Systemic

As part of my job at our small company, I have to drive up and down I-95 in South Florida almost every day. There are two interesting billboards, sponsored by the Emergency Department at two major competing hospitals. On each of the billboards, there's a digital timer that represents the current wait time at the hospital's emergency department. The numbers vary by the day, but the intent is clear—to indicate that the hospital offers short wait times in its ER, and that's something you should consider if you need emergency medicine. It's called private sector competition.

Now consider an example of public sector health care—the recent VA scandal.

Jonah Goldberg comments:

Many have noted, including our own John Fund, that the VA scandal poses an acute threat to the Obama administration because of how much its problems resemble the criticisms of Obamacare itself. But let’s imagine there was no Obamacare. Let’s imagine that Obama had actually followed through on his occasional promises to focus on the economy and jobs first and foremost and didn’t blunder into the huge wasteful distraction that is the Affordable Care Act.

The lessons of the VA would still be a problem for Obama and for liberals generally.

Why? Because the Democratic party simply is the party of government. It is the party that insists on the nobility, efficacy and intellectual superiority of government. The VA is at the intersection of all the things liberals insist are wise and good and just about government. It is government-run healthcare. It is the tangible fulfillment of a sacred obligation the government has with those who’ve sacrificed most for our nation. It is also the one institution and/or constituency that enjoys huge bipartisan support. The VA, rhetorically and politically, is more sacrosanct and less controversial than Medicare, Social Security, road building, the NIH, or public schools. We are constantly told that we could get so many wonderful, super-fantastic things done if only both sides would lay down their ideological blah blah blah blah and work together for yada yada yada. Well, welcome to the VA. How’s that working out for you?

The White House keeps saying these horrible cases of deception and wrongdoing are “isolated incidents” and not “systemic.” As I asked last night on Special Report, how many isolated incidents do you need before they become systemic? Right now, allegations have surfaced in 19 states. That feels systemic to me. But what do I know?

Federal government programs are doomed to this level of inefficiency, mismanagement, high cost and even fraud because there is no incentive to do better, and nothing that Barack Obama or any president says or does will matter. Nothing!

The way to reduce (but not totally eliminate) inefficiency, mismanagement, high cost, and even fraud is the same in virtually every instance of government malfeasance—downsizing the size of the federal government. In the case of the VA, we need to drastically downsize its staff, its administration and its physical plant, and replace the VA in its current form with private sector providers who will be driven by two dirty words —profit and competition—to provide better care to our vets.

UPDATE (5/21/14)
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And this from Kevin O'Brien:

One conclusion we can draw is an old, familiar one: No matter what the issue or activity, bureaucracy's first and strongest instinct is to protect itself in the face of a perceived threat.

Another conclusion is probably just dawning on those Americans with the wit to see it, because so very few of us have had a brush with a medical system of which government is the sole proprietor: Putting a government bureaucracy in charge of one's health is a gamble likely to end badly.

And yet, if Obamacare stands, that is precisely the gamble each and every American eventually will take.

There is no better predictor of the course of a single-payer medical system in the United States than the VA system, because it is a single-payer system.

If an enrolled patient needs something done, he or she applies to the government-run system for approval; waits until the government-run system is ready to act; accepts the government-run system's solution or, if dissatisfied, appeals to that same government-run system for relief. Because the bureaucracy pays the bill, the bureaucracy makes the decisions — when or if treatment will be given, and whether or not the patient has been well enough served.

The 'unimaginable benefits' of a single payer health care system is a well-know progressive fantasy. The reality is much, much different and is exemplified by the VA scandal. If Obamacare survives, it will do to civilian healthcare what the VA has done for military veterans healthcare. We should be very worried.

UPDATE - II (5/24/14):
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And this comment about entrusting big government programs with our privacy, our health, our education, and our welfare from Glen Reynolds of Instapundit:

The “best and brightest” are neither particularly good nor evidently bright. We have the worst political class in our nation’s history, which is the best argument for taking power away from them, not granting it to them.