How the Brits Do Health and IT

This is interesting:

Britain's best-paid civil servant is to quit as the head of NHS information technology, claiming the new, accident-prone computer system is on track.

Richard Granger, the chief executive of Connecting for Health, said he would leave the post, and its £290,000-a-year salary, in October. "There is no doubt about the programme's achievability," said Mr Granger, who took up the role in October 2002. "Most of the building blocks are now in place."

Karen Jennings, the head of health at Unison, the NHS's biggest trade union, said Mr Granger's optimism was at odds with the views of the "majority of NHS staff".

She said: "Technically... things are finally coming together. But lessons must be learned from the way these over-ambitious, big-bang IT projects have been brought in late and so over-budget."

Parts of the project are two years behind schedule and it may now cost a total of £20 billion, which would put it £7 billion over budget.

Mr Granger can point to some successes. An electronic patient-booking service now arranges 20,000 appointments a day and 250 million X-ray images are now stored electronically.

Several things--the guy was the highest paid civil servant. By automating the National Health Service, Britain brings all the advantages and weaknesses of centralized IT to health care, including the problems of doing a big big project. On the other hand, while $40 billion is a bigger project than anything the US government has done, at least outside the military, they appear to have had better success than the FBI has.

Putting Up Fences and Winning the War

The NY times has an op-ed today by Owen and Bing West, Bing was in DOD (under Bush I, I think), Owen was a marine in Iraq. They contrast the ability of NYC cops to identify people and lookup history in databases, with the lack thereof in Iraq. (NYC probably has a large population of illegal immigrants.)

Meanwhile, the people opposing the immigration bill in the senate are calling for tough enforcement. Charles Krauthammer in the Post has an column pushing fences.

I read somewhere that 40 percent of those illegally present in the US arrived on visas, so fences won't be the magic bullet. It seems obvious to me that, if we say that we don't want illegal immigrants, we also are saying we agree to digital ID's, biometric databases, and tight checking of credentials. We can't have one without the other (if indeed we can have the one). As Mr. Heinlein used to say, there's no such thing as a free lunch.

Closing Offices--NRCS

This press report says four NRCS offices are recommended for closure.

Fear the Model Bureaucrat

As in all things, knowledge is power, which means one should be careful of those who excel, particularly those who have mastered the art of faking sincerity. Slightly less dangerous are model bureaucrats, such as this one in Cleveland:

Juanita Myrick got her first job with county human services as a records clerk and quickly devoted herself to the patron saint of government: paperwork. Over the next 17 years, she became the mistress of meticulous documentation -- of clients, welfare checks, case evaluations. No detail was too mundane to escape her.

Having Fun, Ken Cook and EWG

Now that EWG has the database of farm payment beneficiaries up and running (something my old co-workers at USDA couldn't get done :-) ), Ken Cook is having fun by linking the payment data to to geography--in his most recent posts he's shown the people who live in Key West and in San Francisco who benefit from farm program payments.

This is called "rabble-rousing", at least when one's opponents do it. When the good guys do it, it's called alerting the people to injustices.

EWG's Database

Both EWG and the press are pushing the availability of data on who might be benefiting from farm payments. Their old database showed whose name was on the check, the new one (the one that USDA couldn't figure out how to make available online) shows the beneficiaries (i.e., members of estates, stockholders of corporations, etc.). I haven't seen the data myself--I suspect it'd be best to wait a couple days until the initial burst of activity dies down.

If Charlie Stenholm (former blue-dog Dem Representative from Texas defeated by Mr. DeLay's redistricting scheme) is right, and EWG doesn't give the data a fair shake, one wonders why the farm state legislators didn't make sure that USDA put the data up. Maybe they didn't think that far ahead, or maybe they just didn't know technology that well.

Two Bureaucrats Marry

The (former) richest man in the world now has a bureaucrat as a son-in-law:

Brunei Sultan's daughter married a civil servant yesterday in a glittering traditional ceremony.

Unfair Attacks

My wife and I went to the Kennedy center last night for the last ballet of our subscription. Although we've had hot weather already this year, the humidity wasn't bad so it was pleasant. We were on the terrace, overlooking the Potomac. (Isn't that where Captain John Smith sailed 400 years ago?) Discussed the father of a friend, who may have Alzheimer's (or micro-strokes), who was described as getting upset and irritable when things were going on that he didn't understand.

Since I'm paranoid about Alzheimers, I tried making the joke that the same description could readily apply to me. My everloving wife replied: for you, it's a character trait, not an indication of Alzheimers. :-(

How Does Canada Do It? II

An email piqued my interest on what farm programs Canada has and how they are administered. The big one is:

"Beginning 2003 the Canadian Agricultural Income Stabilization (CAIS) program replaces previous safety net programs available to producers. (Farm Income Disaster Program, Canadian Farm Income Program, Net Income Stabilization Account)" from the Alberta corp.

Some background: Canada has roughly 10 percent of our population and their agriculture is 2 percent of the economy, compared to our 1 percent (CIA factbook). Their federal government is weaker than ours. Their equivalent of USDA has 170 regional offices. Both provinces and federal government have agricultural programs, or rather, the federal government runs the program in some provinces and not in other. The estimated 2007 expenditures are $4,757 million for the federal and $3,127 for the provincial. about half of which is for "farm programs" (i.e., crop insurance, subsidies)

The Ontario USDA is Agricorp.com , and its annual report is interesting. They boast about getting payments out in 6 weeks (not clear whether the comparison should be to our disaster payments or to supplemental counter-cyclical payments) but mourn the fact that processing of CAIS applications is slow. (The CAIS process looks to be more like getting a farmers home plan from the producer and making a grant based on it.)

Their equivalent to the non-recourse commodity loan and purchase program of olden days is called the "Advance Payments Program" and is administered through producer organizations. That's similar to the cotton and rice marketing cooperatives the US uses, and the producer associations for tobacco and peanuts, but apparently Canadian organizations were stronger across the board than in the US.

Alberta also delivers the CAIS through a corporation, which seems to have started as a hail insurance corporation.

We (federal employees) should be glad the Bush administration hasn't picked up on this pattern, otherwise FSA would have been privatized.

Post Front Page--Politics and Reform

The Washington Post has two stories on its front page that relate, in a way. One is the second in its series on the DC school system. Today's is a review of the various efforts to reform the system over the years. Every few years new people come to power promising change and improvement, only to leave sometime later, either slinking out the door tired and defeated or thrown out by a new set of reformers. A theme is the power of the bureaucracy to frustrate change even at the cost of protecting incompetence. Another theme is unanticipated consequences--a court suit ends up depriving the system of money by forcing it to spend $50,000 per special ed student (if my quick math is right--$120 million divided by 2400 students?)

The other story is on the use of political connections to select immigration judges. It seems the Bush administration has been appointing judges with such ties.

What's the relationship? New leadership can exert its influence by appointing its people, as in the case of Bush and immigration judges. When it can't exert influence, as in the case of the DC schools, it can't be held responsible. So, bottom line, there's a case to be made for the old Jacksonian spoils system and against the goo-goo Progressive governmental reform people.