LOWRY/The VA's socialist paradise
Wednesday, May 28, 2014 1:00 PM
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.
New York Times columnist Paul Krugman 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 long been plagued by scandal. 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.
The usual Obamacare excuses don't apply here. The existence of the VA isn't politically controversial. No one is trying to repeal it, or "sabotage" it. 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. 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 whistle-blowers. 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."
But the bureaucracy acted with alacrity when its reporting scheme was at risk. In St. Louis, the former chief of psychiatry says he was put under administrative investigation when he complained about wait lists. A whistle-blower who worked in Fort Collins, Colo., alleges that she and a colleague were transferred when they refused to hide wait times.
So far, the VA affair is running the usual course of Obama administration scandals, with the requisite denial and lack of accountability. VA Secretary Eric Shinseki has referred to the incidents 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 Malaysia Airlines 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 wasn't news. 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 of now, it represents 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.
Rich Lowry is editor of National Review. Reach him at firstname.lastname@example.org.