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Review Roundup: Avoidant, Bad Boyfriends

While I’ve been working on other projects, more reviews came in for Avoidant: How to Love (or Leave) a Dismissive Partner. There’s also been some activity on my older book, Bad Boyfriends: Using Attachment Theory to Avoid Mr. (or Ms.) Wrong and Make You a Better Partner. As usual, readers are invited to take questions and concerns to the Jeb Kinnison Attachment Type Forum to discuss attachment issues and their own special situations.

Here I’ll recap the better reviews, leaving out the obvious axe-grinding ones. It’s not uncommon for a reviewer to react negatively for personal reasons and then take it out on the book. Those reviews are self-identifying.

For Avoidant:

5.0 out of 5 stars – Five Stars
By Kate on January 21, 2017
Excellent read! Very informative.

5.0 out of 5 stars – Great to read with your partner
By J Harrison on January 18, 2017
Incredibly helpful. Great to read with your partner, to help guide those difficult conversations.

5.0 out of 5 stars – Along with Wired For Love and Marriage Rebranded
By room7609 on January 9, 2017
If you’re reading this then I know you can relate. This book, along with Wired For Love and Marriage Rebranded, saved me and my marriage. Read all three and ask your spouse to do the same. You’re welcome. 😉

5.0 out of 5 stars – WOW
By M. M. Jackson VINE VOICE on December 25, 2016
Fantastic, fantastic book. Very therapeutic and helpful. A window into the soul of these tormented people who, knowingly or not, manage to so thoroughly torment. I’ve read a few treatments of the subject, this has been the best by far yet. Expands upon his “Bad Boyfriends” book (which also applies to girlfriends, in my case) and in fact pretty much includes a lot of the same material, which you will find expanded here. Between the two, buy this one.

For Bad Boyfriends:

5.0 out of 5 stars – Excellent Primer on Attachment in Relationships
By stephen jensen on January 23, 2017
I’ve been reading a lot on attachment theory lately and so far this has been the best summary of the theory and its implications on relationships. It is focused, dense with insight, and unflinching. Highly recommended. Don’t let the primacy of “Boyfriend” in the title mislead you- its intended audience is everyone.

5.0 out of 5 stars – Five Stars
By S. Boydon on January 1, 2017
This is worth buying because it’s hands-on with lots of material.

5.0 out of 5 stars – I would recommend this book.
By Stephanie P. on December 27, 2016
Well written and correlates to other scholarly or reliable books on attachment theory. My daughter is a childhood and adolescent development major so the links between infancy to dating partners made sense when discussing portions of this book with her as well. The percentages of healthy attachment style adults over 40 was a bit depressing, yet makes me feel better about how hard it’s been to find a good partner after leaving a long term marriage. It’s not that my online profile needs help, it’s truly rough out there.

5.0 out of 5 stars – A book like Kinnison’s reminds me that there are many ways to …
By Catherine Coan on September 24, 2016
Attachment theory can seem limited — avoidant, anxious, secure, I get it! — but it’s not. A book like Kinnison’s reminds me that there are many ways to know a thing. In this case, at the level of love relationships, delving deep. Excellent!

2.0 out of 5 stars- There are much better books focusing on men’s relationship issues
By L. A. Duranon on October 9, 2016
This book is NOT for men. Despite the parenthetical attempt to make this non-gender-specific in its subtitle, this book is really geared toward women’s relationships. If you are a man, don’t buy this book. There are much better books focusing on men’s relationship issues.

On that last review, I’m guessing the reviewer finds it disappointing that I see the attachment types as largely independent of gender — the sexes differ on average, and in particular avoidant and preoccupied traits are reinforced by sex role stereotypes, but there’s no special “men’s point of view” about relationships. I have run into lots of men whose wives are dismissive and rebuff their attempts at intimacy, inverting the usual stereotype. Dismissive women and preoccupied men are more likely to have developed camouflage to hide their true feelings, since “society” is more likely to disapprove of the needy male and the intimacy-avoidant female.

Orlando and Elite Bigotry: Come Out as an American

Marines Marry - photo from Freedom to Marry

Marines Marry – photo from Freedom to Marry

Instapundit (Ed Driscoll posting) has a post up quoting a New York Times piece on Garrison Keillor’s retirement from Prairie Home Companion:

Curiously, Mr. Keillor has always found it difficult spending so much time with the strong, good-looking, above average people of Lake Wobegon, which he based on his relatives, past and present.

In “The Keillor Reader” (2014), he complained bitterly about “their industriousness, their infernal humility, their schoolmarmish sincerity, their earnest interest in you, their clichés falling like clockwork — it can be tiring to be around.”

Speaking on his porch, Mr. Keillor said of Lake Wobegonians, i.e., his relatives, “I am frustrated by them in real life.” They were too controlled by good manners, he said, and “have a very hard time breaking through.”

So why devote so much of his professional life ruminating about them? “It’s the people I think I know,” he replied.

Will he miss them, and the weekly jolt of the show?

“No,” he replied. “No.”

Ed continues: “As with many on the left, in the wake of 9/11, Keillor emerged as a vicious partisan, describing President Bush’s supporters thusly in 2004:”

The party of Lincoln and Liberty was transmogrified into the party of hairy-backed swamp developers and corporate shills, faith-based economists, fundamentalist bullies with Bibles, Christians of convenience, freelance racists, misanthropic frat boys, shrieking midgets of AM radio, tax cheats, nihilists in golf pants, brownshirts in pinstripes, sweatshop tycoons, hacks, fakirs, aggressive dorks, Lamborghini libertarians, people who believe Neil Armstrong’s moonwalk was filmed in Roswell, New Mexico, little honkers out to diminish the rest of us, Newt’s evil spawn and their Etch-A-Sketch president, a dull and rigid man suspicious of the free flow of information and of secular institutions, whose philosophy is a jumble of badly sutured body parts trying to walk.

Then this quote from Christopher Caldwell:

At some point, Democrats became the party of small-town people who think they’re too big for their small towns…For these people, liberalism is not a belief at all. No, it’s something more important: a badge of certain social aspirations. That is why the laments of the small-town leftists get voiced with such intemperance and desperation. As if those who voice them are fighting off the nagging thought: If the Republicans aren’t particularly evil, then maybe I’m not particularly special.

Ed has outlined the problem: the opinion leaders in the Blue Tribe gleefully engage in the extreme stereotyping, bigotry, and prejudice they rightfully decry when applied to everyone but their cultural cousins in the heartland. It is all about feeling superior to their countrymen not so privileged as to live in elite coastal communities where wealth, education, and stable academic or government jobs give them a platform to look down on, and prescribe correct thought to, the great unwashed they have separated themselves from.

The current attempt to paint evangelical Christians and gun control opponents as responsible for a supposed climate of hate leading to the Orlando massacre is a good example. After winning enormous improvements in both law and opinion on gay rights, Democrats and activists want to continue to crusade against old enemies rather than facing the reality — that there is almost no one in their demonized classes who would want them killed, while there are a millions of fundamentalist Islamists, egged on by Salafist training financed for decades by Saudi Arabia, who *do* want them killed. By displacing the blame, the Blue Tribe leaders can avoid considering the enormity of the evil of gays and women being stoned, shot, thrown from buildings, and otherwise sacrificed in a broad swath of the Middle East and Africa where these fundamentalists are in power, and how that evil is coming home to us now.

Burt Gummer from "Tremors" - Tremors Wikia

Burt Gummer from “Tremors” – Tremors Wikia

Yesterday’s post about the infighting between American cultures over the response to Orlando murders gets at some of this — American Red Tribe members, many of whom have some traditionalist beliefs about sex roles and gay marriage, bear no murderous urges toward anyone, and would help defend their fellow citizens should it ever come to that using their stores of guns and ammo and military training. Like the townspeople’s reaction to prepper Burt Gummer in Tremors, “sophisticates” roll their eyes when the ex-military guy seems to be paranoid and overprepared for unlikely threats, but everyone is grateful when the threat appears and he’s the only one who has a useful response. A civilization which has so protected its people that they lose the ability to even imagine the need to defend themselves is ripe for external attack. And the threat from Islamist ideology is real — it’s not a country, it’s not a state (no matter what ISIS’s pretensions are), it’s a thought-virus.

It is not helpful that so many filter the news for the most outrageous behaviors to confirm their fear of the other tribe — steady consumption of clickbait outrage stories would have you believe most Christian leaders want gays killed and approve of the Orlando murders, while the truth is only a minute number of attention-seeking sect leaders (like the Westboro “Baptist” Church) are anything but properly horrified. By choosing to read these outrage porn sites, people nurture old grievances and retain a profoundly wrong idea of the feelings of their Red Tribe countrymen, so much so that it is becoming a danger to our polity.

I grew up in the era when everyone who appeared weak or different could expect to be bullied. We’ve made a lot of progress as a people to remedy that kind of abuse, but the defensive reflexes remain. The generation now in their 50s and 60s are the primary opinion leaders, and edit most of the media we read. They still believe in the ill-will of their flyover countrymen that many of them worked hard to get away from, and identities and egos are built on their feelings of moral superiority. They are easily persuaded that external threats are unimportant compared to the need to continue to suppress their old enemies in the culture wars — and that is a great danger, since by not acting to counteract Islamist ideology and its promoters, and by portraying legitimate criticism of the current government’s management of security and screening of millions of immigrants as racist, sexist, and xenophobic, they block any reform that might reduce the number of Jihadi converts in sensitive positions.

So here’s my suggestion for my Blue Tribe friends — get to know your Red Tribe cousins. Go shooting with them, barbecue some ribs with them, visit the country in the middle you’ve never seen and absorb the culture there without your blinders on. Instead of vacationing in New York or San Francisco or the villa in Tuscany or the south of France, try Salina, Kansas, or New Braunfels, Texas. Get to know some young men who sport cultural signifiers you fear — like pickup trucks, gun racks, and military backgrounds. You’ll find them to be as friendly and civilized as the average coastal resident, just different. And you may come to respect them as much as I do — even though I worked as hard as I could to get away from them when I was young. Your past experience has prejudiced you against a people who in the current reality are your closest and warmest cousins. Bigotry and discrimination have no place in the new America — the President is quite right about that. But his blindness and bigotry toward half the population of his own country is obvious.

Don’t be a bigot. Talk to those people you think you loathe and fear. Come out as an American.


Death by HR: How Affirmative Action Cripples OrganizationsDeath by HR: How Affirmative Action Cripples Organizations

[From Death by HR: How Affirmative Action Cripples Organizations,  available now in Kindle and trade paperback.]

The first review is in: by Elmer T. Jones, author of The Employment Game. Here’s the condensed version; view the entire review here.

Corporate HR Scrambles to Halt Publication of “Death by HR”

Nobody gets a job through HR. The purpose of HR is to protect their parent organization against lawsuits for running afoul of the government’s diversity extortion bureaus. HR kills companies by blanketing industry with onerous gender and race labor compliance rules and forcing companies to hire useless HR staff to process the associated paperwork… a tour de force… carefully explains to CEOs how HR poisons their companies and what steps they may take to marginalize this threat… It is time to turn the tide against this madness, and Death by HR is an important research tool… All CEOs should read this book. If you are a mere worker drone but care about your company, you should forward an anonymous copy to him.

 


The VA Scandals: Death by Bureaucracy

VA Waiting - Rick McKee - The Augusta Chronicle

VA Waiting – Rick McKee – The Augusta Chronicle

[Welcome Instapundit readers! Sign up on the sidebar or add the RSS feed if you want updates…]

The problems with Britain’s NHS are echoed in the Veterans Administration (VA) scandals. What is supposedly free ends up costing lives and health for those who have already paid through their military service, because a civil service and union-protected bureaucracy can’t be held accountable for gross incompetence or even negligent homicide.

The medical benefits for veterans started out as military hospitals and care for those who had been wounded or disabled while in service, but over time (the ratchet effect at work) benefits broadened and were extended to cover most veterans for general healthcare needs, even those unrelated to their service. “The VA health care system has grown from 54 hospitals in 1930, to include 152 hospitals, 800 community-based outpatient clinics, 126 nursing home care units and 35 domiciliaries.”[1] The number of living veterans has declined somewhat but aged in the last decades, and with rising medical costs generally, as of 2015, the VA has nearly 300,000 employees in its medical care area, spending about $75 billion a year for veteran medical care and rehab. There are about 22 million eligible veterans, so the VA is spending about $3,500 per year on each[2]. Since many eligible veterans get their care under other insurance, per person spending on those who primarily rely on the VA is much higher.

Customer satisfaction surveys show most VA clients are reasonably satisfied with the care they receive, and VA staff and doctors appear to care as much about their patients as private-care doctors and staff. So it’s not the quality of doctors or care that are in question — when it is scheduled promptly and part of an ongoing treatment process, VA care is good. Problems appear to be related to the bureaucratic scheduling and other access issues, and again the NHS is similar — patients tend to be happy with the doctors and nurses they see, but getting to see them in a timely manner is hit-or-miss, with delays and mismanagement of facilities prominent.

Like the NHS, staff at VA facilities and offices are civil service and union-protected. Even a motivated manager has trouble firing or removing negligent workers, and management priorities are often enforced by numeric targets which can be gamed by “losing” applications or forging timestamps to make delays in individual cases disappear from performance review and bonus-setting numbers. Managers who might want to implement reforms leading to more responsive systems for patients find themselves blocked or subjected to retaliation for “troublemaking.” Patients caught in bureaucratic snafus have little recourse, since they can’t take their business elsewhere. VA facilities that would be fined or subject to license removal for falling beneath state medical care standards if they were private are exempt and can’t be fined or replaced by better-managed facilities.

The cycle of scandals and bad publicity followed by demands for VA reform and new legislation has occurred several times. The VA was raised to cabinet level in 1988, then underwent drastic reform in 1995-2000, shedding 10,000 employees and keeping costs flat for five years by implementing better management and some of the same numeric performance measures that were gamed in the scandals of 2014.

Pournelle’s Iron Law of Bureaucracy:

In any bureaucratic organization there will be two kinds of people:

First, there will be those who are devoted to the goals of the organization. Examples are dedicated classroom teachers in an educational bureaucracy, many of the engineers and launch technicians and scientists at NASA, even some agricultural scientists and advisors in the former Soviet Union collective farming administration.

Secondly, there will be those dedicated to the organization itself. Examples are many of the administrators in the education system, many professors of education, many teachers union officials, much of the NASA headquarters staff, etc.

The Iron Law states that in every case the second group will gain and keep control of the organization. It will write the rules, and control promotions within the organization.[3]

Management reforms, however well-meaning, will always be gamed by those subject to them. The motivated top-level managers who set reforms in motion soon depart, to be replaced by new political appointees with different priorities and less knowledge of where the bureaucratic bodies are buried than the career civil servants who remain in place.

Federal bureaucracies grow and evolve unnoticed until some scandal is extreme enough to break into the headlines, making it worthwhile for politicians to decry and posture, and occasionally accomplish something. The VA scandals of 2014 started off with at least 40 veterans who died after waiting too long for medical attention at the Phoenix VA hospitals:

At least 40 U.S. veterans died waiting for appointments at the Phoenix Veterans Affairs Health Care system, many of whom were placed on a secret waiting list.

The secret list was part of an elaborate scheme designed by Veterans Affairs managers in Phoenix who were trying to hide that 1,400 to 1,600 sick veterans were forced to wait months to see a doctor, according to a recently retired top VA doctor and several high-level sources….

Dr. Sam Foote just retired after spending 24 years with the VA system in Phoenix. The [doctor said] the Phoenix VA works off two lists for patient appointments. There’s an “official” list that’s shared with officials in Washington and shows the VA has been providing timely appointments, which Foote calls a sham list. And then there’s the real list that’s hidden from outsiders, where wait times can last more than a year.

“The scheme was deliberately put in place to avoid the VA’s own internal rules,” Foot said… the elaborate scheme in Phoenix involved shredding evidence to hide the long list of veterans waiting for appointments and care. Officials at the VA, Foote says, instructed their staff to not actually make doctor’s appointments for veterans within the computer system.

Instead, Foote says, when a veteran comes in seeking an appointment, “they enter information into the computer and do a screen capture hard copy printout. They then do not save what was put into the computer so there’s no record that you were ever here.” [T]he information was gathered on the secret electronic list and then the information that would show when veterans first began waiting for an appointment was actually destroyed. “That hard copy, if you will, that has the patient demographic information is then taken and placed onto a secret electronic waiting list, and then the data that is on that paper is shredded. So the only record that you have ever been there requesting care was on that secret list,” he said. “And they wouldn’t take you off that secret list until you had an appointment time that was less than 14 days so it would give the appearance that they were improving greatly the waiting times, when in fact they were not.”

Foote estimates right now the number of veterans waiting on the “secret list” to see a primary care physician is somewhere between 1,400 and 1,600[4].

The reforms of 2000 had included establishing waiting lists for less urgent care, similar to the rationing-wait lists in most government-provided medical systems like the NHS or Canada’s. For some less urgent operations, a few months of delay smooth demand and hold down the costs of facilities, encouraging those who can afford faster alternatives to seek care elsewhere, a safety valve which many in such systems use — better-off Canadians frequently pay for care in the US to “jump the queue” in their provincial healthcare system, for example. Those who would be most able to cause political problems for the system — well-off and well-connected people — are thus taken out of the complaining group. But VA patients are already self-selected as having no affordable alternatives, and so patients made to wait when there is a significant chance of death or serious worsening of their health have little alternative, and the unfairness of their treatment rankles much more in a society which pretends to honor their military service. A “sacred commitment” dishonored so that managers can get big bonuses while some veterans die unnecessarily is especially potent politically.

The 2014 Phoenix scandal brought out more allegations of secret waiting lists and unnecessary deaths at other VA facilities, including Austin, Texas, Ft. Collins, Colorado, Columbia, South Carolina, and Cheyenne, Wyoming. A VA audit in June 2014 found upwards of 120,000 veterans left waiting or denied care as a result of secret waiting lists intended to disguise actual waiting times[5]. The FBI opened a criminal investigation and Congressional investigators found that all 470 senior managers at the VA received at least “fully successful” performance evaluations and were paid $2.4 million in bonuses for the previous year.[6]

On June 11, 2014, the Senate voted 93–3 to pass the Veterans’ Access to Care through Choice, Accountability, and Transparency Act of 2014, the bill written by Senators McCain and Sanders to reform the VA…. Acting VA Secretary Gibson said he plans to fire some VA executives under an expedited process as soon as he is given the authority by Congress to do so.

In late June 2014, VA General Counsel Will Gunn and VA Acting Undersecretary for Health Robert Jesse stepped down from their positions. Other changes in June 2014 included:

• Moving more than $390 million inside the VA budget to fund care for veterans outside the VA system;
• Deploying mobile VA medical units;
• Ending the goal of providing appointments within the 14-day window that Nabors criticized as unrealistic and said may have “incentivized inappropriate actions”;
• Posting twice-monthly public updates of VA wait times;
• Banning performance bonuses;
• Removing some senior managers from the Phoenix VA system;
• Leadership emphasis on protecting whistleblowers from retaliation.[7]

While many politicians decried the scandal and worked for reform, Senator Bernie Sanders (Socialist-VT) defended the VA and minimized the scandal as long as he could, since the VA is exactly the sort of government-provided medical insurance he believes would be ideal for everyone in the US:

Sen. Bernie Sanders touted his record on veterans’ issues during Tuesday’s debate, citing his position as the former chairman of the Senate Committee on Veterans Affairs when Congress provided billions of extra dollars to boost healthcare for veterans last year.

“We went further in than any time in recent history in improving health care to the men and women of this country who put their lives on the line to defend us,” Sanders said Tuesday, referring to $15 billion given to the Department of Veterans Affairs to decrease wait times and reform the troubled agency.

Yet some veterans groups and others criticize Sanders for what they call a lack of oversight of the VA, and for at times coming to its defense in the midst of the scandal that rocked the agency in 2014.

Paul Rieckhoff, founder and CEO of the Iraq and Afghanistan Veterans of America, said Sanders largely ignored the appeals of organizations like his during a time when media and government reports exposed how veterans were waiting months for appointments and VA officials were covering up the delays. “For far too long he was apologizing for the VA. He was refusing to acknowledge the severity. He was positioning it as a smaller issue than it was while veterans were dying waiting for care.” [8]

Sanders has supported the Castro regime in Cuba with admiring comments about Cuba’s universal healthcare, which like all such systems in communist states can be good for the well-connected in select showplace facilities while bad for the rest:

The difficulty in gaining access to certain medicines and treatments has led to healthcare playing an increasing role in Cuba’s burgeoning black market economy, sometimes termed “sociolismo”. According to former leading Cuban neurosurgeon and dissident Dr Hilda Molina, “The doctors in the hospitals are charging patients under the table for better or quicker service.” Prices for out-of-surgery X-rays have been quoted at $50 to $60. Such “under-the-table payments” reportedly date back to the 1970s, when Cubans used gifts and tips in order to get health benefits. The harsh economic downturn known as the “Special Period” in the 1990s aggravated these payments. The advent of the “dollar economy”, a temporary legalization of the dollar which led some Cubans to receive dollars from their relatives outside of Cuba, meant that a class of Cubans were able to obtain medications and health services that would not be available to them otherwise.[9]

But in the US, despite the political uproar and some long-delayed firings and resignations of high-level VA managers, the scandal did nothing to make lower-level employees more accountable, and the tales of malfeasance and even criminal employees being reinstated or promoted because of union and civil service rules continued:

The VA is a place where people tend to somehow magically fail upward. By that I simply mean that workers at all levels can be caught up in any sort of malfeasance or incompetence and not only retain their jobs, but apparently profit from their actions. We’ve told you the story of the executive who ran her department into the ground and was punished with a plush gig in the Philippines. Then there was the Albany, New York administrator who was found to have drug addicts on staff who were stealing the medication of the veterans and was fired, but somehow got her job back at full pay. And, of course, who could forget the Arizona VA chiefs who cooked up the scheme to keep veterans on phony waiting lists where some of them literally died without seeing a doctor, but will keep their positions with full pay and benefits for as much as two more years. But today we may finally have the story which tilts the pinball machine once and for all.

This one takes place down in Puerto Rico where one diligent VA worker found herself unable to report to work for an extended period of time. She was held up, you see, by an inconvenient inability to get a pass out of prison to make it into the office.[10]

The VA worker was in jail on an armed robbery charge, and missed work when she could not make bail. When she was finally released from jail, she had been fired, but the union got her reinstated despite her guilty plea because in some previous instances other employees had been allowed to keep their jobs:

[The union argued] that management’s labor relations negotiator is a registered sex offender, and the hospital’s director was once arrested and found with painkiller drugs…

Employees said the union demanded her job back and pointed out that Tito Santiago Martinez, the management-side labor relations specialist in Puerto Rico, who is in charge of dealing with the union and employee discipline, is a convicted sex offender. Martinez reportedly disclosed his conviction to the hospital and VA hired him anyway, reasoning that “there’s no children in [the hospital], so they figure I could not harm anyone here.”[11]

The “safety valve” money appropriated by Congress to allow veterans to seek outside care at the VA’s expense required VA bureaucrats to implement it, and not surprisingly it did not go smoothly, since the VA’s mission and monopoly on veteran healthcare would have been threatened if it had been successful; a working program of vouchers for outside care would have made the possibility of expanded VA-paid private care for more veteran healthcare needs more likely. So it was sabotaged:

A survey of non-VA hospitals in Florida, for example, found VA owed more than $100 million in unpaid claims for services provided to veterans under the Choice Card program. Sixty percent of the hospitals described the problems in getting paid as inexplicable, with their claims mysteriously getting “lost.”

A growing number of doctors across the country are refusing to treat patients using the Choice Card for fear of never being paid.

Now the American Federation of Government Employees, which represents most of VA’s nearly 350,000 workers, is using the failure to process payments to justify ending the program–which it opposed from the start because it said it could reduce the growth of its membership rolls. The union also complains that government workers are being forced to talk to non-VA doctors and hospitals about payments.

Incredibly, senior VA leaders are also pressuring Congress to repeal the program [claiming that] it – not the wait-time scandal – is why their agency’s image is in tatters.[12]

Payments were delayed when the VA inexplicably refused to pay bills from outside providers unless detailed records of treatment had been received and filed at the VA. Both VA and contractors promised to improve their systems. Meanwhile, the VA argued for increased funds, and outside observers believed the VA intentionally sabotaged the program to drive veterans back to their facilities:

Last year when VA leaders claimed budget shortfalls threatened to force closure of government hospitals and related healthcare facilities, they asked Congress to let them transfer up to $3.3 billion originally authorized for the Choice Card program. Congressional leaders were skeptical but reluctantly went along.

Sen. Richard Blumenthal  of Connecticut, the top Democrat on the Veterans Affairs committee, said “we’re in this situation, quite frankly, because of gross ineptitude in planning that can only be characterized as malpractice in management.”

Numerous veterans have described being hounded by unpaid doctors and being made to feel like scofflaws and deadbeats, thanks to VA’s failure to cover the costs, as Congress and President Barack Obama promised when they approved the Choice Card program.

“It is now believed by veterans that this is happening by design to force veterans back to VA to justify the existence of VA,” veteran Tony Woody said. “VA administrators fear losing too many veterans to the civilian sector, thus causing them to lose their jobs because they know the civilian sector is far more efficient.”

The situation prompted Woody, a retired U.S. Navy Chief, to ask “since when did a government employee’s job become more important than the lives of the veterans they are supposed to be serving?”[13]

In San Diego, a vet committed suicide in 2014 after waiting for months while his counselling appointments at the VA hospital were repeatedly cancelled at the last minute. The San Diego Union-Tribune editorialized:

The script after each scandal — in 2007, 2014 and now — is predictable: Government officials insist that their only priority is helping veterans to lead healthy, productive lives. But while we have no doubt that the great majority of VA employee are well-meaning and hardworking, actions speak louder than words. It is hard to fathom that all seven of the San Diego VA officials identified as manipulating data to present a false front on the success of local mental care weren’t fired. Instead, after wrongdoing was found, three resigned, two retired and two more still work for the VA.

Meanwhile, on March 15 — nearly two years after Veterans Affairs Secretary Eric Shinseki resigned from President Obama’s Cabinet largely because of pervasive, lethal problems in the Phoenix VA system — the department finally got around to firing the three executives responsible for those deadly debacles. And that came only under intense pressure from Sen. John McCain after the Arizona Republican learned in January that the VA wanted to reassign — not fire — two of these executives.

Nine years after the Walter Reed expose, the Department of Veterans Affairs still looks awfully quick to go into forgive and forget mode when it comes to deplorable employee behavior

It’s appalling to admit, but we think the next infuriating VA scandal is a question of when, not if.[14]

This cycle of scandal, political posturing, and temporary patches will only continue unless the root cause — the structure of the VA’s medical care arm as a civil service-protected, unionized bureaucracy — is dismantled. No one in politics should be proposing any similar government-run universal healthcare schemes until they can demonstrate the will to overcome union bullshit to cover veterans with the excellence and responsiveness they deserve.

Political decisions and monopoly public service providers will always be less efficient and responsive than private providers — largely because competing private companies live and die on performance, and undergo evolutionary pressure to be more efficient and customer-centered. If they are incompetent and fail to satisfy customers, they eventually are replaced or reformed. But the accountability of government agencies is indirect, through elections, where only the largest failures affecting the largest numbers of citizens can overcome the inertia and vested interests supporting incumbent representatives. Certain key functions of government must be accomplished through political means because they are inherently public goods — since no citizen can be excluded from the benefits, it must be a joint enterprise, jointly paid for and controlled. Defense is one key example, and there are serious efficiency problems with defense department weapons procurement and contracting precisely because it is a political process with all the opportunities for graft and pork-barrel spending that entails. But there is no other alternative — and our military does well compared to other world powers because it is still less corrupt and politicized, although that may be changing.

Healthcare for vets is not inherently a public good — it is a benefit for the individual vet, and so it is very possible to imagine different means of providing it that capture some of the benefits in efficiency and responsiveness of multiple competing providers.

One of the problems with the VA system is that not every vet lives close enough to a VA facility to easily use one. The private service option resisted by the VA helps resolve that, making it possible (for example) for a patient to visit the nearest providers rather than drive for an hour or more to a VA hospital. While there are specialties the VA is likely to be better at providing in its own facilities, like rehab for returned injured vets, more routine coverage could be contracted out to insurance carriers on a regional basis, allowing the VA to bargain for best rates and letting vets use the same facilities their neighbors do for care — like the various Tricare insurance programs, which are generally liked, now covering active-duty military and dependents. Eventually VA hospitals could be opened to other patients, where they are underutilized, and employees could be spun out to independent hospital companies without a huge disruption.

The errors and deaths will continue unless there is some drastic change in the structure of the VA’s healthcare services. Will we elect politicians who are courageous enough to do it?

[Last-minute update: this story just crossed the wire: “Veterans Groups Criticize Secret Proposal to End VA Healthcare,” by Bryant Jordan at Military.com:

Several of the largest veterans’ service organizations in the US are criticizing a proposal drafted in secret to shut down veterans’ hospitals and clinics across the country and turn over veterans health care to the private sector. The proposal was circulated outside the normal process by several members of a congressionally mandated Commission on Care created to study how VA will provide health care over the next couple of decades….

The proposal also calls for an immediate halt to new VA construction and for a “BRAC-like process” to begin shuttering existing hospitals and clinics, referring to the Pentagon’s base realignment and closure process. The department’s future role would essentially be to pay the bills of veterans getting care in the private sector….

Instead, the document simply asserts that “the current VA health care system is seriously broken and … there is no efficient path to repair it” without backing up the assertion, the chiefs wrote.

Stay tuned for a major battle!]

[Second PS: A Facebook friend pointed out this attempt to estimate how many vets died waiting for their eligibility to be determined: “307,000 veterans may have died awaiting Veterans Affairs health care, report says,” Curt Devine, CNN, September 3, 2015]

[Third PS – USA Today 4-7-2016 covers FOIA release with more specific data on wait-time scams:

But VA whistle-blowers say schedulers still are manipulating wait times. Shea Wilkes, co-director of a group of more than 40 whistle-blowers from VA medical facilities in more than a dozen states, said the group continues to hear about it from employees across the country who are scared to come forward.

“Until the VA decides it truly wants to change its corrupt and poor culture, those who work on the front lines and possess the true knowledge relating to the VA’s continued data manipulation will remain quiet and in hiding because of fear of workplace harassment and retaliation,” said Wilkes, a social worker at the VA Medical Center in Shreveport, La.

This is not the first time the VA has said it would fix problems with scheduling. When the inspector general found in 2005 that VA schedulers were improperly booking appointments — and wait lists were therefore underestimated by as many as 10,000 veterans — the agency initiated a “national education plan” to retrain schedulers and supervisors. In 2010, VA officials discovered schedulers were using “gaming strategies” to falsify wait times to meet agency performance targets, and they required all schedulers to undergo new training, once again.

]

Fourth PS!: CNN is doing some excellent original reporting on the VA. This item just popped up: a scam Vietnam​ Veterans charity (95% of the funds go to fundraising and “expenses”) is run by a high-level VA lawyer who pays himself $65K a year from charity funds. The VA apparently sees no problem with this, since they also don’t mind felons and pedophiles as employees.


[1] From “History – Department of Veterans Affairs (VA)”, VA web site, 4-3-2016.
http://www.va.gov/about_va/vahistory.asp
[2] “Trends in the Geographic Distribution
of VA Expenditures: FY2000 to FY2009,” Prepared by the National Center for Veterans Analysis and Statistics, December 2010.
http://www.va.gov/vetdata/docs/quickfacts/Gdx-trends.pdf
[3] Jerry Pournelle’s Chaos Manor, Sept. 10, 2010.
http://www.jerrypournelle.com/reports/jerryp/iron.html
[4] “A fatal wait: Veterans languish and die on a VA hospital’s secret list,” Scott Bronstein and Drew Griffin, CNN Investigations, 4-23-2014.
http://www.cnn.com/2014/04/23/health/veterans-dying-health-care-delays/
[5] Cohen, Tom. June 10, 2014. “Audit: More than 120,000 veterans waiting or never got care”. CNN. Cohen, Tom. June 10, 2014. http://www.cnn.com/2014/06/09/politics/va-audit/
[6] Oppel, Richard A., Jr. (June 20, 2014). “Every Senior V.A. Executive Was Rated ‘Fully Successful’ or Better Over 4 Years”. The New York Times. RetrievedJune 21, 2014.
[7] “Veterans Health Administration scandal of 2014,” Wikipedia accessed 4-4-2015, https://en.wikipedia.org/wiki/Veterans_Health_Administration_scandal_of_2014
[8] “Sanders stretched truth on VA record during debate, some vets say,” Drew Griffin and Curt Devine, CNN, October 14, 2015
http://www.cnn.com/2015/10/14/politics/bernie-sanders-va/
[9] From the Wikipedia entry “Healthcare in Cuba,” footnoted as from “Cuba’s Health in Transition and the Central and Eastern European Countries Experience”. Antonio Maria de Gordon. https://archive.is/gsqCq
[10] “Close call: VA worker reinstated with back pay after missing time due to being in prison for armed robbery,” Jazz Shaw, Hot Air, March 22, 2016
http://hotair.com/archives/2016/03/22/close-call-va-worker-reinstated-with-back-pay-after-missing-time-due-to-being-in-prison-for-armed-robbery/
[11] “VA Worker Gets Job Back Despite Armed Robbery Charge” 3-22-2016, Daily Caller news Foundation, Luke Rosiak.

VA Worker Gets Job Back Despite Armed Robbery Charge

[12] “Veterans’ Health Derailed By VA Skipping Out On Millions In Doctor Bills,” Luke Rosiak
Daily Caller News Foundation, 04/03/2016

Veterans’ Health Derailed By VA Skipping Out On MILLIONS In Doctor Bills

[13] “Veterans’ Health Derailed By VA Skipping Out On Millions In Doctor Bills,” Luke Rosiak
Daily Caller News Foundation, 04/03/2016
[14] “VA scandal hits home in painful fashion,” San Diego Union-Tribune, April 3, 2016. http://www.sandiegouniontribune.com/news/2016/apr/03/va-scandal-san-diego-hits-home/


Death by HR: How Affirmative Action Cripples OrganizationsDeath by HR: How Affirmative Action Cripples Organizations

[From Death by HR: How Affirmative Action Cripples Organizations,  available now in Kindle and trade paperback.]

The first review is in: by Elmer T. Jones, author of The Employment Game. Here’s the condensed version; view the entire review here.

Corporate HR Scrambles to Halt Publication of “Death by HR”

Nobody gets a job through HR. The purpose of HR is to protect their parent organization against lawsuits for running afoul of the government’s diversity extortion bureaus. HR kills companies by blanketing industry with onerous gender and race labor compliance rules and forcing companies to hire useless HR staff to process the associated paperwork… a tour de force… carefully explains to CEOs how HR poisons their companies and what steps they may take to marginalize this threat… It is time to turn the tide against this madness, and Death by HR is an important research tool… All CEOs should read this book. If you are a mere worker drone but care about your company, you should forward an anonymous copy to him.

 


More reading on other topics:

Jane Jacobs’ Monstrous Hybrids: Guardians vs Commerce
The Great Progressive Stagnation vs. Dynamism
Death by HR: How Affirmative Action is Crippling America
Death by HR: The End of Merit in Civil Service
Corrupt Feedback Loops: Public Employee Unions
Death by HR: History and Practice of Affirmative Action and the EEOC
Civil Service: Woodrow Wilson’s Progressive Dream
Bootleggers and Baptists
Corrupt Feedback Loops: Justice Dept. Extortion
Corrupt Feedback Loops, Goldman Sachs: More Justice Dept. Extortion
Death by HR: The Birth and Evolution of the HR Department
Death by HR: The Simple Model of Project Labor
Levellers and Redistributionists: The Feudal Underpinnings of Socialism
Sons of Liberty vs. National Front
Trump World: Looking Backward
Minimum Wage: The Parable of the Ladder
Selective Outrage
Culture Wars: Co-Existence Through Limited Government
Social Justice Warriors, Jihadists, and Neo-Nazis: Constructed Identities
Tuitions Inflated, Product Degraded, Student Debts Unsustainable
The Morality of Glamour

On Affirmative Action and Social Policy:

Affirmative Action: Chinese, Indian-Origin Citizens in Malaysia Oppressed
Affirmative Action: Caste Reservation in India
Diversity Hires: Pressure on High Tech<a
Title IX Totalitarianism is Gender-Neutral
Public Schools in Poor Districts: For Control Not Education
Real-Life “Hunger Games”: Soft Oppression Destroys the Poor
The Social Decay of Black Neighborhoods (And Yours!)
Child Welfare Ideas: Every Child Gets a Government Guardian!
“Income Inequality” Propaganda is Just Disguised Materialism

The greatest hits from SubstrateWars.com (Science Fiction topics):

Fear is the Mindkiller
Mirror Neurons and Irene Gallo
YA Dystopias vs Heinlein et al: Social Justice Warriors Strike Again
Selective Outrage
Sons of Liberty vs. National Front
“Tomorrowland”: Tragic Misfire
The Death of “Wired”: Hugo Awards Edition
Hugos, Sad Puppies 3, and Direct Knowledge
Selective Outrage and Angry Tribes
Men of Honor vs Victim Culture
SFF, Hugos, Curating the Best
“Why Aren’t There More Women Futurists?”
Science Fiction Fandom and SJW warfare

More reading on the military:

US Military: From No Standing Armies to Permanent Global Power
US Military: The Desegration Experience

New Discussion Forum Created

Since there have been a lot of comments lately on the attachment type pages, I created a new forum for readers of the blog to talk amongst themselves more quickly, since I’m not always able to check in to approve comments. Feel free to join it and post questions — I’ll answer those as time allows.

Forum Link — http://jebkinnison.boards.net/

The One-Question Narcissism Test

Robert Morse

He believes in himself.

You may have heard about this on NPR — I did. A paper (“Development and Validation of the Single Item Narcissism Scale (SINS)”) by Sara Konrath, Brian P. Meier, and Brad J. Bushman) discusses the development of a single question narcissism “inventory” (normally a battery of questions!)

The question?: “To what extent do you agree with this statement: ‘I am a narcissist.’ (Note: The word “narcissist” means egotistical, self-focused, and vain.)”

Unlike most anti-social sorts, narcissists are apparently not only aware of their tendencies, but not especially ashamed of them. A normal personality inventory takes pains to ask many questions and include cross-checks and misleading feints to try to prevent gaming the test to avoid a socially-disapproved result. This simple self-evaluation question turned out to be about as accurate in scoring narcissists as much longer and more subtle questionnaires.


Death by HR: How Affirmative Action Cripples OrganizationsDeath by HR: How Affirmative Action Cripples Organizations

[From Death by HR: How Affirmative Action Cripples Organizations,  available now in Kindle and trade paperback.]

The first review is in: by Elmer T. Jones, author of The Employment Game. Here’s the condensed version; view the entire review here.

Corporate HR Scrambles to Halt Publication of “Death by HR”

Nobody gets a job through HR. The purpose of HR is to protect their parent organization against lawsuits for running afoul of the government’s diversity extortion bureaus. HR kills companies by blanketing industry with onerous gender and race labor compliance rules and forcing companies to hire useless HR staff to process the associated paperwork… a tour de force… carefully explains to CEOs how HR poisons their companies and what steps they may take to marginalize this threat… It is time to turn the tide against this madness, and Death by HR is an important research tool… All CEOs should read this book. If you are a mere worker drone but care about your company, you should forward an anonymous copy to him.

 


More on Attachment and Personality Types:

What Attachment Type Are You?
Type: Secure
Type: Anxious-Preoccupied
Type: Dismissive-Avoidant
Type: Fearful-Avoidant (aka Anxious-Avoidant)
Avoidant: Emotions Repressed Beneath Conscious Level
Serial Monogamy: the Fearful-Avoidant Do It Faster
Anxious-Preoccupied: Stuck on the Dismissive?
Anxious-Preoccupied / Dismissive-Avoidant Couples: the Silent Treatment
nxious-Preoccupied: Clingy and Insecure Relationship Example
Domestic Violence: Ray and Janay Rice
Malignant Narcissists
Teaching Narcissists to Activate Empathy
Histrionic Personality: Seductive, Dramatic, Theatrical
Life Is Unfair! The Great Chain of Dysfunction Ends With You.
Love Songs of the Secure Attachment Type
On Addiction and the Urge to Rescue
Sale! Sale! Sale! – “Bad Boyfriends” for Kindle, $2.99
Controlling Your Inner Critic: Subpersonalities
“Big Bang Theory” — Aspergers and Emotional/Social Intelligence
Porn Addiction and NoFAP
Introverts in Management

“Trophy Wife” Actually Rare

Donald Trump and his third wife Melania Knauss-Trump

Donald Trump and his third wife Melania Knauss-Trump

The stereotypical “trophy wife” is less common than supposed, according to a new study reported by social science researcher Elizabeth A. McClintock: “Beauty and Status: The Illusion of Exchange in Partner Selection?”, American Sociological Review, 2014; DOI: 10.1177/0003122414536391

The “trophy wife” label generally refers to a beautiful but possibly not too bright wife of a powerful or wealthy husband, with the presumption she is a “trophy” of his high status selected for her looks, and in some sense trading her looks for access to the easy life offered by marrying a high-status man.

In the study (which is pay-to-view but was reported in Science Daily) young couples were interviewed separately and rated for physical attractiveness. Good-looking men tended to be with good-looking women, and highly-accomplished men tended to mate with high-accomplishment women.

“I find that handsome men partner with pretty women and successful men partner with successful women,” says McClintock, who specializes in inequality within romantic partnerships. “So, on average, high-status men do have better-looking wives, but this is because they themselves are considered better looking–perhaps because they are less likely to be overweight and more likely to afford braces, nice clothes and trips to the dermatologist, etc. Secondly, the strongest force by far in partner selection is similarity — in education, race, religion and physical attractiveness.”

McClintock’s research shows that there is not, in fact, a general tendency for women to trade beauty for money. That is not to say trophy wife marriages never happen, just that they are very rare.

“Donald Trump and his third wife Melania Knauss-Trump may very well exemplify the trophy wife stereotype,” McClintock says. “But, there are many examples of rich men who partner with successful women rather than ‘buying’ a supermodel wife. The two men who founded Google (Larry Page and Sergey Brin) both married highly accomplished women — one has a PhD and the other is a wealthy entrepreneur.”

McClintock says the trophy wife stereotype is most often wrongly-applied among non- celebrities. “I’ve heard doctors’ wives referred to as trophy wives by observers who only notice her looks and his status and fail to realize that he is good-looking too and that she is also a successful professional–or was before she had kids and left her job,” McClintock says.

McClintock’s research also indicates that, contrary to the trophy wife stereotype, social class barriers in the marriage market are relatively impermeable. Beautiful women are unlikely to leverage their looks to secure upward mobility by marriage.

Thus the stereotype would appear to be a kind of selection or detection bias: you notice the beautiful wife, assume that characteristic is why her husband selected her, but fail to notice that she is a high-status or accomplished person on her own, and that her husband is also good-looking. This is similar to the common stereotype that Prius drivers tend to drive too slowly in the left lane of freeways, based on the easy identification of a Prius and the tendency to only notice the Prius drivers that are slow.

More on Attachment and Personality Types:

What Attachment Type Are You?
Type: Secure
Type: Anxious-Preoccupied
Type: Dismissive-Avoidant
Type: Fearful-Avoidant (aka Anxious-Avoidant)
Avoidant: Emotions Repressed Beneath Conscious Level
Serial Monogamy: the Fearful-Avoidant Do It Faster
Anxious-Preoccupied: Stuck on the Dismissive?
Anxious-Preoccupied / Dismissive-Avoidant Couples: the Silent Treatment
nxious-Preoccupied: Clingy and Insecure Relationship Example
Domestic Violence: Ray and Janay Rice
Malignant Narcissists
Teaching Narcissists to Activate Empathy
Histrionic Personality: Seductive, Dramatic, Theatrical
Life Is Unfair! The Great Chain of Dysfunction Ends With You.
Love Songs of the Secure Attachment Type
On Addiction and the Urge to Rescue
Sale! Sale! Sale! – “Bad Boyfriends” for Kindle, $2.99
Controlling Your Inner Critic: Subpersonalities
“Big Bang Theory” — Aspergers and Emotional/Social Intelligence
Porn Addiction and NoFAP
Introverts in Management

Marital Discord Linked to Depression

CoupleFighting600x396

Studies generally agree that a happy marriage lowers stress and confers long-term health advantages. On the other hand, an unhappy or stressful relationship may be worse than living alone. This study from University of Wisconsin-Madison researchers demonstrates a link between marital discord and a tendency toward depression, as the burnt-out stress system is also less activated by positive thoughts and experiences.

Which tells us what we already knew: having as your closest partner someone who constantly stresses you out is very bad for you, while the right sort of partner reduces your stress level and increases happiness. Now we wait for the study on how to improve contentious relationships!

More on Divorce, Marriage, and Mateseeking

Marriages Happening Late, Are Good for You
Monogamy and Relationship Failure; “Love Illuminated”
“Millionaire Matchmaker”
More reasons to find a good partner: lower heart disease!
“Princeton Mom” Susan Patton: “Marry Smart” not so smart
“Blue Valentine”
“All the Taken Men are Best” – why women poach married men….
“Marriage Rate Lowest in a Century”
Making Divorce Hard to Strengthen Marriages?
Student Loan Debt: Problems in Divorce
“The Upside of ‘Marrying Down’”
The High Cost of Divorce
Separate Beds Save Marriages?
Marital Discord Linked to Depression
Marriage Contracts: Give People More Legal Options
Older Couples Avoiding Marriage For Financial Reasons
Divorced Men 8 Times as Likely to Commit Suicide as Divorced Women
Vox Charts Millennial Marriage Depression
What’s the Matter with Marriage?
Life Is Unfair! The Great Chain of Dysfunction Ends With You.
Leftover Women: The Chinese Scene
Constant Arguing Can Be Deadly…
“If a fraught relationship significantly shortens your life, are you better off alone?
“Divorce in America: Who Really Wants Out and Why”
View Marriage as a Private Contract?
“It’s up there with ‘Men Are From Mars’ and ‘The Road Less Travelled’”
Free Love, eHarmony, Matchmaking Pseudoscience
Love Songs of the Secure Attachment Type
“The New ‘I Do’”
Unrealistic Expectations: Liberal Arts Woman and Amazon Men
Mark Manson’s “Six Healthy Relationship Habits”
“The Science of Happily Ever After” – Couples Communications
Free Dating Sites: Which Have Attachment Type Screening?
Dating Pool Danger: Harder to Find Good Partners After 30
Mate-Seeking: The Science of Finding Your Best Partner
Perfect Soulmates or Fellow Travelers: Being Happy Depends on Perspective
No Marriage, Please: Cohabiting Taking Over
“Marriage Markets” – Marriage Beyond Our Means?
Rules for Relationships: Realism and Empathy
Limerence vs. Love
The “Fairy Tale” Myth: Both False and Destructive
When to Break Up or Divorce? The Economic View
“Why Are Great Husbands Being Abandoned?”
Divorce and Alimony: State-By-State Reform, Massachusetts Edition
“Sliding” Into Marriage, Small Weddings Associated with Poor Outcomes
Subconscious Positivity Predicts Marriage Success…
Why We Are Attracted to Bad Partners (Who Resemble a Parent)