Actually, the VA is Good
In any debate over whether the United States should implement nationalized healthcare, at least one of three arguments is guaranteed to be made by the opposition. (Feel free to read these in Jerry Stiller’s voice if you want – it’s a lot of fun):
Canada has nationalized healthcare, and it’s a mess – that’s why they come here for medical procedures!
It’s too expensive!
We already have government-run healthcare: the VA! And it stinks!
The first rebuttal is a right-wing talking point based on a misleading interpretation of data by a right-leaning Canadian research institute, which found that in 2014, 52,513 Canadians received healthcare outside of Canada. The misleading part is that nobody asked these people if they’d traveled outside Canada specifically to get healthcare or if they just happened to need it while outside the country.
On top of that, there’s no data indicating the places where these people received non-Canadian healthcare; in other words, this argument is based almost entirely on nonexistent and/or unverifiable data, which should give you some idea of its validity.
The second rebuttal is wrong, but even if Medicare for All did cost more, the only reason to place cost over the possibility of saving lives is if you’re not personally affected. (Or, less charitably, you believe that those who would benefit don’t deserve it.) In other words:
But while the first two arguments fall apart under the merest scrutiny, the third one seems to be on much sturdier ground; after all, nobody is holding up the VA (Department of Veterans Affairs) as a model healthcare system. And some criticisms of the VA are certainly valid: there are significant and, frankly, unacceptable wait times for medically necessary procedures, and the VA has been plagued by mismanagement in recent years, including a “pay for performance” incentive that led to VA managers falsifying patient wait times in order to collect their bonuses. Most importantly, the process to access care from the VA is labyrinthine and frustrating, especially considering that the VA’s patient population – former soldiers – already struggle with asking for help when they need it.
So it should come as no surprise that in an Op-Ed for the Wall Street Journal, George W. Bush’s former chief domestic policy adviser Karl Zinsmeister leaned heavily on the VA’s problems as evidence that socialized medicine will never work in the United States. Since WSJ is behind a paywall and I don’t expect you to fork over $35 a month to read that shit, I’ll dive into the key points of the piece here (Zinsmeister’s arguments are in bold):
In one corner of Washington, socialism has been a living, breathing reality for decades. Just go visit the Department of Veterans Affairs. Draw a military paycheck for a few years, and you’re entitled to cradle-to-grave support for you and family members. Health care at any of more than 1,200 sites. Housing guarantees. Up to 100% of college costs. Special unemployment checks. Life insurance. Nursing-home care. Uncle Sam will literally bury you. This is the socialist dream.
It’s telling that Zinsmeister’s article begins by implying that veterans don’t deserve these things: “Draw a military paycheck for a few years, and you’re entitled…” It’s almost like Zinsmeister doesn’t believe the rah-rah, support-the-troops-by-standing-for-the-anthem shit he’s been slinging for decades, and that he doesn’t care about the military unless he can use it as a prop to help him win an argument against the left. Weird!
The VA has been plagued by negligence, falsified records and gross mismanagement. […] New gushes of public resources have zoomed the annual departmental budget from $45 billion in 2001 to $209 billion this year.
That is a drastic increase. Gee, did something happen in 2001 that led to a war, which would mean more troops, especially as the body count rose and the war continued on to this day?
Nah. We’d have heard about something like that.
The VA now has 366,000 employees—nearly twice what any other civilian government agency can muster. Yet somehow the problems never go away.
This is technically wrong: the VA is a federal agency that falls under the Executive Branch. Presumably Zinsmeister means the largest number of civilian employees, which…is also wrong, as the United States Postal Service employs over 2 million civilians. But if we’re being super technical, the USPS is classified as an independent agency, so they don’t count, which makes Zinsmeister’s claim…uh, still wrong: the Defense Department employs about 750,000 civilians.
Anyway, the idea that “more employees = fewer problems” is moronic. If that were true, every company would hire as many people as they could to make things run as smoothly as possible.
Certainly veterans aren’t doing so well. Despite starting with higher levels of education and training, plus lower rates of criminality, family decay, and illness compared to non-VA-assisted peers, vets now have inexplicably high rates of substance abuse, suicide and withdrawal from the labor force.
Perhaps there’s some correlation between people going off to fight an endless and unnecessary war and feeling shitty and depressed about it when they get back.
Are these “invisible wounds of war”? Only a small fraction of post-9/11 vets experienced fighting.
It’s impossible to know what Zinsmeister means by “fighting.” The official military definition of “combat” has changed over a half-dozen times since World War II, often in response to what happened in whatever war came after the last time the definition was changed. Zinsmeister is being deliberately vague in how he applies the definition, but we can reasonably assume he means Saving Private Ryan-style battles.
Which, yeah, no shit those don’t happen – the Taliban doesn’t have a fucking artillery division. They do what any group does when they’re outnumbered and overmatched: they use guerrilla warfare to even the odds. We should know this, considering we taught them how to do it.
The more plausible diagnosis for most veterans is that they suffer from the invisible wounds of government dependency.
I think the U.S. invasion of Iraq was a colossal mistake and that our continued military presence in the Middle East is as significant a contributing factor to ongoing terrorist threats as anything else. I also think that the VA is a vital resource for veterans whose lives have been irreparably harmed as a result of their participation in the war.
On the other hand, here we have Zinsmeister – the chief domestic policy adviser to the president who started this whole fucking fiasco – minimizing the psychological effects of the war while also building a case against the one resource that can help those in need. Guess which one of us is more likely to be called unpatriotic?
After World War II, 11% of veterans were granted disability compensation. Today close to half of people leaving the U.S. military request lifelong disability benefits, and the payments are much larger than they were then. Fifty percent of a large, talented, young population settling onto government entitlements is a calamity.
Broadly speaking, in World War II soldiers were either in danger or out of it, fighting or not fighting. In this war, soldiers fight endlessly, existing in a perpetual state of mortal terror. Paradoxically, in fact, the times when they think they might be safe are probably more dangerous. It’s easy to see how that would cause the kind of lasting psychological trauma that would make a return to civilian life impossible.
Unless, of course, you’re a tremendous piece of shit like our friend Karl.
America has already entered our next presidential campaign, and ambitious slogans are ringing: Medicare for All! Universal Basic Income! Green New Deal! Free College! But there is an obvious battle cry waiting to be trotted out by socialists: VA Benefits for All!
Though it might not have quite the intended effect.
Get fucked, you self-satisfied ghoul.
Zinsmeister conveniently neglects to mention that despite the unconscionable wait times and the administrative hassles, the veterans who receive care from the VA overwhelmingly praise their experience. Karl and his ilk would have you believe that the VA is some half-assed patchwork clinic that offers little more than the bare minimum medical care for veterans.
Except that’s not true either. The VA is well-known for being on the cutting edge of medicine; in fact, even if you have top-of-the-line private insurance, something that’s “new” to you has likely been standard practice at the VA for a while. The reason new approaches to medicine take so long to be covered by your amazing health insurance is because your amazing health insurance company waits until they can maximize their profit on them. Or, if the pool isn’t big enough, they just don’t bother covering it.
What this should tell you is not that socialized medicine doesn’t work, but that it can’t work in the existing system. If someone can buy private healthcare, there’s no incentive for them to participate in public healthcare; as a result, the only people left in the public healthcare pool are those in the poorest health. This forces the public option to spend all its time fixing numerous existing health problems, which A) takes longer, and B) leaves no time to focus on preventing health problems before they arise.
Profit-seeking behavior is cancerous: it can’t be walled off or isolated, it can only be excised and discarded. As long as capitalism has its hooks in the American healthcare system, socialized medicine will never be truly effective. Zinsmeister and those like him want us to believe that in this, as in all things, capitalism is the solution. What they’re hoping you don’t notice is that capitalism is the reason a solution is necessary.
The VA’s shortcomings aren’t evidence that socialism has failed. They’re evidence that capitalism has succeeded.