Consistently ranked as one of the top ten Hospitals in America, this week, Massachusetts General Hospital was lucky enough to be visited by a crack team of hacker-jackers to improve the efficiency of the hospital. And, boy did they!! Pull up a chair and throw a log on the campfire, boys and girls. You’ll be amazed at how much money they saved!
And by “saved” I mean “saved from going into stupid, unglamorous things like bedpans and surgical masks and instead being funneled into the pockets of billionaires.” It’s not all that surprising. After all, it’s well known that poor people tend to waste their money on trivialities like food, clothing, shelter, and child care while billionaire geniuses tend to spend their money on important things like buying yachts, vacation homes, Judges on the US Extreme Court, and golden toilet seats.
We don’t typically think of surgeons as “poor people” but compared with the greediest people on the planet they sure are! The average salary of surgeons is only about 300 thousand dollars a year while world’s greediest man made over $200 billion! If we round down the surgeon salaries because they often pay taxes, we discover that he makes a million times more than a surgeon! So, it’s not really a great surprise that he can also make a hospital a million times more efficient!
First, President Mush discovered that every single patient seen at Mass General Hospital in its first one hundred years of existence (1811 to 1911) died! Yes, you heard that right: Died! Despite its reputation and ranking, not a single patient seen in that entire century is still alive!
(AI generated image to the prompt: “A graveyard with scores of tombstones. Each tombstone shows birth dates and death dates in the 1800’s.” Notice any issues?).
So, the first brilliant insight of The World’s Greediest Man is simply that Mass General Hospital is actually no better at preserving life than no hospital at all! Everyone who lived during those same years (1811 to 1911) and did not go to Mass General is also dead. There’s no difference! All that money wasted on medical care made no difference at all in the end.
A good workman doesn’t blame their tools. But that doesn’t mean that tools don’t differ in their efficiency. Surgeons, probably because they have a phallic fixation, prefer long thin tools like scalpels, catheters, and scissors. These are not tools for fast work though. For instance, a typical quadruple bypass surgery takes three to six hours! Are you kidding me!? No wonder hospitalization is so expensive.
President Mush and his cracker-jack hackers discovered that there is no part of the human anatomy that cannot be cut much faster with an ordinary chain saw. Sure, the feminized, woke, namby-pamby doctor boys will say that a chain saw isn’t delicate enough for heart surgery. How ridiculous is that? If it’s good enough to hack limbs off a tree, it’s good enough to hack cholesterol out of an artery or whatever the hell it is these pretty boys do during heart surgery.
(AI generated image to the prompt: “A hospital operating room with bright lights. A patient is on the table. The patient is being operated on by a surgeon wielding a chain saw.”)
Not only are there direct savings from having more efficient surgical tools. There are side benefits. When surgery takes three to six hours, time is wasted prepping the patient, giving them pain-killers, monitoring their vital signs, giving them blood—on and on and on. You don’t need such an elaborate set-up when you use a chain saw.
There are other advantages and cost-savings as well. There’s no room between here and the end of this article to list them all in detail, but you can take The World’s Greediest Man at his word. It doesn’t matter if he lies every day on the platform he bought to spout lies. He might lie about test results or political matters but certainly not when it comes to money.
One simple example arises from vastly simplified training programs. Limit doctoring to rich, white, Nazi, males since they are obviously superior. In fact, they are so superior that they demand every aspect of society be even more unfairly tilted so they are guaranteed a win in everything. That proves they’re superior. While training a doctor today takes more than a decade, you can show a rich, white, Nazi male how to run a chain saw in minutes!
For this and other reasons, formulas, fudging, faking, numbers, data, hand-waving, obfuscation, and moving things over three to ten decimal points, President Mush and his hacker-jacks will be able to cut over $5 trillion dollars from Medicare and Medicaid thus enabling an additional $500 trillion dollars to flow into the pockets of The World’s Greediest Man. These savings will also erase the national debt and cause water to flow uphill. Do the math!
This money, by the way, will not be spent on some stupid vanity project such as saving starving children or keeping the earth’s ecosystems from collapsing. Instead, it will be spent on something important and visionary—establishing a Cult Colony on Mars for President Mush and a carefully chosen cohort of consorts to populate the red planet.
Let’s face it. Earth is overrun with all sorts of life forms that are not The World’s Greediest Man. Why would anyone want that? Yech! Spiders! Bees! Trees! Birds! Bacteria, for God’s sake. Mold. Mushrooms. Flowers. Polar bears. Dragonflies. None of them is a problem on Mars. It’s got sand and rocks. And, once The Greediest Man on Earth is there, it will have everything it needs.
(AI generated image to the prompt: “Two rectangular panels. On the left is an image of a lush and beautiful garden with flowers, birds, and butterflies. On the right is an image of the Martian desert with no plants of any kind. Nothing green appears in the right hand image.” This was my fourth attempt to remove any plants from the image of Mars!)
Increased government efficiency! Sign me up! That sounds great!
It sounds especially great if your billionaire-owned media companies keep reminding you that you are paying too much in taxes! Not only that! The national debt keeps going up, up, up and your kids and grandkids will have to pay even more in taxes. And, hey—if billionaires don’t end up paying any taxes, that actually a good thing because that way they can create lots of new jobs! And, besides, if they weren’t doing something worth billions and billions of dollars, why would they be so rich? Of course they deserve it! And, if CEO’s weren’t paid outrageous salaries, they wouldn’t even be CEO’s and some second rate person would just run the company into the ground.
It all sounds so plausible. Yet, every bit of it is a lie. But it isn’t just a bunch of lies that’s been told here and there by a few people. It’s been propagated over and over and over and over again for decades on various media and on social media. It’s been propagated on podcasts, and books, and pamphlets.
“That old lady doesn’t deserve to steal your one cookie! Watch out for her!”
Here are some things to consider.
The very greediest people in the world are not necessarily the most competent. Most jobs are actually created by small businesses, not by giant corporations. Giant corporations often outsource jobs to other countries where the labor is cheaper and where they don’t have to follow any pesky child labor laws or safety in the workplace regulations. Increasingly, giant corporations look to automate more and more jobs and to use AI to replace people.
Highly paid CEO’s have often run giant companies into the ground. Remember that on your next trip to Montgomery Ward’s or Radio Shack. Who else? Lehman Brothers, Bank of New England, Texaco, Chrysler, Enron, PG&E, GM, WorldCom and a host of others. But wait! GM still makes cars. I can get gas at a Texaco station. How could it be that they went bankrupt. You bailed out GM. Texaco went bankrupt, but the brand name was still worth something. Chevron owns the brand.
Also note that in countries where the CEO’s are only paid ten times the average wage of their employees instead of a thousand times as much, the CEO’s do just as good a job.
Are government agencies sometimes inefficient? You bet your life! And you know what else is sometimes inefficient? Everything! Small businesses are inefficient. Large businesses are inefficient. Medium sized businesses are inefficient. Your car engine is inefficient. Your body is inefficient. Your furnace is inefficient. Your stove is inefficient.
You know what is 100% efficient? Things in your dreams. Things in your imagination. I’m not only efficient in my dreams—my God!—I can frigging fly! When I play basketball in my dreams, I can not only jump higher than I ever have in real life, I can hover near the rim! It’s amazing how well I can play various sports when I dream about them.
(AI generated image of an oldster jumping high in a dream.)
But that’s not reality.
In reality, yes, you can improve the efficiency of systems. But to do so effectively, you have to understand the systems you are trying to make more efficient. Here are just a few of the things you need to understand.
You need to understand what the purpose of the system is. How is its performance measured? Who are the stakeholders? What are the different roles that people play? What formal processes and procedures do various people have to follow? What are the unwritten norms that people follow? These are often more important than the formal processes.
You may recall the scene from the movie A Few Good Men when the attorney points out that “Code Red” is nowhere in the manual. He implies that if “Code Red” is not in the manual, it does not exist. Tom Cruise points out the absurdity of this by asking the witness to point out in the manual where it lays out where the mess hall is. Of course, it doesn’t say that because people learn from others where it is.
In almost every complex organization, people find critical short-cuts and work-arounds to improve the efficiency and effectiveness of the organization. In fact, one of the things people sometimes do to protest idiocy on the part of management is to “Work by the Rule” which means they will not do the things they have discovered make things easier but instead follow the written rules to the letter which typically slows things down considerably.
During the 1990’s, management fell in love with something called “Business Process Re-engineering.” This is how it often worked (or, to put it more honestly, how it often failed to work). Management consultants would come in and talk to a few third or fourth level managers to find out how the work was performed now. The consultants would then construct a map of how things worked (often called the “is map”) and then, they would figure out a more efficient way to do things and map that out; the “to be map.” Then, it was the job of management to make people use the new “more efficient” process rather than the old process.
(AI generated image of the Trumputin Misadministration.)
That seems like a good idea—right? Well, yes, in a dream, it’s a good idea. But in reality, the third or fourth level manager hardly ever knows how things are actually done. Their mental model is a vast oversimplification. To understand what is going on in reality, you must observe the people actually doing the work and talk to them as well.
Below is a link to a satirical piece I wrote some time ago that imagines “Business Process Re-engineering” coming to Major League Baseball to make it more efficient. It is meant to make it obvious how silly it is.
But what DOGE is doing is much worse that Business Process Re-engineering. Even putting aside the obvious conflicts of interest and the illegality of what they are doing, they are going about “improving” things without even understanding the high level over-simplification of what is happening!
Imagine you slipped on the ice and broke your arm. Sadly, it’s not a simple fracture. It’s a compound fracture. This means your bone is sticking out through your skin. You are in a great deal of pain. But no worries! While you are going to the emergency room, a group of teen-age hackers go on-line and examine all your private medical records. They discover that you were vaccinated for smallpox, measles, mumps, and whooping cough. Not only that—they look through a sample of other records and find that more than 90% of the Americans who break their arms have been vaccinated for these diseases! Voila! The vaccinations must be the real cause of your broken arm!
(An AI-generated image for the following prompt: “A man has a compound fracture of the upper arm. The arm bone (the humerus) is jutting out of his shirt and his arm. He is bleeding.”)
These folks don’t know diddly squat about medicine, but they sure know how to hack into systems in order to get data! What they are not so good at, however, is making valid inferences about the data they find. You cannot conclude anything from the fact that 90% of Americans who break their arms have been vaccinated without also finding out about other things. For instance, you also need to know what percentage of Americans who have not been vaccinated have also broken their arms. Suppose it’s 95%. That might mean that vaccinations serve some protective function about bones. Or not. We need to look at other things too. But, let’s suppose that they do look at that and it turns out that only 80% of Americans who have not been vaccinated break their arms. See! See! Surely, that proves that vaccinations cause arm breakage.
Not so fast. You still need to look at other factors. Suppose that people who do not get vaccinated tend to die at a much younger age. That could easily account for the difference. All sorts of factors have some influence on the incidence of fractures. Just to name a few, it depends on the type of fracture; it depends on age; it depends on the prevalence of certain activities (people who ski, or paraglide might tend to break more bones than people playing chess); it depends on diet; it depends on weight bearing exercise. If you lift weights and go to the gym, you help protect yourself from fractures. Of course, separating out all these factors takes time and takes expertise. You can’t expect someone, not matter how brilliant a hacker they are, to find an answer.
But hey! We left you in the emergency room! Sadly, we left you there all by yourself. There are no human experts at the hospital, as it turns out, because the hospital was closed due to lack of funding. You happen to be unlucky enough to have been born in a rural area of the country. There’s only one nearby hospital and much of its funding has been cut. It has to operate with a skeleton crew. But, as it turns out, skeletons, ironically, don’t actually know that much about medicine. They are, after all, skeletons. And while a hacker might come to the conclusion that skeletons are much more efficient than flesh and blood humans (lighter, no caloric requirements), it turns out that they cannot move or think without other parts of the body. To make up for that, DOGE put in some automation and AI systems. But they didn’t have time to debug the system before moving on to the next project.
(AI generated image).
The last thing you experienced before passing out and dying from sepsis was this little snippet of dialogue with the AI system.
“Hello! I am the brilliant AI system called MUSH: Multi-User System for Health. I am here to help you with your medical problem! What seems to be your problem?”
“I broke my arm. Can’t you see? My bone is sticking out through my shirt sleeve.”
“Excellent! We’ll have that fixed in no time. Please put your insurance card in the slot provided.”
“I can’t. It’s in my wallet and I can’t reach it with my left hand. And I can’t move my right arm at all.”
“Excellent! We’ll have that fixed in no time. Please put your insurance card in the slot provided.”
“I need a human operator.”
“Excellent! We’ll have that fixed in no time. Please put your insurance card in the slot provided.”
“No, you don’t get it. I have an insurance card but I can’t reach it.”
“You have failed three times to insert your insurance card. Next patient please. I hope you will fill out a short questionnaire about your experience with MUSH: Multi-User System for Health.”