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Z_CNHI News Service

May 30, 2014

Veterans wait for healthcare, we wait for accountability

Editor's note: CNHI newspapers that are not weekly subscribers to Taylor Armerding's column may publish this one if they notify him at t.armerding@verizon.net.

Anybody who has served in the U.S. armed forces could not have been surprised when the Veterans Administration health care scandal “broke” last month.

Hidden wait times? Patients dying due to a lack of prompt treatment, with any mention of “delay” scrubbed from their records? Shredded documents?

It's all the standard dysfunction of government bureaucracies: If the real data might jeopardize your performance bonus, then you fudge the data. And you don’t say anything when others fudge their data. Everybody takes care of everybody else – except those they are supposed to be taking care of.

People die as a result. But, as our compassionate socialist senator, Bernie Sanders of Vermont, said recently in response to questions about the scandal, “We know people die every day.” True enough, Bernie. But I’m pretty sure you won’t get put on a waiting list for necessary treatment if your own health declines.

In general, there is little to stop the VA's dysfunction. Is it going to go out of business? The money is coming from taxpayers, so it is inexhaustible. You can’t go broke. How great is that?

I was in the Army for only two years, but I saw this syndrome at play with leave (vacation) time. Everybody got 30 days – six weeks – which is pretty good for your first job out of college. Not bad even after 20 years.

But everybody also knew how to massage the system so they’d get even more.

It was easy to get credit for a day of work on a Friday, even if you left on vacation on a Thursday night and never showed up for duty the next day. The same thing was true at the end of the next week; have somebody sign you back in the following Friday and get credit for working that day, as well. So, take off six working days (plus two weekends) and only get charged for four days leave.

Add it up, and it’s another 15 days off a year – six weeks becomes nine. What do you think that does to efficiency and productivity? Almost everybody did it, and nobody reported it up the chain of command. It wouldn’t have done any good. Almost all the majors and colonels were doing it, too.

So, the people on both the left and right who say it won’t do any good to fire VA Secretary Eric Shinseki - who as of this writing was still in place - have a point. This kind of corruption is so deeply embedded into the culture of government that exchanging one head bureaucrat for another is unlikely to change it.

Anybody who came in and tried to eliminate catastrophic waiting lists would first have to be honest about how much it would cost, given the pay and benefit packages that government employees enjoy, and the cost of health care in general.

The only way health care is “affordable” by today’s standards is for it to be rationed. It’s easy to tell people all the things that are “covered,” but it's much more difficult to provide those “covered” services to everybody who qualifies.

As a hospital president told me a couple of decades ago, “You can have a health plan that says you can get an MRI every week if you want. But if there are only one or two MRI facilities in your region, do you think that’s going to happen? You’ll wait months.”

Beyond that, anybody who took charge of the VA and demanded accountability and better performance would get hit with so many union grievances that he or she would have little time for anything else.

The other indication that nothing will change once the press moves onto something else is the response of the president. It is the standard, predictable damage control that has been repeated over multiple scandals – the “Fast and Furious” gun-running operation, eavesdropping on The Associated Press, the IRS holding up applications of conservative groups for tax-exempt status in advance of the 2012 elections, the attack on the U.S embassy in Libya that left four Americans dead including the ambassador, and the botched rollout of Obamacare.

First, Obama has his spokespeople say the administration was unaware of this “unacceptable, outrageous” information until it was reported in the press, but that the president is very upset by it. This time, Shinseki was described as “mad as hell,” so the president had to go one better by being “madder than hell.”

Then comes the speech or press conference where the president declares that those responsible will be held accountable, and that he will “not rest” until the problem is solved or the perpetrators are brought to justice.

If possible, as in the VA case, the president will try to insulate himself from criticism by claiming that it will make whatever group is affected a “political football.” Of course, by saying that, Obama is the one making the veterans a political football.

Finally, at some point, the president and his people will mock those who continue to demand answers for what has gone wrong by calling it a “phony scandal … without a smidgen of corruption.”

The final proof that nothing substantive will change is that the president has been promising to fix the VA wait times since he started campaigning for the office.

It’s been almost six years. It hasn’t happened yet. Don’t hold your breath.

Taylor Armerding is an independent columnist. Contact him at t.armerding@verizon.net

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