It's Not the VA: It's Government-Run Health Care

Excellent piece in Reason’s Hit and Run blog by J.D. Tuccille that makes the case it’s not just the Veterans Administration that is at fault for the scandal. The problem is government-run health care systems in general, as the UK, Canada, and other places have already discovered.


Such delays are typical of government-controlled, single-payer systems, I wrote yesterday. They’re such a regular feature that the U.K. National Health Service boasts “you have the legal right to start your NHS consultant-led treatment within a maximum of 18 weeks from referral.”

And the deaths that go with such delays may also be a regular feature of single-payer systems.

“Canada’s growing wait times for health care may have contributed to the deaths of 44,273 Canadian women between 1993 and 2009,” that country’s Fraser Institute announced just yesterday.

The estimated 44,273 deaths between 1993 and 2009 represent 2.5 per cent of all female deaths in Canada during that 16-year period, or 1.2 per cent of Canada’s total mortality (male and female).

More specifically, during that same 16-year period, for every one-week increase in the post-referral wait time for medically necessary elective procedures, three female Canadians died (per 100,000 women).

The study reaching those conclusions found no such dramatic relationship between extended waits for care and male mortality, which is reassuring to those of us with a Y chromosome. For double-XXs, not so much.

Fraser reports that wait times for Canada’s single-payer system have grown across 12 major medical specialties from 9.3 weeks in 1993 to 18.2 weeks in 2013. The extended delays grew so bad in Quebec that Canada’s Supreme Court ruled laws banning private medical insurance unconstitutional in 2005.


Wait times for patients in a government-run system appear to be a feature, not a bug.

Inefficiencies are endemic in large bureaucracies because there is zero incentive to perform at a high level. No one works hard because slackers get paid just the same as good workers. There was no incentive at the VA to figure out a way to cut wait times. In fact, it was easier to attempt to cover up the problem than fix it.

For all the enthusiasm shown by the left for a single-payer system, there doesn’t seem to be much thought given to the consequences.  In fact, those eager to expand the power and reach of Washington rarely, if ever, carefully weigh what would be gained against what would be lost or destroyed. It’s why every major initiative by this president has been a disaster — a lack of prudence and judgement that has led to far too many unintended consequences.

Of course, in the case of the VA vs. sick vets, the consequences were known: death and serious illness. But because there is little or no accountability, there was every incentive to hide the bad news.


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