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Kevin Williamson has written a long essay that seeks to answer a question raised by the Veterans Administration’s failures. It is a question everyone should ask. But, it is a most important question for liberals who believe in using government force to address problems. (Problems most likely caused by earlier state compulsions.). Here’s the question; “How is it possible that the government of the United States of America — arguably the most powerful organization of any sort in the history of the human race, in possession of a navy, a nuclear arsenal, and a vast police apparatus — cannot ensure that its own employees and contractors do not negligently kill its other employees and former employees? Never mind providing veterans with world-class medical care — the federal government cannot even prevent bureaucratic homicide.”
Politics is not always about somebody getting his way and somebody else failing to get his way. Consider the case of the Veterans Affairs hospitals: Nobody wanted this outcome. That outcome, recall, is a great many dead veterans, the result of medical and managerial malpractice. Democrats did not want the hospitals that care for our veterans to be catastrophically mismanaged while administrators set about systematically destroying the evidence of their incompetence, and Republicans did not want that, either. Independents are firmly opposed to negligently killing veterans. It doesn’t poll well. Everybody is so opposed to that outcome that we created a cabinet-level secretariat to prevent it and installed as its boss Eric Shinseki, a highly regarded former Army general. We spent very large sums of money, billions of dollars, to prevent this outcome, almost trebling VA spending from 2000 to 2013 even as the total number of veterans declined by several million.
Nobody wanted these veterans dead, but dead they are. …
… There will be plenty of personal culpability to go around as this mess all comes to light, beginning with President Obama, who offered himself to the American people as, among other things, a competent authority on the management of health care. He promised the country openness and transparency but has worked assiduously against those qualities, which carry not only ethical weight but practical value as well: Open and transparent arrangements are much less prone to abuse, especially abuse of the sort that results in death, because observation is linked to accountability, which is why police officers make so many wrongful arrests and destroy so much evidence in response to the perfectly legal act of videotaping them at work. (E.g.) The right thing to do, in response to 40 and counting veterans killed through negligence on his watch, is for President Obama to resign. A man with any self-respect would do it; a country with any self-respect would demand it. But that of course is not what is going to happen. …
… Politics is mostly words about words, but it has real-world consequences, and death is not an uncommon one. The truth, which in Washington is an unspeakable truth, is that almost the entirety of our conversation about politics is predicated on a fundamental error in our understanding of reality. Unlike a certain Entity with Whom presidents and senators sometimes seem to confuse themselves, politicians cannot speak reality into being. (“Let there be . . . health care.”) The situation at the VA should not surprise us; what did we expect, having no way of even knowing what we should have expected? This outcome was at least as likely as any other, and certainly more likely than one in which reality matched policy through some obscure divine office unknown to us.
If you want to blame somebody, blame Democritus.
Democritus was the Greek philosopher who first imagined the atom, some time around 460 b.c. He thought that if you broke a rock in half, broke one of those halves into even smaller pieces, and kept on going, eventually you would arrive at an indivisible unit of matter, which he called the atom (ἄτομος, “indivisible”). He had a great many ideas about atoms: They are everywhere, eternal, indivisible, always in motion, etc. And the Greek world yawned, and the entire world continued yawning for about 2,000 years. Nobody gave a fig about his atoms.
Then, in the 19th century, a couple of Englishmen went hunting for them. …
… most of us, when we think of an atom, think of Rutherford’s miniature solar system. The macro-micro universe is interesting to the philosophically inclined and deeply compelling to a certain class of stoner. It is very appealing, this infinitely scalable model of the universe. In the false belief that we can comprehend it all at once, we feel a little like that Entity with Whom politicians confuse themselves. There is a reason that the orrery (scale model of the solar system) is so arresting to the imagination of a certain kind of man — it is the very image of what the politician imagines the universe to be like:
The unspoken promise is that of reduction: To understand the whole, understand its parts. Understand the atom and you can build an explanation of the universe. Those ideas could be seductive to scientists, but they were practically opiates for politicians. We still hear the unhappy echo of the early-20th-century hymns to totalitarianism in our political campaigns — “How shall we govern? With science!” Copernicus’s neat solar system, Rutherford’s neat atom — with a world that simple, how difficult could it be to shape it to our own desires? …
… How confident should we be that our policies will produce the desired outcomes? That will depend in some part on how complex the system is that you are attempting to influence. Housing and mortgage markets are very complex, and politicians’ efforts to turn them to their own ends went very badly in 2008, and will go very badly again in the future. Health-insurance markets and medicine are both very complex, and we see how political efforts to manage those have been going.
Operating hospitals is a complex business, too. Consider a counterexample: Our food-stamp program has many problems, but imagine what a Hieronymus Bosch nightmare it would be if, instead of the current practice of giving poor people vouchers for food, we applied the VA model and attempted to have the government deliver the service itself rather than simply paying for it. That would mean federally operated farms, ranches, and slaughterhouses, government grocery stores, warehouses, distribution centers, transportation networks, etc., all managed with the competence and decency exhibited by the VA. Rather than trying to politically steer the extraordinarily complex system of producing and distributing food — rather than biting off way more than we can cognitively chew — we instead chose the relatively simple method, giving poor people vouchers for food. Of course that has its problems and unintended consequences, but they are milder than, say, national famine, which is probably what would come of government-run agriculture. We let the complex problem of food production meet the complex solution of the market.
Not every regulation or government program is doomed to fail. But we might consider the slightly terrifying possibility that when government does get something right, it does so by accident, temporarily, and for reasons that it cannot understand or replicate. …
… Another feature of complex systems is that some of them are very sensitive to initial conditions, as expressed by the butterfly effect. It may be the case that things have gone as well as they have for us in the United States not because of any current policy or because of the unique genius and saintliness of our national leadership as currently constituted, but simply because the right people with the right prejudices did the right things for a relatively short period of time in the 18th century, and what we have now is very little more than the compounded returns on that cultural windfall. That seems to me a more likely explanation for our relatively happy and secure place in the world than that we were led to this point by the kind of thinking, and the kind of men, who brought us the VA hospitals and those dead veterans.
Roger Simon posts on the VA scandal.
Many have wondered about Barack Obama’s prolonged silence concerning the disastrous situation at the Veterans Administration hospitals and then his odd detached demeanor (well, maybe not that odd for him) when he finally did discuss it at a press conference.
The answer is simple. His lifetime dream of a free public (single payer) healthcare system for all just disintegrated in front of him. Forget the wildly ambitious and pervasive “Affordable Care Act,” the government couldn’t even handle the health of our wounded servicemen, acknowledged for years to be by far the group most deserving of medical attention in our country. With veterans dying while waiting lists are falsified, it’s hard to see government healthcare as anything but incompetent, disgraceful and quite possibly criminal.
Government has failed utterly. Does anyone have any doubt that Halliburton or even the dreaded Koch brothers could have better handled the health of our wounded warriors? …
Ben Shapiro asks why the left is no longer claiming the VA is proof government run health care will be so wonderful.
As the fallout from the Veterans Administration cooking of the books and the related deaths of over three dozen veterans continues, President Obama took to the podium on Wednesday to explain that problems at the VA are nothing new. On Wednesday, President Obama took to the podium to first express his tremendous anger – VA Secretary Eric Shinseki was “mad as hell” but President Obama was “madder than hell,” thus winning the rage sweepstakes – and then explained that the VA’s issues go back years:
[A]ll of us, whether here in Washington or all across the country, have to stay focused on the larger mission, which is upholding our sacred trust to all of our veterans, bringing the VA system into the 21st century, which is not an easy task…. caring for our veterans is not an issue that popped up in recent weeks. Some of the problems with respect to how veterans are able to access the benefits that they’ve earned, that’s not a new issue.
Obama’s statement, however, was remarkably short on actual solutions for the VA. Throwing money at the problem hasn’t fixed it: using 2011 dollars, America spent $88.8 billion on the VA in 2007, and $125.3 billion on the VA in 2012.
And herein lies the problem for the left: the failures at the VA, including its bureaucratic incompetence, its waiting lists, and its deaths, all debunk the notion that a government-run healthcare system will work. It’s a fresh slap in the face to all those commentators who, in pushing Obamacare, endorsed the VA as a model.
There are some pretty big names on that list. Paul Krugman in 2011 wrote of the VA’s “huge success story”: …
Power Line has more in this vein. As you can see, Paul Krugman has been a flack for left wing causes for a long time.
At the Wall Street Journal, James Taranto pulls together liberals’ endorsements of Veterans Administration health care. It goes beyond just claiming that VA medicine was top notch; liberals often claimed that the supposed success of the VA is proof that government is superior to the private sector. Taranto titles his post “Socialist Supermodel.” You should read it all, but here are a few highlights:
[I]n January 2006, … former Enron adviser Paul Krugman wrote this:
I know about a health care system that has been highly successful in containing costs, yet provides excellent care. And the story of this system’s success provides a helpful corrective to anti-government ideology. For the government doesn’t just pay the bills in this system–it runs the hospitals and clinics.
No, I’m not talking about some faraway country. The system in question is our very own Veterans Health Administration, whose success story is one of the best-kept secrets in the American policy debate. …
Jonathan Tobin notes the faux outrage of the president.
… Nor is there any indication that Obama or anyone else in this administration is capable of seeing that perhaps the reason for the systemic problems at the VA is the reliance on government health-care institutions burdened by bloated bureaucracies. Given Obama’s almost religious devotion to big government, don’t expect that this president can wrap his brain around the right fix to a problem that may require a complete reform of this system and a switch to a vouchers scheme that would end the spectacle of veterans waiting weeks or months for the health care they need.
For the president to emerge from a meeting about this controversy praising the good services millions get from the VA and speaking of how much Shinseki cares about veterans does nothing to divert the American people from understanding how much Obama has failed as a leader. Nothing said today will enhance the confidence of the public or of veterans that this situation is being handled properly or that the president has the ability to act to stem a crisis in the making. It took him five and a half years to realize that he had to do something more than talk about the need to help veterans. In the meantime, more than 40 died. There’s no telling how many more will suffer and how many other scandals will pop up in the two and a half years he has left in office. But no matter what the total turns out to be, no one should expect anything more than lip service and belated concern from an absentee president.
Jennifer Rubin speculates on what conservative reform of the failed liberal state might look like.
Whether it is the Department of Veterans Affairs, Medicaid, student loans or any other mismanaged and excessively expensive aspect of the liberal welfare state, the left’s answer to any reform proposal is invariably, “No, you’re trying to destroy it!” To try to reform these programs is, in the left’s eyes, an attempt to hurt the poor, sick, disadvantaged and powerless. The recipients in the current system may not get good care or students may be weighed down with huge debt and no useful degree, but liberals are content so long as more and more taxpayer money is poured into failing programs. Likewise, Medicare and Social Security can crowd out all other domestic programs and be on the road to bankruptcy, but reformers who attempt to make it sustainable for the long haul are accused of throwing Granny over the cliff.
The collapse of the welfare state and the instinctive liberal reaction to defend ferociously the status quo are part of the motivation for the reform conservative movement that is shifting the GOP’s agenda from indiscriminately cutting government to rethinking government. At a panel at the American Enterprise Institute (a prior panel and speech by the Senate minority leader are described here), a set of conservative scholars discussed a new policy initiative, “Room to Grow: Conservative Reforms for Limited Government and a Thriving Middle Class.”
One of its authors, Yuval Levin, explains in the book’s introduction: “The fundamentally prescriptive, technocratic approach to American society inherent in the logic of the Left’s policy thinking is a poor fit for American life at any scale. The liberal welfare state ultimately cannot be had at an affordable price. It is not the architecture of one or another particular program that makes it unsustainable. It is unsustainable because the system as a whole must feed off of the innovative, decentralized vitality of American life, yet it undermines both the moral and the economic foundations of that vitality.” In other words, it’s bound to fail. …
Victor Davis Hanson posts on the ethically challenged administration.
Veterans Affairs Secretary Eric Shinseki cannot get a handle on the recent scandalous treatment of veterans in VA hospitals, where more than 40 sick men were allowed to die without proper follow-up treatment. A cover-up allegedly followed. When the Walter Reed Army Medical Center scandal broke under the George W. Bush administration, heads rolled. So far, Shinseki seems immune from similar accountability.
Almost nothing that former secretary of health and human services Kathleen Sebelius promised before, during, or after the implementation of the ill-starred Affordable Care Act came true. She was also cited by the U.S. Office of Special Counsel for violating the Hatch Act, as she improperly campaigned for Obama’s reelection while serving as a cabinet secretary.
Former IRS official Lois Lerner used the federal tax-collection agency to go after groups deemed too conservative. She invoked the Fifth Amendment to avoid telling Congress the whole truth.
Susan Rice, former U.N. ambassador and now national-security adviser, flat-out deceived the public in five television appearances about the Benghazi catastrophe. She insisted that the deaths of four Americans were due to a spontaneous riot induced by a reactionary video maker — even though she had access to intelligence fingering al-Qaeda-affiliated terrorists as the culprits who planned the attack on the anniversary of 9/11. …