Article 94. Flexibility of US Government Reform Design

The US Government Reforms Recommended at this website has a great deal of flexibility in its implementation (See Article 84).  The speed of implementation depends on the number of Outside Consultants who are permanently hired to manage the training and implementation of reforms in the OIG Departments.  I have recommended that about 17 of these specially trained employees be hired to start across the board reforms in 17 OIG offices. This will allow 17 reform implementations to be done simultaneously.  I have also recommended that these17 OIG offices report to a single new US office of Inspector General (This title may be modified) reporting to the OMB for coordination of reform implementations and subsequent  budget and efficiency management after reforms have been implemented.

An alternative to hiring 17 professional Right-sizers (consultants) to head OIG departments and to train OIG Analysts is the following:   Hire a professional Right-sizer to Head the new OIG organization (the USOIG) and have him train his current 17 OIG Department heads in the process of Right-sizing.  This will slow the implementation of reforms by only a few weeks but will bring unity to a diverse organization. The new OIG organization will delay its current responsibility for investigations until after Right-sizing and Enterprise lean have been implemented. When the reforms have been completed OIG Analysts will return to their current duties of investigations and will manage the bottoms-up manpower budgets of the department.

I recommend against a pilot implementation which can delay reforms for at least six months. But the number of OIG offices to be reformed can vary from 17.  The selection of the OIG offices is left up to the Trump Administration in planning for the reforms. One criteria that may be helpful is that the size of the OIG offices be approximately the same which will allow the implementations to end at the same time but this is not required.  OIG offices whose primary work is repetitive is best for work measurement and budget management.  OIGs whose work is repetitive but varies in length can be managed successfully using statistical processes.  However OIGs Like Homeland Security who respond to treats from outside are better left for the department to manage through planning.


U.S. Offices of Inspector General  (from Wikipedia)
Presidentially appointed inspectors general  
* Recommended that each be combined under new USOIG (reporting to the OMB) for implementation of Reforms and subsequent management of budgets and efficiency in addition to current OIG duties.

    Agency for International Development (AID-OIG)
    *United States Department of Agriculture (USDA-OIG) inline
    Central Intelligence Agency (CIA-OIG)
    *United States Department of Commerce (DOC-OIG)
    Corporation for National and Community Service (CNCS-OIG)
    *Office of the Inspector General, Department of Defense (DOD-OIG)
    *United States Department of Education (ED-OIG)
    *United States Department of Energy (DOE-OIG)
    *Environmental Protection Agency (EPA-OIG)
    Export-Import Bank of the United States (EIB-OIG)
    Federal Deposit Insurance Corporation (FDIC-OIG)
    *General Services Administration (GSA-OIG)
    *United States Department of Health and Human Services (HHS-OIG)
    Department of Homeland Security Office of Inspector General (DHS-OIG)
    *United States Department of Housing and Urban Development (HUD-OIG)
    *United States Department of the Interior (DOI-OIG)
    United States Department of Justice Office of the Inspector General(DOJ-OIG) 
    *United States Department of Labor Office of Inspector General (DOL-OIG) 
    *National Aeronautics and Space Administration (NASA-OIG)
    Nuclear Regulatory Commission (NRC-OIG)
    *United States Office of Personnel Management (OPM-OIG)
    Railroad Retirement Board (RRB-OIG)
    Small Business Administration (SBA-OIG) inline
    *Social Security Administration (SSA-OIG) inline
    United States Department of State — Office of Inspector General (OIG) for the U.S. Department of State and the Broadcasting Board of Governors (BBG) (DOS-OIG)    Tennessee Valley Authority (TVA-OIG) inline
    *Office of Inspector General for the Department of Transportation (DOT-OIG)
    United States Department of the Treasury (Treasury OIG)
    *Treasury Inspector General for Tax Administration (TIGTA) of the Department   of the Treasury
    *United States Department of Veterans Affairs (VA-OIG)

Overview of US Government Reform Process                                 As Recommended by Lawrence Rosier Principal Consultant

The process begins by the passage of a Congressional Reform Bill for funding and to clear the way for the orderly implementation of reforms. See Article 88.

The Reform Process  
Using the General Reform Model.   See Article 84

1. Simplification
Government activities to be reformed must first undergo a simplification process where: outdated, duplicated and noneffective operations are eliminated. I have developed the Consolidation Model and the Effectiveness Test to aid in this step.

2. Right-sizing
Professional outside Consultants are permanently hired to manage the training and implementation of Right-sizing done by Departmental OIG Analysts. Right-sizing involves: measuring the work required to do a process and the addition of all the processes to form what I call a bottoms up manpower budget providing the correct staffing needed to do the work.

3. Implementation of Enterprise Lean 
Enterprise Lean is implemented by organizing the work force into continuous improvement Teams. The leader of each Team is elected by the team members in most of the organization and may be appointed in the top management teams. OIG Analysts facilitate the process in each Department.  This process has been highly successful in improving government operations and in eliminating red tape in the states of Iowa and Minnesota.

4. Implementation of Team Management Replacing Bureaucracy
With several months of operation the Team Management organization will replace the Bureaucratic organization as the preferred management organization.

This approach will make the necessary improvements to 17 DC government departments.  With the widespread training of government personnel the remainder of the Federal government outside of Washington will eventually be reformed.

The above Government Reform process leverages the use of government OIG employees and minimizes the use of expensive outside consultants providing major reform at minimum expense.  The process was developed over a ten year period by Lawrence Rosier Principal Consultant.

Article 93. Example of Massive Medicare Fraud

 Example of Massive Medicare Fraud

Hospitals throughout the US in a large numbers are using sick and confused mostly elderly patients as cash cows billing Medicare for unnecessary treatments. This mass fraud is used to finance hospital operations and building projects.

Example of how the Fraud works:
An elderly person without a private Doctor seeks healthcare through the hospitals walk-in clinic.  The clinic gives convincing advice suggesting the patient needs blood tests and suggests that a hospital doctor becomes the patient’s private doctor.  Once the patient selects a private doctor connected to the hospital the Doctor arranges for extensive blood tests and other related tests including X-rays and other expensive observations.  The hospital can run-up thousands of dollars of unnecessary tests and exploratory operations all billed to Medicare.  This is not an isolated case but common practice.  At present there is no mechanism for preventing this type of fraud.  The cost of prosecuting those committing this type of fraud is in most cases greater than the cost of the fraud itself.

The Solution:
Require all Medicaid patients to have a private doctor.  This Doctor must be certified to be an independent doctor not connected to a clinic or a hospital in any way and subject to verification by Medicare.  The private doctor will independently determine what tests and exploratory operations are required for the patients healthcare.

This suggested solution can save $billions in unnecessary Medicare expenses.