Commentary: VA Scandal Raises Red Flags for Single Payer (June, 2014)

By Rob RoperRob Roper

“Let’s talk about big government run [healthcare] plans,” Vermont Senator Bernie Sanders needled fellow Veterans’ Affairs Committee member John McCain. “I don’t want to shock anybody here and have people dashing out of the room, but the VA (Veterans’ Administration) is a socialized healthcare system, right Mr. McCain? Socialized medicine.”

Yes, it is.

As Senator Sanders pointed out, in the socialized system of the VA, the staff is “not out there busy raising money; charging them [customers] money.” We hear similar arguments in favor of implementing a government-run, single payer healthcare system here in Vermont. Get the profit motive out of our healthcare system, get private sector people who are motivated by greed out of the healthcare system, and everyone will get all the care they need when they need it.

The recently unfolding scandal at the VA involving bureaucratic fraud, care denied to patients, cover-ups, and the deaths of some forty veterans in the Phoenix, Arizona, VA while they waited months and in some cases over a year for an appointment should raise some red flags for Vermonters. We are just a few years away from entering our own VA-like system: single payer Green Mountain Care. As such, it’s in our best interests to ask some hard questions about the root causes of how a government-run healthcare system allowed these things to happen.

First, a brief review of what happened in Phoenix. The managers of the Veterans’ hospital there were caught covering up that fact that 1400 to 1600 patients were denied care while being placed on waiting lists for up to fourteen months to see a doctor. The VA has a policy to provide all care in a “timely manner,” which is supposed to mean within thirty days (Green Mountain Care’s promise is more vague: care “at the appropriate time in the appropriate setting”). Allegedly, as a result of the failure forty veterans passed away while waiting to see a doctor.

In order to cover up what was happening, hospital staff kept two sets of books, an official but fake set showing patients receiving the timely care politicians had promised, and a second “secret” set that reflected the grim reality.

The Phoenix story is not an isolated incident. Since Phoenix, similar accounts have emerged in over twenty-five states. Neither is this a new issue. Quality questions have dogged the VA for years. During the Bush Administration the Walter Reed facility in Maryland was the focus of some scandalous quality issues in which, according to the Washington Post, “troops who lost limbs and suffered traumatic brain injuries or post-traumatic stress were quartered for months in moldy and rodent-infested rooms with inadequate follow-up care.”

It doesn’t matter who’s running the system. It’s the system.

So, how does this happen and why does it never get fixed in a government-run, socialized system where the profit motive has been removed?

Let’s be honest, people in government have the same personal profit motives and are just as prone to greed as anybody else. It’s not because of an absence of greed that six of the top ten richest counties in the country today are suburbs of Washington DC, and 13 of the top 30 form a circle around the capital. The power of government is a tempting tool for those wishing to enrich themselves and their cronies.

At the Phoenix VA, an article in Forbes reports:

  • Staff salaries were as high as $357,528 for doctor executives and $147,724 for nurse staff.  The average Arizona doctor makes just over half of what the top-paid Phoenix VA doctors make, according to federal stats.
  • From 2011 to 2013, over $843,000 in bonuses were awarded to the staff.
  • The hospital’s 2013 gardening budget was more than $180,000.
  • The hospital’s interior design bills surpassed $211,000 for the past three years.

The problem with any government run system is that the bureaucrats running that system are not accountable to the people being served by that system. Bureaucrats are ultimately accountable to the politicians who control their funding, and that’s who they aim to please. Politicians aren’t accountable to patients, they’re accountable to voters, and that’s who they aim to please. What do politicians seeking re-election hate more than anything else? Bad headlines. What do voters hate more than anything, politicians who raise taxes.

Problems don’t get fixed because in order to fix them, you have to draw attention to the fact that there is problem in first place, and that’s bad headlines. Fixing a problem once admitted to will likely require more resources and higher taxes. Better to just call the situation a “big nothing-burger” and promise big fixes after the next election. If this weren’t the case, the VA would have been fixed long ago.

- Rob Roper is president of the Ethan Allen Institute

{ 7 comments… read them below or add one }

john mendenhall June 3, 2014 at 2:17 am

Hasn’t Bernie run for years on a campaign based on “fighting for the Vets and elderly?”
So this is all on his ilustrious watch?
Step aside Mr. Sanders.

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Valerie Mullin June 4, 2014 at 5:33 pm

Your VA fact numbers prove that Single Payer numbers will not decrease cost. Just shift money and power out of our hands into the government. Bernie wants to add more Vets to the VA system? Why? The VA gets tax money for each person in the rolls thus growing the VA’s budget. This is not a budget problem, it’s a socialized healthcare problem.

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Patricia Crocker June 5, 2014 at 3:22 am

Excellent points Valerie!

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Valerie Mullin June 4, 2014 at 5:42 pm
Ivan Smith June 5, 2014 at 1:18 am

Ok, Where were you people when people were denied health coverage because of the bogus concept of Pre-existing conditions? The EAI and VFHCF et al will glam on to anything that they think they can get mileage out of. Most people are happy and are cared well by the VA in spite of being over run by the wars, and then starved of money by the GOP in congress over the last several years in the interest of” fiscal discipline”. A few bad actors hasn’t ruined it all. Medicare is the same way

What is in danger is the for profit insurance structure that is really responsible for our biggest problems in this area. It really has no future.

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Patricia Crocker June 5, 2014 at 3:30 am

Ivan, you complain about “for profit” insurance companies. What makes you think that a Government system will be any better? The problem is power and Human nature. The more likely that power can be concentrated on those furthest from the patient makes corruption and greed possible. There are many solutions that give the patient control, without turning all of our choices and dignity over to someone else. HSA’s with high deductible plans for catastrophic events gives the patient choices and control. It also encourages competition, which will drive costs down. Single payer, government controlled healthcare is not the answer. It hasn’t worked anywhere else. https://www.youtube.com/watch?v=FnqkIWwWDsg

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Kay Trudell June 5, 2014 at 7:19 am

I am going to go on a bit of a rant here, so I’ll admit it up front and then get on with it. Bernie Sanders the self-declared socialist mocked John McCain the progressive RINO?? They aren’t that far apart these days. I do not believe either of them. As for Bernie, he says plainly that he is a socialist, yet Vermonters keep voting him in. Why? For the government goodies and false promises of utopia here on earth. We as a state and nation have embraced the false and freedom-destroying promises of utopian socialism while ignoring the US Constitution. That document set up a Constitutional Republic, not a socialist government. We seem to like statism and bureaucracy instead of the limited government the Founding Fathers envisioned. Every time the US government has strayed from Article 1, Section 8 in said Constitution and introduced a new federal entitlement program and the bureaucracy that goes with it, it was usually under a Democrat administration (FDR, LBJ, Clinton, Obama). And did inside-the-beltway Republicans stop this trend? Nope. They went along to get along. Pie in the sky promises were made by Democrats — promises they have no intention of keeping. At least Republicans finally got it right when they all refused to vote for Obamacare. That fiasco belongs solely to the Democrats. We are now beginning to reap the fruits of our inattention to the precious and timeless principles of our Constitution in favor of socialism. The problems coming to light in the VA are only a symptom of a much deeper rot in our federal government. Bernie might have thought he was mocking John McCain, but in reality he was exposing the dangerous flaws in socialist systems like the VA. Who is accountable? Where does the buck stop? Who will accept responsibility for this mess? We made promises to our veterans that we need to keep. There is no need for the VA to run out of money or for our vets to die on secret waiting lists. Close the borders to all illegal immigration, stop all entitlement programs and financial welfare to non citizens, stop spending federal monies to provide all services to all people inside our borders in any language they choose, and direct those monies into promises that were made to Americans by Democrat (and yes, Republican) administrations as they grew government. Stop blaming ordinary American citizens for what their government mandated from on high. Create no new entitlement programs and reform the mismanagement in the ones that exist. These programs are in financial trouble now because of wasteful, greedy, self-serving, bloated bureaucracy and top administration with no accountability, and politicians using the promise of government goodies to buy votes. Sarah Palin was right. There are death panels. This is Obamacare for veterans. This is what Obamacare for civilians (all the rest of us) will soon look like. I would like to ask people who didn’t like exclusions and “rationing” of healthcare by private insurance companies if they like government healthcare rationing by bureaucrats better? Big private insurance bad; big bloated government good? Vermont’s Shumlincare is another example of socialism and where we are headed. Thanks, libs and progs. You advocated for this befuddled bed and now we all have to lie in it while you try to exempt yourselves (Joel Cook). Bernie says lots of things to the voters that he doesn’t mean. He is good at slogans that will advance the socialist agenda. Bernie does not really care about vets and elders in his heart of hearts. We are useful tools to be appealed to and propagandized and manipulated in order to advance the socialist agenda. If we are too gullible to see it, we will get the government we deserve, and all the oppression that comes with it. And we will all have destroyed the US Constitution in the process. That process has already started. The liberty that currently exists in America, if lost, will be near impossible to regain. Bernie is beating John McCain over the head with the serious flaws in a program whose very principles (socialism) Bernie supports. Wake up, people. This VA scandal is a huge red flag (pun intended).

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