For the left, the Department of Veterans Affairs is how health care is ideally supposed to work. No insurance companies, no private doctors, no competition — just the government and the patient.
Paul Krugman, The New York Times columnist, has held up the VA as a model for the entire country. The Washington Monthly ran a famous article in 2005 arguing that the VA was leading the way for U.S. health care. The socialist senator from Vermont, Bernie Sanders, is such a reflexive defender that in an instantly notorious interview on CNN he pooh-poohed the burgeoning scandal that may involve fatalities with the undeniable observation that “people die every day.”
The VA is an island of socialism in American health care. It generally provides adequate care — to a limited universe of people and for only certain conditions — but has been plagued by scandal for decades. It is perhaps the worst bureaucracy in the federal government. As with all such single-payer-type systems, the cost of the notionally free health care is in the rationing, in this case the wait times that have had desperately ill vets hung out to dry for months.
Paul Waldman wrote a blog post in The Washington Post Wednesday imploring President Barack Obama to fix the VA to redeem the liberal vision of government. If six years into his presidency he has yet to fix the VA he promised to fix before he took office, that’s either an indictment of his presidency or the liberal vision of government or both.
As my National Review colleague Jonah Goldberg points out, the usual excuses don’t apply here. The existence of the VA isn’t politically controversial. No one is trying to repeal it, or “sabotage” it. It hasn’t lacked for funds. Its budget has been increasing at a rapid clip. What we’re seeing is simply unaccountable bureaucracy in action.
When the bench mark was created for VA facilities to get vets appointments within 14 days, meeting the goal was easy: All it took was logging appointments dishonestly to hide the wait time, and administrators could duly pocket their performance bonuses. This is how poorly performing government bureaucracies have met goals from time immemorial; it’s why, on a much more vast and monstrous scale, Soviet five-year plans were always such runaway successes on paper.
The VA system worked for everyone but the patients — and the whistleblowers. The daughter-in-law of a Navy vet in Phoenix who died after never getting follow-up for his “urgent” case was told, in lines that perfectly capture the spirit of socialized medicine, “It’s a seven-month waiting list. And you’re gonna have to have patience.”
So far, the VA affair is running the usual course of such Obama administration scandals, with the requisite denial and lack of accountability. VA Secretary Eric Shinseki has referred to the wait-time problems at facilities as “isolated cases” (even though 26 facilities are now under investigation). No one has been fired. One of Shinseki’s deputies, Dr. Robert Petzel, resigned, but was scheduled to retire this year anyway. It was an appropriately Potemkin departure in a scandal involving Potemkin waiting lists.
The White House has reverted to its default position of maintaining that it doesn’t know much about what’s happening in the vast government it always wants to make bigger. Spokesman Jay Carney seemed to suggest the other day that the president first heard about the scandal from a CNN report. Pity the president having to wait for the coverage of missing Malaysian Flight 370 to die down before learning about malfeasance at his own VA.
Of course, the problem with wait times and the trustworthiness of the VA’s own reporting should have been news to no one. The Government Accountability Office has been warning of it since 2000. It headlined a report published in December 2012, “VA HEALTH CARE: Reliability of Reported Outpatient Medical Appointment Wait Times and Scheduling Oversight Need Improvement.”
The VA obviously isn’t going anywhere, but the scandal should be the occasion for making it more transparent and accountable and giving vets more choices. As Pete Hegseth of Concerned Veterans for America writes, the VA should be “a results-driven, customer-service-oriented agency.” As of now, it’s a case study in how a bureaucracy tends to its own interests, even at the expense of veterans relying on it for matters of life and death.