As a scandal involving long delays at Veterans Affairs hospitals mounts, it's worth recalling that liberals have long touted the socialized medical system as evidence that government-run health care can work.
New York Times columnist Paul Krugman has penned several valentines to the Veterans Health Administration over the years. In a 2006 column, Krugman argued that the system was, “one of the best-kept secrets in the American policy debate.”
He explained, “pundits and policy makers don't talk about the veterans' system because they can't handle the cognitive dissonance. ... For the lesson of the V.H.A.'s success story -- that a government agency can deliver better care at lower cost than the private sector -- runs completely counter to the pro-privatization, anti-government conventional wisdom that dominates today's Washington.”
In 2011, Krugman wrote a column blasting Mitt Romney after the Republican presidential candidate called for partially privatizing the system. “What Mr. Romney and everyone else should know is that the V.H.A. is a huge policy success story, which offers important lessons for future health reform,” he wrote.
The lessons, he said, were that the incentives created by its integrated care model led to less waste and better quality care. “(Y)es, this is ‘socialized medicine,’” Krugman wrote, noting that some private enterprises also took a similar approach. “But it works — and suggests what it will take to solve the troubles of U.S. health care more broadly.”
In a 2007 article for the American Prospect, Ezra Klein also praised the system's outcomes. “What makes this such an explosive story is that the VHA is a truly socialized medical system,” Klein wrote. “The unquestioned leader in American health care is a government agency that employs 198,000 federal workers from five different unions, and nonetheless maintains short wait times and high consumer satisfaction.”
Both authors cited Phillip Longman, who wrote an influential book on the Left titled Best Care Anywhere: Why VA Health Care is Better Than Yours. Longman, in a 2005 article for the Washington Monthly that led to the book, wrote, “It turns out that precisely because the VHA is a big, government-run system that has nearly a lifetime relationship with its patients, it has incentives for investing in quality and keeping its patients well--incentives that are lacking in for-profit medicine.”
The description of the system offered by liberals stands in stark contrast to the horrifying reality depicted in recent reports on how the veterans' health care system has neglected patients and covered up wait times – at a deadly cost.
The Washington Examiner reported in February that backlogged orders for medical care were being mass purged at hospitals in Los Angeles and Dallas to make wait times seem less than they really were.
Last month, CNN reported that at least 40 veterans had died waiting for treatment at the Phoenix Veterans Affairs medical system, and that many were put on a “secret waiting list” to mask the fact that 1,400 to 1,600 veterans had to wait months for doctors.
Earlier this month, the Examiner's Mark Flatten also reported on patients in Texas who had trouble getting colonoscopies. “By the time that you do the colonoscopies on these patients, you went from a stage 1 to a stage 4 [colorectal cancer], which is basically inoperable,” Dr. Richard Krugman, a former associate chief of staff at the Veterans Affairs health care system based in Harlingen, Texas, said in an interview.
A Los Angeles Times investigation found that the problems with the system were widespread. Though the VA has touted improved wait times, the article quoted Dr. Jose Mathews, chief of psychiatry at the VA St. Louis Health Care System, as saying, “The performance data the VA puts out is garbage -- it's designed to make the VA look good on paper.”
Last September, I spent time in England researching the socialized British medical system, the National Health Service, for the Examiner's magazine edition, and encountered similar stories - of patient neglect and an unaccountable bureaucracy focused on gaming the system so they could claim to be meeting targets.
If liberals want to toast the Veterans medical system as an example of government-run health care done right, they are going to have to seriously grapple with its tragic failures.