I am a doctor. Professional standards require me to have evidence, also known as scientific proof, that what I suggest to a patient is the best available choice. I am also expected to share that evidence with the patient.
“Trust me,” is not acceptable as a justification for my choices. When it comes to our health, patients need to be sure that the decision they make has solid evidence proving that it will help.
In the commercial world, evidence is also required before decision-making, but for a different reason It is not some code of professional standards that forces them to look at hard facts. It is the crucible of a free market. If business people make decisions without good evidence or use "cooked" data, the company will lose money, and a competitor will “eat their lunch.” Soon the company making decisions free of evidence will be out of business.
In a large, complex organization, a manager who advises the corporation to hire his big sister’s third cousin instead of a well-qualified, highly credentialed person with excellent references will soon find himself out on the street looking for a job.
In contrast to commerce or medicine, our government bureaucracy has three different and quite inappropriate ways to handle data: evidence avoidance, evidence alteration, and their most common mode, evidence-free decision making.
Evidence Avoidance
CGI – Conseillers en Gestion et Informatique, French for “Consultants in management and information technology” – is a Canada-based multinational Information Technology consulting company that was responsible for the now-infamous first version of healthcare.gov.
Even before the Obama administration hired CGI, they had a questionable reputation based on previous history of failed projects and unsatisfactory reports from people who had used them in the past. They were chosen by the Obama administration to develop a $93 million web site. Why? Because our government decided to ignore the evidence right in front of them.
The glitches, failures, blind alleys, user-unfriendliness, and data losses of healthcare.gov are all nicely documented. CGI was fired but still got paid, just like Jonathan Gruber. The price tag for healthcare.gov is now over $690 million and rising. We The People will pay probably a billion dollars … for a web site that sells something more than 50 percent of us don’t want.
(Did you know that the young woman whose face was used to promote on the healthcare.gov website asked that her likeness be removed?)
In this Friday, Oct. 11, 2013 computer frame grab, the HealthCare.gov website is displayed. The model whose face appeared on the much-maligned Obama health care website says she felt intimidated by harsh public criticism of the program. The woman, who identified herself only as "Adriana" in an interview with ABC News, says she was never paid for appearing on the website's home page. (AP/HealthCare.gov)
The story of government evidence-avoidance has now reached a pinnacle. Guess whom the IRS hired to verify eligibility for subsidies; to develop new tax forms; and to track the more than 6 million Americans who will be subject to penalties? That’s right, you guessed it – CGI!! This is a new high for government “evidence-avoidance.” They avoid even their own history with CGI and their failures.
Evidence Alteration
The Congressional Budget Office is typically described as a non-partisan agency on whose accounting results we can rely. That description is disingenuous. The CBO is as much a government organ as the Food and Drug Administration, the Enivornmental Protection Agency, or National Institutes of Heakth. As such, it is more sensitive to political sensibilities than to any commitment to the truth.
The recent CBO accounting of the Medicare Trust Fund is a case in point. It used evidence-alteration, so-called cooking the books, fitting their results to a pre-conceived, politically-directed conclusion.
The Balance Budget Act of 1997 created a formula called the Sustained Growth Ratio that reduces the large and increasing deficit in the Medicare Trust. When the ratio was passed, Medicare’s projected date-to-bankruptcy was 2015. Ever since 2003, Congress has stopped the application of the ratio and therefore the deficit has been growing. However, when the CBO accounted the Trust for its 2014 Report on Medicare, it calculated the amount in the Trust as though the ratio had been in effect, while knowing that it had not. Thereby, the CBO projected Medicare’s date-to-bankruptcy was now 2030, even though my own calculation suggests it will be insolvent during the first post-Obama administration.
In late 2014, the president hailed the success he had achieved in balancing Medicare’s budget based on the false, frankly fraudulent CBO Report. This was alteration-of-evidence by the government.
Evidence-Free
While there are so many choices for a good example of government decision making free of any evidence, Obamacare is probably the acme.
Did Congress have any, repeat any, hard evidence that proved the Patient Protection and Affordable Health Care Act, now called Obamacare, would do what was promised? What was this evidence? Where was it? What did the Democrats offer us except “Hope & Change”?
Nancy Pelosi gave us proof of the government’s lack of evidence for Obamacare when she said, “We’ll have to pass it to see what’s in it.”
How can you possibly have evidence-of-effect when you don’t know what you need evidence about?
Look at CGI, at the Medicare Trust, and at Obamacare, and ask yourself these questions:
Why do we tolerate government actions that would be malpractice in medicine or suicide in business? In fact, why do we keep sending back the same people to Washington who make evidence-free decisions, that consistently hurt rather than help We The People?
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