Still plagued by scandal, VA needs market reforms

The Department of Veterans Affairs just got another black eye — this time from its own internal auditor.

The VA’s inspector general reported earlier this month that the applications of nearly 900,000 veterans for health care were still “pending.” The agency’s record-keeping is so bad that one-third of those applicants may, in fact, be dead. The VA admits that it has no way of knowing.

This latest snafu comes more than a year after revelations of deadly waiting lists at the VA sparked an uproar.

Yet corruption and incompetence continue to plague the agency. That’s part and parcel of any government-run, single-payer health care system. The errors and substandard care for our nation’s vets won’t stop until Congress empowers them to demand better care by instituting market reforms in the VA.

A bevy of recent scandals have demonstrated that the agency has learned nothing in the past year.

In Ohio, a VA office is drawing criticism for “scheduling irregularities” that caused delayed appointments for pulmonary care patients, 150 of whom are now dead.

In Georgia, a VA program analyst in charge of solving long waiting lists was indicted last month for deliberately hiding the problem he was hired to solve.

In Pennsylvania, VA employees were caught manipulating the office’s backlog to hide waiting times.

And in Wisconsin, deficiencies in psychiatric care at a VA facility contributed to the death of a 35-year-old Marine, according to a
report this month by the VA’s inspector general.

VA officials are calling all this wrongdoing “mismanagement.” But it seems to be standard operating procedure at the VA — for the better part of a century, even before the agency became a cabinet-level department.

“Third-Rate Medicine for First-Rate Men” is how one newspaper headline described veteran health treatment in 1945.

In recent decades, failure to provide timely and quality care for veterans has resulted in major scandals, from New Orleans in 1976, to Los Angeles in 1981, to Chicago in 1991.

As is typical of massive bureaucracies, the VA routinely blames a lack of resources for these failures. And as is typical of elected politicians, Congress routinely obliges with increased funding.

But the VA’s problems have nothing to do with resources. Its budget has increased from $45 billion to $153 billion in the last 15 years. The agency’s spending increased nearly 200 percent — while the number of veterans increased only 68 percent.

In fact, with over 275,000 workers, the Veterans Health Administration is the largest non-defense employer in the federal government.

Single-payer systems allocate resources from the top, causing distorted costs and incentives, which lead to fraud and waste. A VA hospital project in Denver is now called “the biggest construction failure in VA history” after its budget somehow ballooned from $328 million to $1.7 billion — the size of Greece’s IMF debt default.

The financial irresponsibility common to single-payer systems leads to cutbacks — but only in health care efficiency and quality.

In Canada’s government-run system, for example, many patients are forced to wait more than four months to see a neurosurgeon, according to the Fraser Institute, a Canadian think tank. In Britain, thousands of patients must wait more than 18 weeks for post-referral medical treatment. An infirmary in Bristol, England, has been scandalized for substandard care that allegedly caused the deaths of dozens of babies.

Government health care monopolies have never worked — not for entire nations and certainly not as administrations in charge of veterans’ health care.

Fortunately, Congress has an appetite for reform. The Senate just introduced legislation that would allow veterans to receive health care from private providers. Some 77 percent of vets express strong support for increasing choices in their insurance products, so this legislative effort is a positive step.

But veterans’ health will more fully improve if they are liberated from government control over their care altogether. That means granting veterans control through health care vouchers and increasing their choices of providers. It also means moving away from the status quo of government-controlled hospitals and eliminating Washington’s ability to ration prescription drugs and other treatments.

Only then will veterans’ health care merit a new motto: “First-Rate Medicine for First-Rate Men.”

Nothing contained in this blog is to be construed as necessarily reflecting the views of the Pacific Research Institute or as an attempt to thwart or aid the passage of any legislation.

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