Another masterpiece from the wizards of the editorial page. The VA scandal shows us the future of Obamacare: when you remove price incentives from care you get rationing, which is what the VA was doing. When you ration, people die needlessly.
The Government Health-Care Model - WSJ.com
The Government Health-Care Model - WSJ.com
more at the sourcePresident Obama addressed the Veterans Affairs scandal on Wednesday, saying he's waiting for an Inspector General "audit" of what went wrong. And the press corps is debating whether VA Secretary Eric Shinseki should be fired. These are sideshows. The real story of the VA scandal is the failure of what liberals have long hailed as the model of government health care.
Don't take our word for it. As recently as November 2011, Paul Krugman praised the VA as a triumph of "socialized medicine," as he put it: "What's behind this success? Crucially, the V.H.A. is an integrated system, which provides health care as well as paying for it. So it's free from the perverse incentives created when doctors and hospitals profit from expensive tests and procedures, whether or not those procedures actually make medical sense."
Ah, yes, the VA lacks the evil profit motive. What the egalitarians ignore, however, is that a government system contains its own "perverse incentives," such as rationing that leads to treatment delays and preventable deaths, which the bureaucracy then tries to cover up. This isn't an accident or one-time error. It is inherent in a system that allocates resources by political force rather than individual consumer choices. The VA is ObamaCare's ultimate destination.
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The VA operates on a "global budget" that Congress sets each year to provide veterans a guaranteed level of benefits. All veterans are entitled to free preventative screenings, immunizations, lab services and EKGs. Most are required to pay little to nothing out of pocket for medical appointments, hospital care and drugs.
All of this creates an ever-growing demand for more services, but in a world of inevitably limited resources. As in every government-run system, the only way the VA can provide universal, low-cost health care is by rationing. At the VA, this means long waiting lists to see doctors and get the "free" treatment veterans are entitled to.
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So it's no surprise that allegations are spilling out that VA facilities keep secret waiting lists to hide queues that exceed the government's targets. A retired doctor at a veterans hospital in Phoenix last month charged that staff concealed months-long delays for as many as 1,600 veterans, allegedly resulting in 40 preventable deaths. Excessive wait-times have also been reported in Fort Collins, Durham, Cheyenne, Austin and Chicago, among others.
A new Inspector General report is all but certain to reaffirm the conclusions from its 2005, 2007 and 2012 reports. To wit, VA centers fudge their data. The VA has consistently boasted in its performance reviews that more than 90% of patients receive appointments within 14 days of their "desired date." Yet according to the IG's 2012 report, the measures "had no real value" because the VA "does not have a reliable and accurate method of determining whether they are providing patients timely access" to care.
VA officials claim backlogs are due to difficulty hiring and retaining staff, but that's another problem endemic to government health care. Compensation is often too low to attract doctors, particularly in high-demand specialties like physical therapy and gastroenterology. While VA medical centers can refer patients for private consultations to reduce backlogs, they rarely do.