One who was probably not taken by surprise is longtime Yale Law Professor Peter Schuck, who identified the problems at the VA before the scandal broke in his recently published book, “Why Government Fails So Often and How It Can Do Better.”
Schuck is no anti-government libertarian. He says he has voted for every Democratic presidential candidate but one since 1964.
The federal government, he notes, does more things than ever and gets less respect than ever from the people it purports to serve. There is, he argues, a connection.
The Department of Veterans Affairs is a case in point. Writing well before the current scandal, Schuck notes that the VA’s budget has more than doubled in real terms over a dozen years, from $45 billion in 2000 to $154 billion in 2012, and that it hired many more claims processors.
“Yet as Congress keeps authorizing new benefits and makes eligibility easier, the backlog (now 900,000 claims) grows steadily worse due to the agency’s continued reliance on paper records, its perversely designed production quotas that encourage employees to reach for the thin folders first, the numerous refilled and appealed claims after denials, and its lax definition of disability to include common age-related conditions.”
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But, as the Ethics and Public Policy Center’s Yuval Levin points out, “centrally run, highly bureaucratic public health care systems that do not permit meaningful pricing and do not allow for competition among providers of care can really only respond to supply and demand pressures through waiting lines.” Long queues are the price of free care.
It’s easy to call for eliminating waste, fraud and abuse, and sometimes an administrative change can improve performance. Levin, who worked in the George W. Bush administration, credits the Clinton administration for some “very well executed” modernization efforts at the VA.
But policy failure and mismanagement, Schuck argues, are the result of “the deep structures of our policy system — perverse incentives, collective irrationality, lack of credibility with necessary stakeholders, the superior speed, flexibility and incentives of private markets, obstacles to implementation, the inherent limits of law as a policy instrument and a mediocre and degraded bureaucracy.”
It doesn’t help when you have a president uninterested in the actual operations of government and a VA secretary unduly trusting of subordinates.
Obama came to office determined to expand government and confident that Americans would like it. Instead, Obamacare, the sluggish economy and now the VA scandal have tended to discredit big government more than any abstract argument could.
