Simple Arbitration

Daily Observer

September 28, 1973

 

Administration Strangles Freedom

 

            “You seem engrossed, Harry,” Lapius muttered.

            I dropped the newspaper.  Lapius was in a conversational mood that would not permit me the luxury of silent concentration.  “Sure I’m engrossed. This Watergate affair.  Politics sure is a dirty business.”

            “On the contrary my dear boy, it’s a glorious business.””

            I was aghast.  “I am aghast,” I said. “In the light of these disclosures how can you make a statement like that?”

            “They caught the scoundrels, didn’t they?”

            “Most of them,” I admitted.  “But they don’t always catch them.”

            “Remember, Harry, you can’t fool all of the people all of the time.”

            “But if you fool all of them just once, that’s the ball game.  You can kiss the country goodbye.”

            Lapius slammed his jaws tightly, preparing to issue a definitive statement.  “The country is safe as long as there’s a free press.  Actually, Harry, I have a lot of faith in the political process.  It is turbulent and encourages conflict.  Paradoxically, the real danger to the country resides in the nature of Congress.”

            Lapius was shifting ground too fast.  “How about Disneyland?”  I asked.

            “Don’t be coy,” he admonished.  “I say Congress because they establish administrative programs, and it is the administrative system that is choking the country, stifling its freedom.  Administration is the opposite of politics.  It is harsh and violent.  It permits no conflict.  The more programs Congress establishes the less freedom we have.  What once was accomplished by the tug of war between political pressure groups become rigidified in a set of rules.  The rules throw the system out of gear.  They replace reason.  They replace the pitched battles of the body politic.”

            “Come on Simon.  You’re pulling my leg.  Look how corrupt politics is.”

            “Of course it’s corrupt; - corruption on all sides.  That’s what gives the political system balance.”

            “But look at the excess.”

            “They balance out, bless them.  Excesses to the left and to the right oscillate finally somewhere near the center.  Corruptions cancel each other.  Administration, on the other hand while not itself corrupt, is corrupting.  This is because an administrative program can only be satisfied by a written record.  Since the requirements of a program are known in advance, people running the program find it compelling to contrive records that satisfy these requirements.  It would be silly of them to do otherwise.  In addition, the administrative system has no watchdog –.”

            “But you just praised the free press --.”

            “Humbug.  The press watches only the big events in the large arenas.  It can’t involve itself with all the minutiae --.”  Lapius stopped short and emitted a sigh of exasperation that zephyr-like, threatened to blow out the pilot in the stove.  “Harry, do you realize what percentage of our lives is conducted under administrative codes administered by administrators?  By God, it’s a whole new profession to be an administrator.  What was it William Shannon wrote--?”

            After eating, Lapius was usually too bloated to bestir himself. “There Harry, on my desk under the blotter.  I clipped it but hadn’t filed it yet.  Get it for me like a good lad.”

            I trotted obediently for the clipping and returned with it between my teeth.

            “Here’s what Shannon wrote.”  Lapius adjusted his bifocals and started to read.

            “Men and women who cannot teach physics or Greek or history, who cannot heal a sick child or build a bridge or write a poem, such person often find a living in the intellectual wasteland of educational administration.”

            “Of course,” Lapius continued, “Shannon referred to education, but it applies to administration in general.”

            “Simon,” I tut-tutted, “You are prejudiced.”

            “Not only prejudiced, Harry, but intolerant.  Take a simple example of an administered enterprise, a hospital.  You are familiar with hospitals, doctor, are you not?”  he asked bitingly.  I ignored the thrust.

            “Look at the conspiracy of corruption that exists in a hospital.”

            I looked but couldn’t see anything.

            “Aren’t you called to the record room to complete charts, doctor, under threat of having your privileges taken away?  Don’t you have to insert signatures that have been omitted, cover orders written by a resident physician in your absence, write final notes on patients that died in the middle of the night while you were sleeping?”

            “Of course, but that’s just to satisfy requirements of the Joint Commission for Accreditation of Hospitals (JCAH) and the state inspection committees, that charts be completed.”

            “Precisely.  But the assumption is that all this was done while the patient was still in the hospital.  The true representation of the fact is the appearance of the chart when the patient leaves the hospital.  To certify a medication you didn’t even know had been administered is fraudulent, yet there is collusion between all parties, the accreditation committees to alter a record in order to satisfy some administrative statute.”

            “But the statute is unrealistic.”

            “Of course it is.  But how can you change it to conform to reality.”

            “Go to the board of directors,” I suggested lamely.

            “The board of directors!  They won’t change a light bulb unless it is permitted in the hospital code.  They are simply an anonymous corporate body established to insure that the hospital runs properly according to law.”

            “What’s wrong with that?”

            “Everything.  The law isn’t a sick patient.  The law isn’t a tray of cold food, an overheated room, a hard bench in the emergency room, an understaffed nursing station.  The law isn’t human.  True, laws are written to insure the welfare of the patient, but administrators are trained to look to the law rather than the patient.”

            “What would you suggest?”

            “Conflict, Harry.  Conflict between a strong medical staff, a cohesive staff of employees and the administration, where criticism can fly back and forth without reprisal.  A tripartite system of equal powers all dedicated to the welfare of the patient.  The individual must be supreme.”

            “But in our society no individual is above the law.”

            “The patient is an exception.  The law must be bent in behalf of his welfare.”

            “Suppose there’s a deadlock between these three equal power.”

            “Then take it to arbitration.  Politicize the system.  Give it some freedom.”

            “Simon,” I said yawning, “I’m tired.  I’m going to bed.”

            “You are not,” he thundered, “I’m not finished yet.”

            “Simon.  To whom can I take this matter of my going to bed for arbitration?”

            “All right, go to bed,” he grumbled.