Let's do a straight-up trade: Congress shall use the VA medical system; veterans get to use the plan available to Congress (and other federal employees) — the "Federal Employees Health Benefit Program" which is private insurance that offers the important element of choice. That was the suggestion from a friend of mine the other day and one that I've heard in various incarnations from time to time. I'll have to say, the sentiment has some appeal.
Of course, we'd have to even up the numbers somewhat to make it fit under the salary cap. Perhaps including the entire bureaucracies of the EPA and IRS in the to-the-VA column would help even the numbers a bit? Maybe even include a “player to be named later” with a thought toward the guy at 1600 Pennsylvania Avenue?
This is of course fantasy, but it illustrates the frustration that some of us feel over the inherent lie of big government that is the mother's milk of liberal progressives. When government gets involved, you get bad results. Period. The bigger government involvement gets, the worse the results become.
Let's be honest with ourselves, shall we? President Obama is not a gifted manager nor a gifted administrator. He is an ideologue. His main qualification for the presidency of the United States is that he was a rabble rousing community organizer from the mecca of rabble rousing community organization, Chicago.
But it doesn't matter if he were Jack Welch during his General Electric prime — he wouldn't have been able to make a significant dent toward improving the competency of the VA — at least not for long. There have been periodic dust-ups regarding the poor performance of the VA for about as long as I can remember, spanning numerous administrations. What else would you expect? It's a huge government bureaucracy!
That means it is practically genetically incapable of excellence. Don't get me wrong; there are surely any number of excellent and dedicated physicians within the VA, not to mention plenty of other competent employees of all stripes. But throw them all into a government morass the size of the VA and the inherent entropy is sure to sap the last ounce of entrepreneurial ingenuity out of them faster than Nancy Pelosi can jump out of her seat in ecstatic applause during an Obama State of the Union address.
Don't believe me? Show me another government monopoly that is exceeding your expectations. How about the public schools? Seems I've heard a complaint or two on that topic. I'm sure glad Jimmy Carter started the Department of Education in 1979. That huge bureaucracy really turned things around!
Every day 300 million Americans cast decisive votes when they choose to spend their money at merchant A instead of merchant B. Those merchants have to react and compete to earn those dollars, which in turn weeds out the poor performers and rewards those who provide excellence.
Bloated government bureaucracies turn this concept on its ear and render it null. No longer does one have to provide excellence to survive. Firing a poor teacher, for example, is about as daunting a task as sending a rocket to the moon. I can't say I have any particular experience with the VA, but I imagine firing a poor performer there is probably similarly difficult. You'd likely have to run down the hallway with a machine gun yelling “Allahu Akbar” in order to get dismissed.
Check that. The current administration would be more likely to issue a commendation than pursue a dismissal for that bit of initiative.
Our veterans deserve better, so what is the solution? Certainly we should attempt to hold the executive branch and the VA to account as much as we can despite the problems I've already outlined. But the only real answer with a chance for substantive improvement is that we need to introduce competition into the mix to the degree that we can. This isn't a novel idea and has been proposed by many before me.
Give our veterans the choice of where to get their healthcare. If, in their judgment, a VA facility offers them the best care in a given situation, then they can choose that option. However, if they think a private facility gives them a better chance, let them avail themselves of that option. Whether that choice is effected via vouchers or some other mechanism is not terribly important. It's the insertion of choice into the equation, which yields competition and improved outcome, that is the important part.
Let's move the healthcare for our veterans toward the free market and watch it make a quantum leap forward in the same way everything else does when competition is introduced. Maybe we can trade President Obama for a high draft pick or two in the process. Shoot, I'll even settle for a sixth rounder at this point.
Eric Minor is a software consultant based in the greater Seattle area. He also owns Animal Crackers Kid's Store in Gig Harbor, Washington.