Friday, May 30, 2014

The VA Scandal as an Example of Why Single Payer Doesn't Work

It was not all that long ago that leftists were holding out the VA as a shining example of how successful a government operated, single-payer healthcare system can be in America.

Now, as those with half a brain suspected all along, the VA has been exposed to be nothing more than a rotten bureaucracy, with more people working to protect and expand that bureaucracy than to actually provide the service that the bureaucracy was intended to provide. 

They attempt to scoff and dismiss this as a faux-scandal, and claim that the people drumming on this are just playing politics and trying to gain political ground by pointing it out.  I have no doubt that many of the people bringing this to light have exactly that intent in doing so, and would be participating in the cover up, themselves, had they been in power when the scandal broke, but that is entirely irrelevant.

People died because VA executives were more interested in lying about long wait times so that they could make bonus money, than they were in actually, you know, FIXING THE PROBLEM WITH THE WAIT TIMES. 

The problem with single payer, government run systems is that the left sees them as a paragon of virtue, not corrupted by the drive for profit like private healthcare systems.  They are completely blind to the fact that:

  1. 1.       Government cannot be a paragon of virtue any more than private industry, and in fact, does not have any driver to be such, other than the altruism of the people running the show.  If you’re relying on the altruism of people who have risen to the top of a government bureaucracy to ensure the virtue of your organization, then you will find, invariably, that that organization will not be virtuous. 
  3. 2.       The same drivers that exist to drive a private corporation to profit, exist in a government bureaucracy in the form of cost cutting and budget management.  When you reward your top executives with bonus pay to make key performance indicator goals, you drive them to make those goals in any way they can in the same way that profit supposedly drives the same in private industry.  In private industry, however, the method to make those goals cannot be cutting services to clients, because they will simply go elsewhere, and the goals will not be met.  In Single payer, the method to make those goals is almost invariably cutting services to clients, because the driver of competition does not exist, and the primary objective of any bureaucrat is to protect and expand the bureaucracy at all costs, not to provide services.  The only way to avoid this is to rely on whistleblowers and the virtue of top executives.  Neither of those are good options, as proven by this VA scandal, where whistleblowers were ignored, and top executives were not virtuous.  40 people died waiting for services at just one VA hospital, while the bureaucrats lied on paperwork in order to hide the long wait times and still get their bonuses. 
  5. 3.       A single payer system denies the user any recourse.  Similar to any other dealing with the government, including, for instance, the Department of Motor Vehicles, you have no other option.  You encounter surly, inefficient, slow service at the DMV, and when you complain about it, I’ve always found the response a refreshing bit of honesty.  Where else are you going to go?  What are you going  to do about it?  You HAVE to deal with us.  You have no other choice.  Now sit down in that chair right there and wait for your number, plebe.  The VA scandal has shown us that this is how it will be with government run medical services, also.  Where else are you going to go?  We don’t honestly give two hot shits about your “health problems.”  Shut up and we’ll get to you when we feel like it.  I’ve got paperwork to fill out to make sure I get my bonus.  Saving you gains me nothing.  This form gains me an additional 20% of my salary.  So sit down, and shut up, and if I’m lucky, you’ll die before I have to deal with you. 

This VA scandal is a perfect example of why single payer systems are cruelty defined.  The VA was held up as a paragon of the single-payer model only a paltry few months ago.  I agree.  It IS the model of single payer, by which we should all judge such a system.  It is exactly the paragon of the system that they tout.  Wait times and death by uncaring bureaucracy.  Cutting wait times by faking paperwork instead of actually cutting wait times.  Allowing people to die – to literally die – without care in order to protect and expand your bureaucracy, and your bonus check. 

To those of us with free-thinking minds, this is the logical result of putting the government in charge of health care.  To those among us who have consumed the “government uber alles” koolaid, this is a massive blow to their worldview, and I would expect them to attempt in any way possible to minimize the true impact of this scandal.  

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