Every time I turn on the news these days I seem to hear about some new request, or outright appointment, of a "czar" of something or another in Obama's new administration. Nancy Killefer as "performance czar" (or "czarina"?), for example. I'm sure there will soon be a "green czar" and a "climate czar" and of course there's Dr. Sanjay Gupta as Surgeon General… effectively a "czar by any other name." I opened up my latest issue of Men's Fitness to find an editorial asking for another "fitness czar." A couple weeks ago we were discussing an "auto czar."
What the heck?
Cato has a good piece on the Surgeon General, which could be generalized (!) and applied to all such czaristic positions.
In reality, the surgeon general is little more than the “national
nanny,” hectoring us to stop smoking, lose weight, exercise more, and
never ever go out without a condom. I’ve been flipping through my copy
of the Constitution, and I can’t find the authorization for the federal
government to take taxpayers’ money to establish an office to tell us
how we should live our lives.
There are a few problems aside from the nanny and outright constitutional questions. First of all, aren't there private organizations already performing the function?
instructing us on how to be healthy, wealthy and wise without the
government’s getting involved. The American Lung Association can tell
us not to smoke. Alcoholics Anonymous can preach sobriety. The American
Medical Association can lecture couch potatoes on the benefits of
losing weight and exercising more. Planned Parenthood and the Family
Research Council can fight it out over when and how we should have sex.
And in most cases isn't there already a government, taxpayer-funded organization that is charged with the same responsibility?
a Department of Health and Human Services that is supposed to be
running the government’s health care programs. Why not let HHS take
over any useful functions of the Public Health Service and dump the
rest, including the surgeon general?
But the biggest problem hinges on the "responsibility" term I used above. What is the true "responsibility" of a czar? To pontificate? And what is the accountability and authority? Without authority and accoutability, responsibility is a myth and true performance is probably a pipe dream. John Seddon, a lean health care guru in the UK, has written extensively on this problem, which fellow lean blogger Mark has occassionally commented on. Czars without authority and accountability set targets and goals, which simply leads to gaming the system by those also without accountability to the authority-less czar. For example, to meet a "four hour accident and emergency" treatment target…
target which had meant extra staff were brought into casualty when
performance was being measured, meaning operations elsewhere in the
hospital had to be cancelled. Another gaming method involved patients having to wait in an ambulance outside A&E until staff were confident they could meet the target.
Ah yes… this will be fun. Czars and czarinas, already redundant with the responsibility of existing government organizations, spewing targets and goals galore with no one truly accountable to them, all trying to figure out how to make themselves look good. Gotta love it. Let the dysfunction begin.