home Loans, to which our small mortgage was assigned, “blocked” our account from using third-party “billpay” checks to make payment. This “blockage” occurred after MetLife had rejected a single payment in an inaccurate amount (due to a change in escrow figures) and after we had corrected the amount and MetLife had so verified. After several phone calls through godawful telephone queues, no one could give us any reason at all (let alone a good reason!) for the blockage, but no one would release it. I had to locate the firm’s general counsel and send him a threat of suit to clear this problem up.

2. TD Ameritrade. Recently I tried to transfer funds from an Ameritrade on-line brokerage account to an account at a separate bank. Ameritrade’s website purports to makes this easy, using the government-run ACH (automatic clearing house) system. I had set up the transfer parameters months beforehand, had “verified” them using Ameritrade’s automated system, and had transferred money into Ameritrade using this setup. Yet when tried I to transfer money out to my bank, Ameritrade refused to honor my on-line request.

The next day I got a secure e-mail, purportedly signed by the company's president, that “explained” as follows: “We are unable to process your request for an electronic withdrawal of [amount] from your TD AMERITRADE account.” No reason why. No suggestion as to how to fix the problem. Just the message, in effect, “We blew you off, customer, so there!” The only suggestion was to send an e-mail reply or stand in the telephone queue.

As it turned out, Ameritrade has a rule that the first outward transfer of funds requires telephone verification for security purposes. Fair enough. But that rule nowhere appears on the website, and the e-mail didn’t mention it. If government had done a similar thing, it would appear on Limbaugh or Beck as an example of how incompetent government is.

I hate to name Ameritrade as an example of incompetent business. It is a firm I still patronize and respect. It has the best on-line brokerage website that I have used so far and has dealt with me honestly. The fact that even this relative paragon of modern business could be so disappointing only highlights the incompetence of modern business generally.

3. Telephone queues. There ought to be a special place in Hell for the person who invented automated telephone queues. Apparently they serve the needs of business well. Virtually every big business has one, as do many medium-sized firms.

I am hardly a technophobe (see Point 4 below). But I abhor telephone queues almost as much as I abhor stupidity. My consistent experience over about a decade reveals a “success rate” in solving problems of less than 20%, and a wasted-time factor (as compared to using the Internet for the same purpose) of at least one-half hour per call, and sometimes over an hour.

These queues apparently serve business’ needs. They employ otherwise unemployable, untrained morons to man the phones at minimum wage or less.

The marvel is business’ failure to understand how doing so affects the customer relationship, despite all the endless recorded messages about how “important your call is.” If my call is so important, I think, why don’t you put someone on the phone who has at least average intelligence and knows something about your business and our culture, and so can answer my question or help me without my having to waste time and energy begging to speak to a supervisor who does?

I have written a lengthy parody of telephone queues, so I won’t belabor the point. Suffice it to say that the basic problem remains: you cannot have uneducated, untrained (or untrainable) people reading from a canned script, without any knowledge, authority or incentive to respond helpfully as one human to another, and still hope to maintain an acceptable customer relationship. Yet major banks, brokerages, mutual funds, and software houses (among others) put their customers through this wringer daily, all in the relentless pursuit of reduced cost and profit.

My personal response is to shun telephone queues like the plague, use the Internet when I can, and terminate business relationships when I can’t. One of the pleasures of dealing with small, local businesses, I have found, is that many have a real, live human being answer the phone before the fourth ring.

4. Business and the Internet. I’ve used (and occasionally programmed) computers for 49 years. So I’m not afraid of them. I know what they can and can’t do and how they work. I took to the Internet like a duck to water and try to do as much of my work and personal business on it as I can.

If I had to grade business’ websites―especially banks’ and brokers’ sites―I would give most of them marks no higher than C. Most are cluttered, confusing, poorly organized, hard to navigate, and inconsistent in design (and sometimes even information) from page to page.

It often takes me as much as half an hour to find basic information on a commercial website. Even the sites of “critical businesses”―banks, brokerages, private utilities, and credit cards―have barely adequate navigation tools. Many come cluttered with useless ads and promotions that distract attention from on-line business and slow the website down, sometimes substantially.

When I see useless promotions and advertisements where an important link to basic information ought to be, I want to scream, “I’ve already got an account. I don’t need another one. I just need the one I’ve got to work. Get a clue!”

Then there are the incessant demands to switch to on-line statements and away from paper. I would love to do that. On-line records are electronically searchable, easy to store, copy and back up, and so much faster, more convenient and more efficient than paper.

But have you ever read banks’ or brokerages’ agreements for on-line statements? They are drafted very carefully to take away all your rights as a consumer that Congress and state law have granted you over the last several decades. If you “sign up,” you’ll abandon those legal rights and go back to a state of nature and caveat emptor. These businesses are using their desire to save themselves money as an excuse to take away your legal rights.

Thanks, but no thanks. As I laboriously file my paper statements, I take perverse pleasure in knowing that each one costs the bank or brokerage several dollars. “If you want to make things cheaper,” I think to myself, “draft an agreement that’s fair and that preserves at least some of my legal rights, and I’ll sign it.”

Private Medicine

One of many pernicious cultural myths—and the one that most astounds me—is the notion that our almost-entirely-private health-care system is the best in the world. During the debate on health-insurance reform, several pundits debunked that myth far better than I could; here’s the best refutation. I will not try to duplicate their efforts here.

Insofar as my personal experience is concerned, I can only conclude that people who admire our health-care system must be very, very sick when they use it, too sick to notice obvious flaws. In my experience, the best of our private health-care providers have administration that is so inefficient and comically incompetent as to make comparison with government ludicrous.

1. Abysmal “Customer” Communication. For the past decade or so, I have used one of the our country’s “household brand” medical complexes. I cannot name it without compromising my anonymity. But it’s a huge, well-known complex, with a sterling reputation for medicine and consistent ratings among the top five hospitals nationwide in several key specialties. The main complex alone (there are satellite offices) occupies a significant part of the territory of the city in which it originated and contributes enormously to that city’s economy. Economically, it is a big, big deal.

I use this facility because its doctors are very good and its equipment is up to date. I have no quarrel with the quality of medicine it practices. But if I look at this facility as a “business” and myself as a “customer,” I have to conclude that its administration is far worse than that of any government institution I have ever used, including the Post Office (see below), various departments of motor vehicles in various states, and even local utilities.

In fact, this facility has the worst communication equipment and procedures of any organization of any kind that I have dealt with in my entire adult life. Just getting a message to a sentient life form inside it is an ordeal comparable to approaching an alien species.

Recently, while out of town, I tried to make an appointment using this firm’s Web-based appointment system. That system has an elaborate set of on-line forms, which took me an hour to fill out. I took the time because: (1) I have a longstanding patient relationship with a particular physician whose care I sought and (2) I wanted to give that doctor and his medical staff detailed and accurate information about several medical tests I had had out of town. A month later, I called the doctor’s office to inquire why there had been no response. I was told that no one had seen or heard of my on-line request. It had vanished into a black hole.

The assistant who took this message promised that the doctor would review my request for a procedure and get back to me. After hearing nothing for a week, I called again, only to be informed there had been no progress whatsoever. It was as if my on-line submission and my phone call had never been made. So I contacted three different people in three difference offices in the hope of getting some response. It is now several days later and I have heard nothing.

I would have a right to be furious if the institution were a dry cleaner and the issue were a lost pair of pants. But this is a health-care provider, and my health is at stake. Yet because of my longstanding relationship with a particular physician and the difficulty of starting anew with someone else, I am as much a “captive” of this farcically inefficient and incompetent system as if it were my government and I had nowhere else to turn. So much for the theoretical benefits of “competition” in private health care!

This experience is not an isolated incident. Over the past decade, I have learned to avoid this institution’s communications systems like antibiotic-resistant bacteria. I (and my physicians) try to schedule follow-up and future appointments before I leave the office. Otherwise, simply getting an appointment—let alone conveying any information to the system and its doctors—typically takes from twenty to forty-five minutes on a telephone queue that makes my parody look good.

2. Private Medical Records. Over the last several months I have had the misfortune to use another medical group in another city. It’s a smallish group with a specialty practice of a half-dozen doctors. It is well regarded in its community and the object of frequent referrals.

After having had several medical tests with this group, I wanted to send the results to my primary specialist in another state. On signing up with this group, I had filled out several pages of forms. They included a blanket authorization to release medical information to my wife and to the “household name” medical institution discussed above.

Yet when I left a telephone message asking this group to send my records, what I got was nothing. Later I got a call from the group’s medical records specialist. She informed me that (1) the blanket authorization I had filled out on intake was no good for this purpose and (2) I could authorize the transmission only by a manual signature on the group's additional forms. Neither she nor the group’s lawyer had apparently heard of the Uniform Electronic Transactions Act, which all states involved had adopted, and whose purpose was to allow such authorizations (among many other things) by e-mail. I ended up sending my primary specialist’s office what records I had on hand myself, by Federal Express, at a cost of $30.

Compare this sorry history with government. A close relative of mine worked in an office of our military that handles troops’ medical records. At least seven years ago (and probably even earlier), the US military had digitized all medical records and could send a service person’s entire file, including high-resolution digital diagnostic images, to any permanent US military medical institution, anywhere in the world, at the click of a mouse.

3. The “Overhead” of Accounting for Profit. One of the most absurd things about our privatized medical system is the extraordinary amount of employment, effort, inefficiency, and waste that go into accounting for all its private profit.

This point hit home to me while I was waiting for my blood to be drawn in the office of a local diagnostic laboratory. I had waited patiently while at least two people who had signed in after me had their tests and left. When I inquired why, there was a further delay until I was called to a special counter to sign a form.

The issue had nothing to do with my health care or medicine. The firm wanted me to sign a form saying that some of the tests my doctor had ordered might not be covered by Medicare or my supplemental insurance and that I agreed to pay in any event.

After this annoyance, I took notice of the front desk. Its operation, which kept three people busy full time, was devoted entirely to payment. It checked insurance records of incoming patients and verified that their insurance or they would pay.

I estimated that there were not more than five phlebotomists in the back room actually drawing blood and running other tests. So in this one, small health-care firm, three out of eight, or 37.5% of its employees, were not in health care, but accounting. Their role was to insure private payment. Is there any wonder why our health-care system is twice as expensive as the rest of the developed world’s?

But even that was not all. This particular firm has the annoying habit of making copies of the very same insurance cards, and asking you to fill out the very same forms (with basic information such as name, address, telephone number and physician), every time you come into the office. It keeps no records on you, no matter how many times you use its services.

Over a period of four months, I had this same private firm do several tests. Each time, it was as if I had never been there before. If an office of government used such wasteful procedures, the right wing would ridicule it, and rightly so. Yet I have never seen any government office do anything so inefficient and wasteful.

4. Private Health Insurance. Since reaching the age when the warranty on my body appears to have expired, I have had triply redundant health insurance: a primary policy, a second policy through my wife, and an “excess major medical” policy with a high dollar limit and a large deductible. I have kept this triple redundancy not because I like to spend money unnecessarily, and certainly not because I like private insurers. I feel I cannot trust any single private insurer to be there when I need it, and I have ample reason (1, 2 and 3) for my fear.

Even now that I am covered by Medicare, I keep the triple redundancy. I have been so traumatized by the absurd administrative incompetence and inefficiency of private health care in this country that I do not trust anyone to do the right thing. As I gain experience in the Medicare system, I eventually may drop my excess major medical policy.

I could continue these examples, but someone else’s personal complaints do not make the most fascinating reading. My point is simple. My personal experience with private business reflects the type of incompetence, high-handedness, and non-responsiveness that right-wing propaganda attributes to government. But in my experience, business has these failings far more often and far more egregiously.


Government

The right-wing’s full-scale assault on government always puzzled me. Nothing in my nearly 65 years of life ever hinted that our government is in any way incompetent or high-handed in general, let alone more so than business. My biggest surprises were in the opposite direction: where I expected problems from government I got smooth, competent and helpful service.

1. Medicare and Social Security. Signing up for these vital government programs as I approached 65 was my most pleasant surprise. Perhaps because they are not trying constantly to sell you extraneous products, the websites for Medicare and Social Security are far better than those for most businesses. They are clear, uncluttered, well organized, informative, and well linked. I would give them at least a B, higher than the C I would give most websites of large businesses.

Other aspects of these two vital government programs are comparable. The mailings I have received from them are incomparably better in every way than those from equivalent private businesses. They are short, succinct, clear, well-organized and written in simple English. They give you all the information that you need to make basic decisions, plus clear contact information and instructions for getting more.

The government’s telephone queues were similarly superior. There was a telephone queue for Medicare, but its purpose was simply to make an appointment for an interview with a real, live person at an office convenient to my home. When I got there, I was impressed with the modern, architecturally attractive building. The man who took my interview was intelligent, articulate, and helpful, with an encyclopedic knowledge of the complex rules, regulations, exceptions and conditions that control both Medicare and Social Security. I already had done considerable research on the relevant websites, and everything this man said jibed with or supplemented what I had read. When I left the office, I felt well served, cared for and confident.

2. Comparison with Ceridian Benefits. At about the same time, I had the opportunity to compare these government programs with an equivalent private business. In the interim between my retirement from full-time employment and my enrollment in Medicare, I had had to rely on a continuation/extension of private health insurance known as COBRA, which a private firm called Ceridian Benefits administers.

As I compared the Medicare documents and website with their Ceridian counterparts, two things struck me. First, the government’s explanations were invariably clearer, simpler, easier to follow and more internally consistent than the private firm’s. Second, the private firm’s documents and website were confusing and at times internally consistent, even about what payments were due and when. It seemed to me (perhaps unfairly) that the private firm was trying to encourage mistakes in due dates so that it could terminate my insurance for nonpayment. Now that I have reached Medicare age I let this redundant private insurance lapse, and I feel much more secure.

3. The Post Office. Right-wing ideologues love to demagogue the Post Office. I can never understand why, or why their listeners stand for it.

Back in the seventies I did get fed up with standing in long lines at urban branches at Christmas time. But since then I’ve learned not to go at peak times and to choose branches (usually in suburbs) where there is more space and less of a crowd. (The same trick works for departments of motor vehicles. I once changed states, i.e., got a new driver’s license and changed my car’s state registration, in a mere 45 minutes in a suburban office.)

I cannot remember the last time I had poor service at a Post Office. The clerks are courteous and helpful, even friendly. Off the top of their heads, they know all the rates, charges, rules and regulations of the post, overnight mail, customs, duties, insurance and so forth.

Furthermore, the Post Office is more modern and accommodative than many businesses. It has innovations like self-stick stamps, reasonably priced overnight mail, and all sorts of envelopes, labels and packaging designed to comply with relevant regulations, both at home and abroad. Its Website is excellent, with on-line postage calculators, branch locators, and a ZIP-Code+four calculator that I use routinely to find and verify complete ZIP codes in seconds.

The two Post-Office branches that I used most in the past several years also have highly responsive phone service. They have no telephone queue, and it never takes more than a few rings to get a real, live human being on the line. Often that person is familiar with my postal route and location.

I would be overjoyed if my banks and brokerage firms offered the same personal responsiveness. And I’d be astounded if private health-care providers, when needed, would visit my home, just as mail carriers do every weekday.

4. The IRS. The greatest public ire of all has our Internal Revenue Service as its target. That’s not surprising; the IRS’ purpose is to take your money and make sure you pay your fair share. But if you accept that purpose, the IRS’ efficiency and competence are not bad.

I’ve only been audited once, and the process was impressive. After the first few phone calls (which were trying) I had a real person with a name and an extension number who was assigned my case and was able to discuss it in detail. Eventually the case was assigned to a local office. I had to drive to a neighboring town to present my side, but when I did I was pleased to find the representatives there knowledgeable, professional, reasonable, courteous and competent. On a disputed point of law and calculation, we made a reasonable compromise, concluded a deal and avoided both litigation and an interminable hassle.

That was exactly the way I would expect a reasonable business to act. But in fact I have seen little such reasonableness in the big businesses I have dealt with. With Chase I met a stone wall. With MetLife I could not get anyone even to take my money equivalent. I had to threaten suit just to get someone with a brain to pay attention. My conclusion is that, where my money is at stake, I would rather deal with the IRS than with Chase or MetLife.

Conclusion

Again I could go on and on. I could describe the CDC’s health website, which puts every comparable, private health-related website to shame, with authoritative, well-written and well-organized information on every disease and condition, including up-to-the-minute epidemiology. I could describe how often I rely on government sources for critical information and statistics, especially about the federal budget and about energy. I could describe how much poorer we would be without these resources, which our government makes available and updates constantly, free of charge, for the entire world.

But my personal bottom line is simple. Given the choice, and based on my own personal life experience, I would much rather deal with government than with private business—especially big business—on any matter that affects my life or livelihood. There is no comparison. The mere contemplation of those useless private telephone queues makes me shudder.

I suspect that most consumers, if they thought about it, would feel much the same way. But many don’t ever think about it. They just absorb the relentless right-wing ridicule of government from the air around them and never examine it against their own life experiences.

That is one reason why I’m all for more females in government and business at every level. I think there may be a gender difference here. Women, I think, are more likely than men to examine lies against their personal experiences, and less likely to act on oft-repeated abstract claims (like “government is incompetent”) without thinking about them. I would love to see some serious psychological research on this point.

But gender difference or no, I cannot believe that my personal experience is that different from the average consumer’s. If anything, my education and multiple careers probably give me an advantage in dealing with recalcitrant or dishonest businesses trying to take my money and give me little or nothing in return. I know where the bodies are buried.

If people would only examine their own personal experiences with government and business in depth, as I have done here, they might debunk the myth of government incompetence. They might begin to understand the source of that myth: a deliberate lie, designed to get them to reject and distrust the government that protects them from both hardship and predation by private business. In short, they might begin to see what dupes they’ve been and wise up.

So Much Advice for the President!

I hesitate to upstage today’s post, the more so because I think the myth of government incompetence is one of the most errant and destructive cultural artifacts of our day. But I cannot refrain from commenting on Frank Rich’s column in the New York Times today. Of all the pundits’ recent well-meaning suggestions as to what the President should do and how he should change―including finding his inner Hulk―Rich’s, in my view, comes closest to the mark.

As I see it, Rich suggests that the President has given too much deference to experts in deciding whether, and (if so) when and how, to intervene in our many rapidly unfolding national disasters. The two most obvious are the financial meltdown and the Great BP Oil Spill.

My first reaction on reading Rich’s column was defensive. Although not on the President’s team, I consider myself an expert, and I have described experts generally as one of his most important constituencies. After eight years of unprecedented disasters coming from an ignorant and stupid man’s “gut,” additional scorn for legitimate study and expertise is the last thing we need.

But buried in Rich’s usual incisive reporting and lively prose was another lesson entirely. In this technological age, when fragmented division of labor is essential just to limp along, no single person can be an expert in everything―certainly not in fields as diverse as international finance and deep-ocean oil drilling. A president must trust the knowledge and expertise of others and be receptive to the recommendations they provide.

But we elected the President in large measure for his good judgment and strategic vision. It is worth recounting how strong those qualities are in him. In 2002, months before our invasion of Iraq, the future president said:

“I know that even a successful war against Iraq will require a US occupation of undetermined length, at undetermined cost, with undetermined consequences. I know that an invasion of Iraq without a clear rationale and without strong international support will only fan the flames of the Middle East, and encourage the worst, rather than best, impulses of the Arab world, and strengthen the recruitment arm of al-Qaeda.”

When the President made that statement, no one expected him even to be a candidate for the highest office, let alone the winner. He did not have a phalanx of experts and consultants to call on or to heed. These words were his own personal judgment, and his alone.

Every word turned out out to be true and still is. Not only that, he made the right call although everyone else of consequence in the country, including his eventual Democratic opponent, the media, Congress and the executive branch, was beating the drums for war. That is the kind of independent, sensible judgment the President has, and that is why we elected him. (The fact that far better men than Dubya and Rumsfeld, including Defense Secretary Gates and Generals Petraeus, Odierno and McChrystal, managed to turn a bad situation around by dint of our nation’s extraordinary investment and our military’s tragic personal sacrifice does not detract one iota from the accuracy and prescience of the President’s judgment eight years ago. Despite all the sacrifice and expense, we still don’t know today whether our adventure in Iraq will ultimately succeed.)

I do not believe the President has lost that capacity. But the awesome succession of serious crises he has faced may have set him back on his heels. Since assuming office he has had to grapple with: (1) a domestic and global economic meltdown, (2) the need to stop a military slide in Afghanistan, (3) an unruly and dangerous Iraqi polity, (4) Iran’s resurgent nuclear ambitions, (5) an increasingly menacing North Korea run by a sick, aging and unstable dictator, (6) an increasingly intransigent and dangerous Israeli government, (7) several attempts by terrorists to harm us on our own soil or on our airlines, (8) a near-meltdown in our domestic auto industry, and now (9) the Great BP Oil Spill. On the average, that’s better than one new crisis every two months.

In contrast, the President’s two predecessors came into office at a time when we, like Francis Fukuyama, saw the “end of history.” Bill Clinton’s biggest problem was deficits, which he turned into surpluses. Dubya’s biggest problems, at least as he told it in his campaign, were gay marriage, alleged “oppression” of fundamentalist religion, and loss the “traditional values.” The only reason Dubya could get close enough to the presidency to allow the Supreme Court to steal it for him was that no one saw superior leadership as a vital national necessity. All that changed on 9/11, and more dramatically in 2008.

If the President has made any mistakes at all, I think they involve not relying more on his own good judgment. He is a humble and flexible man. Time and time again he has demonstrated the honesty and courage to change course when the facts and circumstances demanded. So we and he needn’t worry about mistakes. If any are made, he will correct them soon enough.

But we elected the President for his unusual combination of brains, education, judgment, vision, coolness under fire and empathy. We didn’t elect Tim Geithner, Larry Summers, or Ken Salazar.

I, for one, would like to see the President override these advisors more often. Even if he made mistakes and had to correct them, I would rather see that happen than believe he defers too much to “experts” lacking obvious seasoning, let alone ones with serious substantive and political shortcomings, such as alumni of Goldman Sachs and their protégés.

In fact, I would applaud the President’s removing Geithner, Summers or both, and appointing as Treasury Secretary someone with gray hair, eminence and a regulatory portfolio―someone like Paul Volcker, but maybe younger―who could represent the people and not our wholly discredited financial elite.

Although Obama's résumé was not unusual for presidents, it was not an especially rich one. Perhaps through personal affinity, the President has appointed economic and financial experts with less seasoning than his own. If he chooses to clean house, in whole or in part, to revitalize his administration or improve the prospects for midterm elections, I would like to see some fully gray hair. But most of all, I would like to believe that every decision made, especially on the economic side, is the product of the President’s own superb judgment, which was what gave me and millions of others hope for change.

The President doesn’t need an inner Hulk or an uncharacteristic outburst of anger. What he needs is to get outside the bubble, rediscover the inner strength of his own good judgment, and regain confidence in himself. Maybe that brief “vacation” in Chicago wasn’t such a bad idea.

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