Snow Jobs

Last weekend’s family vacation in the great state of Utah generated a characteristically keen insight: at very high levels of stupidity, it is in fact possible to collide with one’s own skipole, take a bad tumble, and crack several ribs. Ten very painful minutes later, I found myself in the Alta Ski Clinic. It‘s a small, seasonal operation. The usual economic reason to produce customer satisfaction (generate repeat business or referrals) doesn’t apply to the clinic; and for good measures, it’s (yikes!) a local monopoly. What a great place it is, though.  It’s run by Dr. Ken Libre, an all-around good guy and, intriguingly, a reformed policy wonk:  years ago, he left the Center for Strategic and International Studies and became a physician with a terrific entrepreneurial streak.  No one on his team earns downtown wages but they all get to ski over lunch. They love the mountain and their work, and it shows. The clinic doesn’t accept insurance, only cash. In a manner of speaking, the place is off the grid. That’s probably why you get your money’s worth and leave with warm and fuzzy feelings.

In contrast, arriving at the Medical Center near Salt Lake City for this additional test, that scan, and yonder questionnaire, you know right away you’ve entered the medical-industrial complex. You didn’t need a neck brace for the bouncy ride down the canyon; but they slap one on you in the Center’s parking lot because, the ambulance guys sheepishly explain, it’s required by Trauma II “protocol.” (Excess caution?  A way to hike insurance reimbursements?) Folks are competent, and some seem very dedicated; but the whole place oozes bureaucratic  values.  Good luck begging six people up and down the hierarchy to discharge you because you’re medically good to go (they’ve said so) and you have a plane to catch: the doctor isn’t in, the nurses are in report, the aides are in the cafeteria moping about their contracts, and there’s one more form for you to fill in and someone to sign.

Meanwhile in the Utah statehouse, on a not wholly unrelated note, Governor Gary R.  Herbert delivered a concise, measured, workman-like State of the State address, justly taking satisfaction in the state’s solid financial condition and its thriving economy. However, the editors of the Salt Lake Tribune  found fault with the governor’s  comment that

…frankly, the vast majority of regulations causing the most harm to Utah business come from Washington, D.C. – part of the regulatory colossus created by an overreaching, out-of-control, and out-of-touch federal government. I am firmly resolved to work with our Congressional delegation and my fellow Governors to tell the Washington bureaucrats to get out of the way of Utah’s economic recovery, and stop the senseless flow of onerous and misguided regulation from our nation’s capitol.

Surely, that observation is factually correct (think environmental regulation, energy policy, and land use control). Still, the Tribune’s editors found the“Don’t Tread on Me” tone disconcerting.  Echoing the theme, columnist Peg McEntee asked “Where would Utah be without the federal government?” “Utah has always relied heavily on federal money,” she noted, from Medicaid to military installations. That, too, is accurate; but what follows? McEntee:

Rather than erect a “bulwark against federal overreach,” as the governor put it, the people must be fully engaged in forging governments—state and federal—that work for all the people.

To call that a bromide is grossly unfair to binary compounds of all descriptions. For a true alternative to Governor Herbert’s healthy skepticism vis-à-vis Washington, the Tribune may wish to recall the memorable slogan of SNL’s Jamaican Tourism Bureau:  “Come Govern Us.”

Michael S. Greve is a professor at George Mason University School of Law. From 2000 to August, 2012, Professor Greve was the John G. Searle Scholar at the American Enterprise Institute, where he remains a visiting scholar. His most recent book isy The Upside-Down Constitution (Harvard University Press, 2012).

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Comments

  1. Daniel Artz says

    Here’s a little secret that the Medical Establishment would prefer you not know — you don’t need to wait for a doctor to “check you out”. You are not a captive, and if you feel well enough to walk out (yes, I said walk — tell the orderly that insists on wheeling you out in a wheelchair to stuff it!), then you are perfectly free to do just that. The Floor Nurse will tell you that she’ll have to put in your Chart that you left “against medical advice”, but so what? Medical advice is just that — advice, which you are free to accept or reject, just like advice from a lawyer or from a friend. So next time, if you are ready to go, but there’s no doctor to sign your discharge, because he’s out to lunch, in surgery, or stuck behind a slow foursome on the back nine, there’s no need to wait. Just tell the Nurse that you are leaving. She’ll undoubtedly say “But you can’t – you haven’t been discharged.”. Just tell her that yours was a statement, not a question; you have not been committed to the hospital by a court order, and you are free to leave when you feel like it.

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