I couple of weeks ago I read
this article (dutch) in the newspaper. Apparently it's also available via CBS
60 minutes
I don't know if any of you have ever heard of this before, but it sort of says that an 'American developing organization' Remote Area Medical (RAM) which generally operates in Africa and the rest of the Americas, (has) set(s) up camps, currently near Wise, VA and another one soon near near Los Angeles, CA. They offer patients from poor, surrounding areas free (dental) treatment, because none of them can afford it. They show up a night in advance, beause the wait is so long, that you could easily miss the opportunity to receive treatment.
It strikes me as absurd that 'development' strategies and interventions, commonly thought to exist only in the poorest of the poorest countries, are deemed necesarry to support a fraction of the American population. It's what they commonly do in failed states, as part of post-conflict nation-building efforts or whenever a natural disaster occurs.
What I also understand from the short time I have been here - echoing TFF - is that the VA for example is in a rather pathetic shape. Some of the problems associated with this 'big government program' and perhaps other programs as well:
- malpractice/malfunctioning employees are almost impossible to get rid of. Hired for life.
- sheer impossible to hire/keep well young and educated people. Many can earn much more working for businesses.
- high age of current employees, some/most lacking the skills to keep up with modern tech. Many with a low education.
- almost zero incentives to improve performance, especially when one reaches a certain position. No/diffuse responsibility, ownership.
- Outdated equipment, technology, workflow methods.
Government isn't going to get anything done if it is seriously lacking in the 'human capital' department...
And guess what, to improve their operations government hires big consultancy companies with the well educated youngsters who come in to assess and recommend and analyze, while paying these companies exorbitant fees that could easily be used to permanently employ high quality employees in the first place.