Лучше меньше, да лучше

Dateline Washington DC, 12/29/13 MUST CREDIT PBA NEWS Breaking

PBA News has exclusively obtained a draft of the report that President B.H. Obama has prepared over the Christmas break. The report is expected to be released in full on New Year’s Eve, when it is expected to receive little attention. A final draft was delivered to PBA News by a source close to the leadership of HHS. We have confirmed the existence and content of the report with multiple sources,, and are publishing early as a service to the public.

In the matter of improving our healthcare system, Healthcare.gov should not, in my opinion,  either strive after quantity or hurry. We have so far been able to devote so little thought and attention to the efficiency of the website that it would now be quite legitimate if we took special care to secure its thorough organisation, and concentrated in the Department of Health and Human Services a staff of workers really abreast of the times, i.e., not inferior to the best Amazon.com standards. For an Obama solution this condition is, of course, too modest. But our experience of the first four years has fairly crammed our heads with mistrust and scepticism. These qualities assert themselves involuntarily when, for example, we hear people dilating at too great length and too flippantly on “affordable” health care. For a start, we should be satisfied with real health care; for a start we should be glad to dispense with the crude types of medical care, i.e., Medicare or VA hospitals, etc. In matters of medicine, haste and sweeping measures are most harmful. Many of our young Navigators. and web designers should get this well into their heads

Thus, in the matter of the Affordable Care Act, we should now draw the conclusion from our past experience that it would be better to proceed more slowly.

Healthcare.gov is so deplorable, not to say wretched, that we must first think very carefully how to combat its defects, bearing in mind that these defects are rooted in the past, which, although it has been overthrown, has not yet been overcome, has not yet reached the stage of a culture that has receded into the distant past. I say culture deliberately, because in these matters we can only regard as achieved what has become part and parcel of our culture, of our social life, our habits. We might say that the good in our medical system has not been properly studied, understood, and taken to heart; it has been hastily grasped at; it has not been verified or tested, corroborated by experience, and not made durable, etc. Of course, it could not be otherwise in a revolutionary epoch, when development proceeded at such break-neck speed that in a matter of four years we passed from a free market for healthcare to the Obamacare.

It is time we did something about it. We must show sound scepticism for too rapid progress, for boastfulness, etc. We must give thought to testing the steps forward we proclaim every hour, take every minute and then prove every second that they are flimsy, superficial and misunderstood. The most harmful thing here would be haste. The most harmful thing would be to rely on the assumption that we know at least something, or that we have any considerable number of elements necessary for the building of a really new medical apparatus, one really worthy to be called Obamacare.

No, we are ridiculously deficient of such an apparatus, and even of the elements of it, and we must remember that we should not stint time on building it, and that it will take many, many years

What elements have we for building this apparatus? Only two. First, the workers who are absorbed in the struggle of web design. These elements are not sufficient educated. They would like to build a better apparatus for us, but they do not know how. They cannot build one. They have not yet developed the culture required for this; and it is culture that is required. Nothing will be achieved in this by doing things in a rush, by assault, by vim or vigour, or in general, by any of the best human qualities. Secondly, we have elements of knowledge, education and training, but they are ridiculously inadequate compared with private enterprises.

Here we must not forget that we are too prone to compensate (or imagine that we can compensate) our lack of knowledge by zeal, haste, etc.

In order to transform our healthcare delivery system we must at all costs set out, first, to learn, secondly, to learn, and thirdly, to learn, and then see to it that learning shall not remain a dead letter, or a fashionable catch-phrase (and we should admit in all frankness that this happens very often with us), that learning shall really become part of our very being, that it shall actually and fully become a constituent element of our social life. In short, we must not make the demands that were made by individualists, but demands that are fit and proper for a country which has set out to transform its medical treatment system

The conclusion to be drawn from the above are the following: we must make Health and Human Services a really exemplary. department, an instrument to improve Healthcare.gov.

In order that it may attain the desired high level, we must follow the rule: “Measure your cloth seven times before you cut.”

For this purpose, we must utilise the very best of what there is in our social system, and utilize it with the greatest caution, thoughtfulness and knowledge, to build up the new website.

For this purpose, the best elements that we have in our social system- such as, first, the advanced workers, and, second, the really enlightened elements for whom we can vouch. that they will not take the word for the deed, and will not utter a single word that goes against their conscience- should not shrink from admitting any difficulty and should not shrink from any struggle in order to achieve the object they have seriously set themselves.

We have been bustling for four years trying to build our website, but it has been mere bustle, which has proved useless in these four years, or even futile, or even harmful. This bustle created the impression that we were doing something, but in effect it.  was only clogging up our institutions and our brains.

It is high time things were changed.

We must follow the rule: Better fewer, but better. We must follow the rule: Better get good human material in two or even three years than work in haste without hope of getting any at all.

I know that it will be hard to keep to this rule and apply it under our conditions. I know that the opposite rule will force its way through a thousand loopholes. I know that enormous resistance will have to be put up, that devilish persistence will be required, that in the first few years at least work in this field will be hellishly hard. Nevertheless, I am convinced that only by such effort shall we be able to achieve our aim; and that only by achieving this aim shall we create a system that is really worthy of the name of Obamacare.

PBA News acknowledges the invaluable source Marxist Internet Archive.

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