As the progressive wing of the Democratic Party embraces a series of old ideas about the general superiority of public-sector programs, it has also adopted a deluded idea about what the public sector can achieve. Along the way, Democrats also assumed an immoral conceit. They no longer devote much time to thinking about what systems result in the best outcomes for people, but instead what will deliver the best outcomes for government. This form of sophistry is the only psychological construct that could remotely explain the left’s new belief that the only problem with the Department of Veteran’s Affairs is that it’s just not big enough.
The progressive muse, Rep. Alexandria Ocasio-Cortez, recently gave voice to this pathology at a town hall in the Bronx in which she railed against the prospect of introducing private-sector reforms into the VA system. “If it ain’t broke,” she said, “don’t fix it.” Such callous ignorance of the conditions afflicting the VA should be automatically disqualifying. Rather, for her cheering section, it is a rallying cry.
In a piece echoing Ocasio-Cortez’s sentiment, The Nation’s Jasper Craven acknowledged the minor hiccups that have given the VA a bad name. Among them, a 2014 scandal involving a Phoenix veterans’ hospital where administrators falsified records to show that care was being delivered in a timely fashion when it was not. But, Craven insists, the nefarious Koch-backed forces of privatization have misstated how widespread these abuses were. “The Phoenix scandal did reveal serious capacity issues and administrative wrongdoing, but it was not indicative of endemic issues,” he wrote. This is patently false.
A 2018 Inspector General’s report following an extensive investigation into the VA’s problems expounded on what former Secretary of Veterans Affairs David Shulkin acknowledged were “systemic” problems within the VA. The report savaged the department’s “failed leadership” and the pervasive “climate of complacency” within its ranks. They found that poor accounting procedures led to the waste of millions of taxpayer dollars—including at least $92 million in overpriced medical equipment. Patients’ sensitive medical data was routinely exposed to data breaches.
VA hospitals around the country have been implicated in scandals involving rationed services and unresponsive administrators. In Washington D.C., patients were given “prolonged or unnecessary anesthesia” while medical staff searched for missing medical equipment. Care is routinely delayed or denied, and incompetence in at least one facility resulted in “unnecessary risk” for patients “and resulted in a breakdown of core services.” In Texas, former VA doctors have accused the department of denying colonoscopies for cancer patients, jeopardizing veterans’ access to non-VA specialists by slow-walking reimbursements, and engaging in precisely the same manipulation of data relating to wait times that plagued the Phoenix facility (where 40 veterans died while awaiting medical appointments). Another effort to falsify the wait times veterans faced was uncovered in Colorado.
In Illinois, a culture deemed dismissive toward patient safety was blamed for unnecessary deaths. In New Hampshire, dangerous conditions, including a fly-ridden operating room, resulted in canceled surgeries. And in Tennessee, tissue was mishandled, unnecessary amputations were performed, and patients with life-threatening and acute conditions were forced to leave the premises to find emergency care at private facilities that actually functioned like hospitals. From Kansas to Missouri, the wait-time scandal cost veterans the care they needed at non-VA facilities to which veterans who face wait times over 30 days are legally allowed to appeal.
When the Phoenix VA scandal broke, it engulfed Barack Obama’s government and eventually took VA Sec. Eric Shinseki down with it. His successor, Sec. Bob McDonald, insisted that he had removed 60 VA employees over the wait-time scandal. It turned out that only eight had been dismissed. When McDonald dismissed the wait-times scandal, insisting that it was a meaningless metric and comparing it to the wait for rides at Disneyland, he lost the confidence of the Republican-led Congress and limited his capacity to implement reforms. Shulkin, McDonald’s successor, was forced to resign when he was found to have lied about the amount of time he spent in Europe with his wife on pleasure trips paid for by U.S. taxpayers.
If this isn’t systemic, I don’t know what is.
Craven cites a variety of studies that purport to demonstrate that veterans are more satisfied with the care they receive at VA facilities than they are with private hospitals. He also cited a study that claims wait times are often shorter at federal institutions than they are in the private sector, but the study only examined wait times for new patients and first appointments—not the time it takes for life-saving care to be administered at the point of delivery. Surely the VA has made needed reforms since the VA scandal exploded into the national consciousness. The backlog is reduced and outcomes have improved on the margins, but those reforms do not go far enough. At least, not according to veterans.
“Unfortunately, few on the left have crafted a coherent argument in defense of the agency,” Craven lamented. This is indisputable, and exhibit A in support of this claim must be Craven’s own argument. By his own admission, his foremost concern isn’t for the care administered in these facilities but the project of nationalizing the health-care model in this country. For a movement that has the temerity to admonish privatization advocates for their lack of compassion, you would think they might evince some of their own.