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July 20, 2011

Ohio Orders Retraining of Medicaid Officials

If you don't know the background: O'Keefe's crew stung the Ohio Medicaid offices, catching a Medicaid staffer instructing a "Russian Drug Dealer" as to how he could defraud the state for Medicaid benefits his illegal and very high paying occupation should not qualify him for.

For example, she advised him to not mention his $800,000 McClaren F-1 super sportscar.

A couple of points. These workers were county level workers, not state level workers.

Why does this matter? Well, it matters to John Kasich, the Republican Governor of Ohio. He doesn't want to be tarred by this. And it's fair to say that certainly he wouldn't support the easy-peasy bureaucracy of free money regime that's in place. That's a Democratic creation.

Still, it's his job to fight that. He's ordered retraining.

Now that's nice and all, but I wrote to someone from the Ohio government, telling him that wasn't enough:

Thanks... shouldn't there be unannounced tests, too? Like O'Keefe's sting, but with people hired by the government?

This is not to attack Kasich. It is to note the nature of bureaucracy when it's handing out money. A bureaucrat only gets a complaint when he denies benefits, because the person he denied them to has a reason to complain. If that bureaucrat just fixes things so everyone gets money, there is no one to complain.

Thus the real rule -- forget training; people pick up on the real rule governing the situation -- is to just give money to virtually anyone.

Training will not cure this. What is needed is someone to complain on the other side of things -- as in the O'Keefe sting, where the complainer will be someone who actually got benefits but didn't actually qualify for them. As this situation will not arise naturally, it must be created via a state program of testing its bureaucrats.

No matter what the job is -- even in non-bureaucratic positions -- an employee's real directive is to avoid complaints by clients and hassles from superiors and above all else not get fired.

If a system is in place -- and I don't give a fig what's in the employee manuals; I mean the real governing system in place -- has all the incentives on one side of things (here, to just give out money willy-nilly; in the Army, to just promote Muslim officers even if they were giving "psychiatric research presentations" celebrating Islamic jihad -- then that is how the bureaucrats will act.

If bureaucrats began to get fired based on what we saw here in Ohio, there would at least be some incentive on the other side of things to deny money to plainly-ineligible fraudsters. As things stand, there is not.

It's clear that this woman has done this dozens (hundreds?) of times before. Nothing the "drug dealers" said fazed her in the least. She laughed it all off with "I'm not listening la-la-la" jokes. She had a ready defrauding scheme (call yourselves "babysitters").

She knows the real rule where she works is to make sure no one who comes into her office seeking "free government money" has any reason to file a complaint against her. And she behaves accordingly.

You can "retrain" this woman to tell her that she should also be considering the law and the taxpayer but until the law and the taxpayer actually threaten to take her cushy job away from by complaining about things from the other side, she's going to keep doing the same damn thing.

Look, you don't have to take my word for it. Enjoy the expert opinion of one Peter Gibbons.

By the Way: This woman needs to be fired.

I have avoided pouring criticism on her personally because it's my sense this is just Standard Operating Procedure and it's more The System that's to blame, with its perverse incentive scheme, than she herself.

But the only way to cure this situation is to lay down the law that there are real consequences to joining a conspiracy to defraud the government-- even if you work for the government. Especially if you work for the government.

The incentives must be laid down on the other side of things too: If you do this, and you get caught, you get fired. Period.

Otherwise you can "retrain" until the cows come home. The fact will remain that the real rule of the bureaucracy is that you can only get into a hassle by denying benefits, and that means you have incentivized all government workers to "fix" applications and offer advice about success at fraud.

A bureaucrat's motivation is not to serve the citizens or any of that bullshit. Her real motivation is just to do as little work as possible and receive as big a paycheck as possible for that low level of work.

In fact, that's most people's motivation at work. Most jobs, however, offer some kind of countervailing incentives to do a good job. Or, you know, you can just get fired for not doing a good job; something tells me that that possibility doesn't exist in a robust form when it comes to state bureaucrats.

When there is no counterbalance, when the taxpayer is never in the room, when the only threat to your easy-peasy paper-pushing job comes from a denial of benefits.... well, you won't have many, if any, denials of benefits. You'll have this-- rampant, routintized, SOP fraud, with the government a party to its own defrauding.

This is very much like the situation where a police force has become, through years of incentives, pretty corrupt. In a sense, you can hardly blame the cops who routinely take bribes. Because that's the real rule at work -- Take bribes. That's what the system has told them. Again, throw the rulebook out the window. Those are just words. What counts is action. And if most cops are taking penny-ante bribes, and none of them are being fired for that, then the real rule is "You are permitted to supplement your income through modest bribery."

And the only way to fix that is to start implementing stings and to start firing cops. In many cases, this will be unfair surprise to the cops getting fired over things that "everybody does."

But that's life. The only way to change the real rules of the situation is to begin imposing real consequences for behavior you wish to discourage.

And Further: Is it just me or is the "Employee Manual" treated as exactly what it is -- a corporate legal CYA document with little connection to the real world?

Who reads this? I have never been tested on it. That would be a manner to insure I read it and know it; but no company I've worked for tested me on it. They just handed it to me. It immediately went into the bottom desk drawer. I never saw it again until I cleared the desk out.

The fact that no one does this (AFAIK) is a major signal that it's CYA nonsense.

Another point: No party seems to take an interest in the lawful, proper functioning of the bureaucracy.

Democrats, the party of government, should take an interest, because it would help them sell more government if government actually functioned properly, but they don't, because their two biggest groups of supporters are government workers, who want to do nothing at work and get raises every year from their employers the taxpayers, and those on the government dole, who obviously have no desire to see welfare qualifications made more rigorous.

Republicans, the party of smaller government, should, in theory, take an interest in reforming bureaucracies, because these jackasses all vote against us anyway and we might as well squeeze some minimum level of job performance out of them, and we should also have an eye on protecting the taxpayer, but we tend not to, because we tend to view these bureaucracies as enemy camps, bastions of the Democrats, and we sort of just let them make the rules for their camps.

But we shouldn't. There's a line Democrats love to use: "Republicans campaign on the argument government doesn't work and then when they're in office they spend all their time proving it."

That's a hard knock. We should overcome that. We should recognize that whether we would have authorized these various welfare schemes in the first place, it is a fact on the ground that they exist, whether with our consent or without it, and we should be bears about making this crap work properly.

Now, some might say that that enables the welfare state by increasing its performance. Well, perhaps. But it also puts us in a position of credibility and authority to start making statements about what should be consolidated or closed down. If we became known as the Party of Smaller but High-Functioning Government we'd be in a better position to make it smaller still.

The Democrats don't like capitalism and have a vested interest (even subconsciously) in seeing it fail. We give in to the urge to wish the government to be as poorly-functioning as possible at our own expense.

I like John Kasich. I think it sucks he has such a low approval rating in Ohio. But he was elected to reform things. He should do so. And he should stop with this "retraining incorrigible bureaucrats" bullshit. He needs to change the system, not give "retraining" to these paper-pushers to instruct them that fraud is illegal.

They really know that already, don't they? Or rather, they know it's supposedly illegal.

In practice, they know it's not only legal but encouraged.

That must be changed. "Retraining" does not change that. Only consequences for poor performance does.

As expensive as it is to fire a unionized government employee: It's worth every dime.

As Admiral Nelson Voltaire advised: Sometimes you have to hang an admiral or two... to encourage the others. (Corrected; Voltaire was explaining the hanging of Admiral Byng in the Seven Years War, 50 years or so before Nelson would be in a position to order the hanging of admirals.)

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posted by Ace at 10:56 AM

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