VA scandal is no mark against big government
For some, the veterans hospitals scandal is a human tragedy pure and simple. Those who loyally served their nation in uniform, putting their lives on the line, were shunned when they sought medical help.
For others, however, the troubles at the Department of Veterans Affairs have provided what one pundit called “A gift from God.”
For those commentators, the scandal confirmed their worst fears. The logic runs like this: The VA provides a government-run health service; the failures of the VA are a disgrace; ipso facto, all government-run health systems are a disgrace; proving that all government-run bodies are a disgrace. So all government should be sharply reduced — if not abandoned altogether.
Anyone who has been kept waiting inordinately by a doctor or hospital, or who has had their treatment or prescription drugs denied by their health insurance company, knows that. Anyone kept hanging on the line for an ill-named “customer service representative” and told by an automaton, “Your call is important to us,” knows that private companies treat customers with equal disdain.
The difference is that in the VA scandal, democratic accountability eventually — it took far too long, we know — kicked in. The top man resigned and top managers who presided over the incompetence and subterfuge were fired. It is a further scandal that it took President Barack Obama himself to push the wrongdoers into admitting responsibility. But at least the problem was ultimately addressed.
When can you remember a chief executive officer of an aberrant cable TV company or phone or utility company or even a health insurance company — fill in your favorite offender here — falling on their sword for keeping their customers waiting?
This is the full quote from the “Gift from God” analyst, former neurosurgeon Ben Carson: “What’s happening with the veterans is a gift from God to show us what happens when you take layers and layers of bureaucracy and place them between the patients and the healthcare provider.”
Perhaps, as a brain surgeon, Carson is given special treatment when he visits the doctor. But the rest of us endure “layers and layers of bureaucracy” whenever we try to access the healthcare we have so expensively bought.
One reason American healthcare is two-and-a-half times more expensive than in comparable countries is because of the “layers and layers” of insurance sales agents, ID checkers, referral faxers, hospital debt collectors from insurance companies and all the other expensive bureaucrats with no medical knowledge who are employed to administer and police the system. Add to that routine over-charging by doctors and Americans seeking healthcare are being ruthlessly abused and exploited by a commercial scheme that offers them little real choice.
Why do even the smartest free-market dogmatists, who like to paint the world in black and white, fail to see the flaws in commercial companies? Here is the dean of conservative commentators, Charles Krauthammer: “If there’s ever been evidence that a government-run system of healthcare is a disaster, it’s here,” he said. “It’s rationing, it’s waitlists, and corruption and laziness — as you get when people are salaried, rather than working in the free market.”
Cannot those employed on salaries by private companies, particularly employees of corporate behemoths who operate near-monopolies, also ration their customers and say they have been put them on waitlists that do not exist? Can employees of commercial firms not also be corrupt and lazy? Does the free market not employ salaried workers? This muddled thinking is simply partisanship posing as intellectual rigor.
The public-private divide is a red herring that used to distract the left from clear thinking. For a century or more, socialists and communists believed that the world’s problems would be solved if only the “commanding heights” of an economy and the “means of production” were brought into state ownership. Many otherwise smart people fell for an ideology that failed to fulfil its promise the second it was put into practice.
State socialism is now as extinct as the broad-faced potoroo and few except die-hard ideologues dare suggest the government should run everything. Yet the government, tempered by democracy, still has an important role to play when the private sector is found wanting.
It is not merely in treating veterans — whose profound mental and physical wounds can often be so expensive to treat that private insurance companies cannot offer an affordable rate. In many Western European countries taxpayer-funded health systems keep down the skyrocketing costs of treating their ageing populations, just as here in the United States the Social Security system provides an equitable, and relatively inexpensive, way of providing a decent standard of living for retirees.
Other essential services, too, are best administered by the state. Such as the armed services and the police. Schooling, too, is too important to the nation to be left solely to the private sector. State education too often fails, but it is not because taxpayers fund it — it is because the money is spent unwisely.
The question is not whether to have the government provide services the private sector cannot supply. It is a matter of where to draw the line between public and private.
Nicholas Wapshott is the author of Ronald Reagan and Margaret Thatcher: A Political Marriage, and Keynes Hayek: The Clash That Defined Modern Economics. Read extracts here.
PHOTO (TOP): U.S. military veterans listen in the audience during a House Veterans’ Affairs Committee hearing on the Phoenix VA Healthcare System wait list, on Capitol Hill in Washington May 28, 2014. REUTERS/Jonathan Ernst
PHOTO (INSERT 1): Vietnam veteran Fred Downs gives a thumbs up during a demonstration of modular prosthetic arm technology developed by the Defense Advanced Research Projects Agency at the Pentagon in Washington, April 22, 2014. REUTERS/Kevin Lamarque
PHOTO (INSERT 2): Veterans Affairs Secretary Eric Shinseki addresses The National Coalition for Homeless Veterans conference in Washington May 30, 2014. REUTERS/Gary Camero
PHOTO (INSERT 3): A pileup of claims at the Department of Veterans Affairs facility in Roanoke, Virginia, July 25. 2012. REUTERS/Government Handout