Death panels, it turns out, gave the government far too much credit. That phrase evokes the image of gathered experts making educated if potentially callous decisions about someone’s medical care. At the Phoenix VA, people were cut off and left to die by bureaucratic malfeasance and systemic indifference which makes death panels seem dignified by comparison.
In Phoenix, veterans who requested an appointment were entered into the system. Then, once they walked out the door, their request was printed and the computer record was deleted. The printed record was added to a secret list of people waiting for appointments and then the printed record was shredded to hide any paper trail. When there was an actual opening in the schedule, someone was taken off the secret list and re-entered in the computer.
As many as 40 people may have died while on the secret waiting list, which is horrible. Similar games were apparently being played at VA hospitals in half a dozen other states. Different hospitals appear to have used slightly different bureaucratic workarounds to game the system. All of this may have been done to insure administrators received bonuses. It was, in effect, a numerical coverup of what was really going on with long delays.
But it’s important to point out that the secret lists or other tricks weren’t in themselves the problem. The problem was that the VA was unable to get veterans an appointment to see a doctor within a reasonable period of time. That problem would have remained even if secret lists and other gimmicks had never been employed to hide it.
Apparently the Bush administration knew there were significant problems with wait times and scheduling when it left office. This information was passed on to the Obama administration during the transition. The problem is not partisan but systemic. But as a piece published yesterday by the Cleveland Plain Dealer points out, this may be just the beginning.
Financial incentives and disincentives written into Obamacare will, if allowed to play out, wipe out first the market for individual health insurance plans and, not long after, the plans that employers buy for employees. The result — and this was certainly an intended consequence — will be a
medical insurance system at first dominated by and eventually exclusive to the federal government.
The experience of veterans who get their medical care at the
sufferance of the VA should be instructive to all Americans. The VA
offers precisely what Obamacare offers: not a guarantee of treatment in
time of need, but a guarantee of a place in line for treatment at a time
of the bureaucracy’s choosing. For some, that time will never come.
Bureaucracies rightly see people as captive clients, not as customers
free to take their business elsewhere. (If Obamacare is allowed to
remain the law, eventually there will be no “elsewhere.”) So the place
in line can change — or simply disappear — to suit the needs of the
bureaucracy. Unless, of course, you “know somebody.”
There are always trade-offs in any system. But Democrats, like the President and Senator Reid, who see socialized medicine as a solution should be forced to defend their goals openly. How is the fully socialized VA system, which has been lagging in terms of delays for appointment for at least a decade, better than a private system? Before we make the VA our model for the future of American healthcare, let’s have its proponents defend it now while some of its failings are in the public’s view.
And this time, unlike in 2009, let’s not accuse people who see where Obamacare is leading of being conspiracy theorists. If one of the architects of the program says it may happen and the highest ranking Democrats in Congress says it should happen, it’s clearly within the realm of possibility.