Jonah Goldberg:
There is only one guaranteed way to get fired from the Department of Veterans’ Affairs. Falsifying records won’t do it. Prescribing obsolete drugs won’t do it. Cutting all manner of corners on health and safety is, at worst, going to get you a reprimand. No, the only sure-fire way to get canned at the VA is to report any of these matters to authorities who might do something about it.
That, at least, is what the U.S. Office of Special Counsel recently reported to the president of the United States. The Special Counsel’s office is the agency to which government whistleblowers go to report wrongdoing.
“Our concern is really about the pattern that we’re seeing, where whistleblowers who disclose wrongdoing are facing trumped-up punishment, but the employees who put veterans’ health at risk are going unpunished,” Special Counsel Carolyn Lerner recently told National Public Radio.
Now, obviously, this shouldn’t happen. Everyone, except perhaps the managers at the VA, probably agrees with that. So by all means, let’s have some reforms and further protections for whistleblowers.
But that’s not a real solution. The real fix is to get rid of the VA entirely.
The United States has an absolute obligation to do right by veterans. It does not have an absolute obligation to run a lousy, wasteful, unaccountable, corrupt, and inefficient bureaucracy out of Washington. Of all those adjectives, the one that gets to the core of the problem is “unaccountable.”
Elected officials are supposed to be held responsible for the actions of the government, right? Well, which politician should we fire for the endless stream of outrageous VA scandals of the last few years? The president? Leave aside the fact that he won’t be on the ballot in 2016; not a lot of voters put reforming the VA bureaucracy at the top of their list of priorities.
Is there a congressman or senator who might lose an election because of the VA scandals? If there is, I can’t figure out who it might be. Every representative and senator has raced to the cameras to express their outrage, and not one is accepting a scintilla of responsibility for the problem. But they are all responsible because they have simply ceded authority to the bureaucrats themselves.
There is a reason the Founding Fathers put most governmental functions at the state and local level. It’s because a large nation cannot be run from the center.
Imagine that the federal government simply gave all of the VA hospitals to the states they’re in. Instead of the VA budget, Congress just cut checks to states to spend on their veterans. You’d still have problems, of course. But what you would also have are local elected officials — city councilmen, state legislators, mayors, governors, etc. — whom voters could hold directly accountable. Moreover, these officials would be more likely to understand the nature of the problems faced by their constituents.
I doubt anything could get worse by turning this over to the state.
The VA healthcare system has had serious problems on occasion, the same as any other large healthcare organization. With the VA, such problems become media events because they can be politicized. That’s good to the extent that media attention result in correction. It’s destructive, and entirely against the interest of veterans, to the extent that it becomes a means of attack on the existence of the institution itself.
There are a couple of underlying fact that Forbes mentions, which fail to get much attention:
That’s straightforward enough. In general, patients have better treatment outcome at VA hospitals, and are less likely to suffer harm—hospital related infections, for example—than in the private sector system.
Private sector hospitals and the private medical sector in general don’t tend to publicize things like long wait times, medication and treatment errors, failure to meet established standards for attentiveness and followups, problems with hospital contracted infections, etc. When such things come to the public’s attention, they don’t instantly become political weapons.
The push for privatization, of course, is always on the minds of people on the right, even when there’s little or no evidence that the private sector can perform the tasks in question cheaper or better, or even as well. With the right-leaning public, it’s a manifestation of a pervasive hostility toward government. With the corporate and financial sectors they simply want access to the cash streams, whether they relate to healthcare services, providing security services, or to the nation’s retirement system.
From the Rand Corporation: Improving Quality of Care; How the VA Outpaces Other Systems in Delivering Patient Care
One of the things I noticed after moving to Florida is billboards advertising low wait times in various Hospitals ERs which struck me because I’ve spent a couple very unpleasant nights in ER waiting rooms in NYC
A little competition is a good thing.