If the ongoing scandal in the Department of Veterans Affairs (VA) health care system provides evidence of anything — in addition to our ongoing failure to provide adequate care for our veterans — it’s that Washington’s response is sadly predictable.
The first instinct in Washington is to look for scapegoats, or at least a sacrificial lamb. Accordingly, VA Secretary Eric Shinseki has resigned. No doubt he should have, since he was apparently clueless about the ongoing problems in his department. But the keyword here is “ongoing.” The problems within the VA health system go back decades, long before the current administration.
In fact, as long ago as 2001, there were warnings that veterans were waiting more than two months to be seen, and the VA’s inspector general had warned about problems with the waiting lists as far back as 2005. For that matter, back in 1945, then-Secretary Frank Hines resigned after reports of shoddy care at VA-run hospitals.
The Clinton administration did do a fair job of making improvements, but the underlying structural problems remained, and it didn’t take long for the system to slip back to its old ways. After he left the VA, Kenneth Kizer, Clinton’s undersecretary of Veterans Affairs for Health, who is credited with upgrading the system, described the VA culture as “toxic.”
Washington’s second instinct is to throw money at the problem. The Senate has now done this, passing legislation sponsored by Sens. John McCain (R-Ariz.) and Bernie Sanders (I-Vt.) that would increase VA spending by roughly $2 billion, open 26 new clinics in 18 states and hire additional VA doctors and nurses. In the grand Washington tradition of add-ons, it also includes spending for things that have nothing to do with health care, such as guaranteeing “in-state” tuition at public colleges and universities to all veterans. Of course, since the bill is “emergency legislation,” it is not subject to normal budget rules, such as having to be paid for through taxes or cuts in other spending.
But the VA’s problem is not a lack of money. The VA spent $57 billion on health care last year, up 76 percent since 2007, while the number of unique patients increased by just 9 percent.
If there is one thing all Americans can agree on, it’s that we owe our veterans all the care they need to treat the injuries they suffered while serving their county. But that doesn’t mean that the federal government can or should run a massive bureaucracy that builds and owns hospitals, hires doctors and provides care directly to millions of veterans regardless of whether or not their illnesses are service-related.
Michael D. Tanner is a senior fellow at the Cato Institute, heading research into a variety of domestic policies with particular emphasis on health care reform, welfare policy, and Social Security. His most recent white paper, "Bad Medicine: A Guide to the Real Costs and Consequences of the New Health Care Law," provides a detailed examination of the Patient Protection and Affordable Care Act (Obamacare) and what it means to taxpayers, workers, physicians, and patients.