The Health Care Spectator

The VA: It’s the Government, Stupid

Foreshadowing Obamacare death panels.

By 5.22.14

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“Government is not the solution to our problem; government is the problem.” 
— President Ronald Reagan in his first Inaugural Address, January 20, 1981

It’s the government, stupid. Rush Limbaugh is right. The VA scandal is a preview of Obamacare. As Mediaite wrote up his take the other day:

Limbaugh: VA Deaths Scandal a Preview of What Obamacare Will Be Like

Rush Limbaugh took on the VA deaths scandal on Monday, touting this as the home of the “death panels” the right had been speaking of years ago. And because that was a talking point against Obamacare, Limbaugh argued that what happened to veterans waiting for benefits at the VA is a “microcosm” of what will happen once Obamacare is fully implemented.

This is exactly correct. This is what socialism in America looks like. And I would add here this mindset has produced, successively in recent years, an economic implosion because government decided every American should own a home. Followed by a “health care” program that has caused millions to lose their health insurance. Now comes word that the VA — the closest thing to “universal health care” in America — is and has been for years one long rolling disaster. Veterans untreated, dying, committing suicide, secret lists, lackadaisical care or partial care or no care.

All this before you even get to the IRS — now revealed as nothing more than a politically-driven bureaucracy that targets the President’s political opponents at bureaucratic whim or after prodding from powerful politicians like Michigan’s Senator Carl Levin.

When Ronald Reagan said “government is not the solution to our problem, government is the problem” this is exactly what he was talking about. When conservatives talk about limited government this is exactly the reason. Command-and-control federal bureaucracies are spectacularly unsuited to governing. For decades, the progressive movement in America has insisted that whatever the problem, the answer was to build a huge concrete box on the banks of the Potomac, stuff it with unionized bureaucrats who have serious salaries and lots of benefits, write volumes of regulations — and repeat. Education, health, transportation, the environment — you name it, there was a bureaucracy created to deal with it. Most important, intentions were all that counted. Not performance, not reality — intentions. If you cared passionately about X, that was good enough. The reality of the inevitable failure of top-down, government-controlled anything simply didn’t matter.

Yesterday President Obama stepped into the White House press room and did exactly what liberals always do in these situations. He denounced the problem, said the problem had been around for decades, but he’d been working really hard on the problem for the last five years. And in typical Obama style, he portrayed the whole thing as if he were just some sort of bystander who stumbled into the problem reading his morning newspaper.

Let’s stick with Reagan and the concept of “limited government” for a moment. Paul Kengor’s classic 11 Principles of a Reagan Conservative. In discussing Reagan’s belief in limited government, Kengor writes: 

In reducing taxes, Ronald Reagan also wanted to reduce government to a more limited role. By 1981, Reagan concluded, government was involved in or doing far more than it should.

Reagan conservatism, and conservatism generally, is often misunderstood as antigovernment. It is not. Conservatives believe that government has a role in preserving freedom and order and providing certain services. Conservatives are willing to use government to promote the common good of the citizenry, and even (at times) to protect citizens from themselves.…

Ronald Reagan, in line with traditional conservative thinking, was not anti-government, but anti-big government. He was against unnecessary government, intrusive government, overly burdensome government, “nanny state” cradle-to-grave government, ever-expanding and encroaching government. As he said in his first inaugural, “it’s not my intention to do away with government.”

…An oft-quoted Reagan quip was this line: “The nine most terrifying words in the English language are: “I’m from the government and I’m here to help.”

What Reagan was trying to humorously express, however, was his view that the federal government frequently worsens things where it shouldn’t be involved in the first place. Reagan believed heartily that things better left to the private sector ought to be left to the private sector. In his “Time for Choosing” speech he insisted that “outside of its legitimate functions, government does nothing as well or as economically as the private sector of the economy.” 

The horrific stories emerging from the Veterans Affairs scandal are a case in point. One of the few things that can safely be said to unite Americans of all political persuasions is the care of the nation’s veterans. That veterans should be taken of is as close to a unifying principle in America as there can be. The original motto of the VA, inscribed on a plaque at the entrance to the Department of Veteran’s Affairs headquarters in Washington, is this line from Abraham Lincoln: 

To care for him who shall have borne the battle and for his widow and his orphan

That veterans should be cared for is not in dispute. What should be discussed in the wake of these revelations of disasters is how best to do that. And it is patently obvious that the government command-and-control method of taking care of veterans is, quite literally, killing them. The realization that these men and women have survived the horrors of war — only to come home and die at the hands of a massive government bureaucracy is as appalling as it is true.

Veterans are dying not because of the quality of the care when they get it. They are dying because they can’t get access to quality health care. Where have we heard this before? Take a look at Sweden, where a government-run health care system rules the day. Back in April, Per Bylund, a Swede who is currently a research professor in the Hankamer School of Business at Baylor University, had a piece in the Wall Street Journal that had this sub-headline: 

Universal public health care means the average Swede with “high risk” prostate cancer waits 220 days for treatment.

The problem in Swedish health care is access, says Bylund, and it’s a huge problem.

So too is access the problem with the Canadian health care system, much lauded by liberals. As reported in the Ottawa Citizen:

But, as it currently stands, Canada’s health care system is failing when it comes to access, he said. Among the world’s wealthiest nations, Canada is at or near the bottom when it comes to same-day access to a doctor or a nurse…

And Britain and its ballyhooed National Health Service — universal care? Here’s a typical report, this one from Forbes:

Waits for care are shocking in the NHS, frequently exposed by British media reports, and long proven by facts, yet they go virtually unreported in the U.S. For instance, in 2010, about one-third of England’s NHS patients deemed ill enough by their GP waited more than one additional month for a specialist appointment. In 2008-2009, the average wait for CABG (coronary artery bypass) in the UK was 57 days. And the impact of this delayed access was obvious. For example, twice as many bypass procedures and four times as many angioplasties are performed in patients needing surgery for heart disease per capita in the U.S. as in the UK. Another study showed that more UK residents die (per capita) than Americans from heart attack despite the far higher burden of risk factors in Americans for these fatal events. In fact, the heart disease mortality rate in England was 36 percent higher than that in the U.S.

Access to medical care is so poor in the NHS that the government was compelled to issue England’s 2010 “NHS Constitution” in which it was declared that no patient should wait beyond 18 weeks for treatment — four months — after GP referral. Defined as acceptable by bureaucrats who set them, such targets propagate the illusion of meeting quality standards despite seriously endangering their citizens, all of whom share an equally poor access to health care. Even given this extraordinarily long leash, the number of patients not being treated within that time soared by 43% to almost 30,000 last January. BBC subsequently discovered that many patients initially assessed as needing surgery were later re-categorized by the hospital so that they could be removed from waiting lists to distort the already unconscionable delays. Royal College of Surgeons President Norman Williams, calling this “outrageous,” charged that hospitals are cutting their waiting lists by artificially raising thresholds.

Notice that last line on the Brits? That hospitals are “cutting their waiting lists by artificially raising thresholds”? And what is at the core of the Veterans scandal here in the U.S.? That’s right, the manipulation of the waiting lists — which is exactly what is happening in Britain.

The election of 2014 is now underway in earnest. It is expected, as one poll after another documents, that the GOP is well-positioned to win the Senate, to have a rousing victory across the board. Maybe so.

But victory for Republicans is next to meaningless if there is no understanding that the opportunity is there for the taking to make this election a referendum on the role of Big Government. Reagan’s victory over Jimmy Carter and four years later over Walter Mondale was never cast by Reagan as a victory of one personality over another. Reagan made sure that Americans understood he believed in certain principles — one of which was limited government. 

What has happened at the VA is exactly where America is headed with Obamacare. It is in fact where Sweden, Canada, and Britain already are. Sarah Palin had it right years ago. When the government is involved in this process, “death panels” are inevitable. And in the case of the VA Palin’s death panels take the form of manipulating waiting lists. 

What’s killing these veterans isn’t disease. It’s government, stupid.

Government isn’t the solution, it’s the problem.

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About the Author
Jeffrey Lord is a former Reagan White House political director and author. He writes from Pennsylvania at jlpa1@aol.com.