As allegations of cover-ups, incompetence, fraud and even death at certain Veterans Administration hospitals grow, so do the calls for sweeping reforms that would give the large majority of vets private insurance or a voucher to let them get the care they need in the private sector. But don’t hold your breath.
At best, all Congress and the administration will likely do—if they do anything—is tweak around the edges. There are just too many people who benefit from the status quo.
Members of Congress have a vested interest in the current VA health care system. Not in a system that’s corrupt, inefficient and mismanaged, to be sure, but in having the VA facilities in their districts.
According to the Government Accountability Officethere are more than 150 VA health care systems around the country, 130 nursing homes and 850 outpatient clinics. Thus, every senator’s state has several VA facilities, and most House members will have one or more facilities in their district. And they like that.
Historically, elected officials wanted and lobbied for new facilities to be built in their districts, not for policy and quality-of-care reasons, but for economic and political ones.
VA facilities, especially the hospitals, bring bundles of federal cash to the district. And they provide lots of well-paying jobs. Like having a military base in their district, VA facilities are something of a status symbol for elected officials.
Politicians get to go to the hospitals and clinics and schmooze with vets, shake their hands and hear their stories and concerns. In other words, VA facilities provide great photo ops. Hugging a vet is better than kissing a baby.
I have personally participated as a speaker in two press events held at VA hospitals: one sponsored by a senator and one by a congressmen.
Now, there’s nothing wrong with such events. And many elected officials genuinely care about our veterans and the health care they receive. But many never looked behind the curtains to see if good care was being delivered in a timely manner.
Unions also have a vested interest in the status quo. As several commentatorshave pointed out in the past few weeks, VA hospitals are heavily unionized, which creates lots of extra costs and inefficiencies. And, as with failing public schools, the unions’ “solution” always seems to be throwing more money at the problem.
Finally, single-payer proponents—which include many Obamacare supporters such as House Minority Leader Nancy Pelosi, Senate Majority Leader Harry Reid and, of course, the president himself—will fight any market-oriented reforms. The whole point of Obamacare was that they don’t believe markets can function in the health care system.
Giving our vets a voucher for private health insurance, or even letting them enroll in the Federal Employees Health Benefits Program (FEHPB), which covers some 8.2 million current and former federal employees and their dependents, would be a tacit admission that private health insurance is better than big-government care. Many Democratic leaders do not want to make that concession.
So while Congress may pass something in the wake of the emerging scandal, that legislation would likely include even more money for the VA and may allow some vets to go to the private sector if their waiting line is too long—though unions would likely fight that provision.
But real reform that would give all eligible vets private coverage, or a voucher to buy it, and a dramatic shrinking of the VA hospital system is too radical. Even if the vets don’t get much benefit from the current VA system, there are too many non-vets who do.