“…Government never will be able to satisfy demand for a valuable service given away free or nearly free…If a private hospital operator in a competitive market saw wait times growing, it would raise prices to maximize profits, which would have the effect of reducing demand. Another hospital, seeing this, might keep prices low to fill empty beds…

…Then the first hospital might decide profits can be better maximized by increasing capacity rather than by defending high prices. And so on: competition, the basic stuff you learned in high-school economics. None of this can happen in the VA, where excess demand means either Congress must allocate more money, administrators must bark hopelessly at doctors and nurses to work faster, or all must engage in fraud…”, Holman W. Jenkins, Jr., Wall Street Journal, June 4, 2014

 

Health Care Is Our Other Afghanistan

The president and his worker bees believe in ObamaCare about as much as they believe in the Afghanistan war.

By Holman W. Jenkins, Jr.

Bob Shrum, John Kerry‘s presidential campaign adviser, did history a service when he acknowledged that the Kerry campaign in 2004 raised Afghanistan to the status of “the right war” as an implicit criticism of the Iraq war without Democrats seeming indiscriminately antiwar and antimilitary.

Barack Obama adopted the good war/bad war patter and wedded himself to Afghanistan, a war he clearly didn’t believe in and wasn’t committed to. The spin continues today. Bringing home Sgt. Bowe Bergdahl, the last American captive and an alleged deserter, might have served a practical purpose in closing one more door to our continued involvement in Afghanistan. A goal might also have been fostering a tacit understanding with the Taliban to lay off U.S. forces as they make their exit, after which Afghanistan is no longer our problem.

But why the celebratory involvement of Mr. Obama, Defense Secretary Chuck Hagel and others? Why not leave it to lower functionaries to announce in non-exclamatory fashion the prisoner exchange? The blowback the White House is now reaping suggests either an administration sinking in cynicism or—worse—an administration that no longer knows what its own hidden agendas and private reasonings are.

President Obama and then-Veterans Affairs head Eric Shinseki, April 17. Win McNamee/Getty Images

The same is true in the Veterans Affairs scandal. Mr. Obama cannot be blamed for the unworkability of the VA health-care program. Government never will be able to satisfy demand for a valuable service given away free or nearly free. That would be true even if the department did not suffer all the infirmities of a politicized bureaucracy captured by organized labor. As long as the system takes anything like its present form, Secretary Sisyphus will have endless employment.

But you’d expect the president, since domestic policy and health care are so close to his political heart, to be more on top of matters. It’s hard to escape the impression, as with Afghanistan, that the administration has become lost in its own disingenuousness. Mr. Obama gave us ObamaCare: You might assume, therefore, he considers ObamaCare a model for addressing America’s health-care dissatisfactions and would jump at an opportunity to propose enrolling veterans under the Affordable Care Act.

You’d be wrong. In fact, Republicans are more nearly doing so, with proposals to create a private option for VA beneficiaries. You don’t have to be an incorrigible polemicist to suspect (know) that Mr. Obama and his allies would actually prefer to enroll the rest of us in something like the VA, whatever its failings. His supporters keep telling us as much: Paul Krugman, Harry Reid, virtually the whole of the U.S. labor movement. A few even applauded ObamaCare’s early fiasco hoping it would accelerate progress toward single payer.

Mr. Obama and his worker bees believe in ObamaCare about as much as they believe in the Afghanistan war. ObamaCare was a political kludge because Democrats couldn’t muster voter support for a single-payer system.

No matter what you read, the VA’s now-infamous bonus system did not cause veterans to be wait-listed and denied care. Veterans were wait-listed and denied care because of an insufficiency of doctors and appointment slots. The bonus system only caused administrators to engage in elaborate feats of data fakery to shield the system’s ultimate overseers from having to acknowledge the unrealistic performance targets they imposed on underlings.

Of course it’s hilarious to imagine bureaucrats sitting around congratulating themselves on their “private sector efficiency” in handing out bonuses even for lousy performance. But this is unfair. Everyone would have known what was going on, including those at the highest level in Washington. The bonuses were surreptitiously repurposed as retention bonuses for staff who were required to game implausible mandates and deal with angry and frustrated veterans who weren’t getting the free care they were promised.

If a private hospital operator in a competitive market saw wait times growing, it would raise prices to maximize profits, which would have the effect of reducing demand. Another hospital, seeing this, might keep prices low to fill empty beds. Then the first hospital might decide profits can be better maximized by increasing capacity rather than by defending high prices. And so on: competition, the basic stuff you learned in high-school economics.

None of this can happen in the VA, where excess demand means either Congress must allocate more money, administrators must bark hopelessly at doctors and nurses to work faster, or all must engage in fraud. Republicans inevitably will inherit ObamaCare someday, along with the VA and all our other junky health-care interventions. It’s time they start making sense of our cacophony of health-care programs since Mr. Obama won’t.

Posted on June 4, 2014, in Postings. Bookmark the permalink. Leave a comment.

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