"So Secretary Eric Shinseki is now ex-secretary Shinseki, and cleaning up the Department of Veterans Affairs' health care mess will now be someone else's job.
But there's a good chance that no matter who is in charge, the cleanup will be, basically, impossible.
That's because the VA is government health care.
Not all that long ago, some people were boosting the VA's government-run nature as a plus.
Writing in the Washington Post during the debate over Obamacare, Ezra Klein suggested that we should expand VA coverage to non-veterans, because the government just does health care better than the private sector:
"Medicare is single-payer, but VA is actually socialized medicine, where the government owns the hospitals and employs the doctors. ... If you ordered America's different health systems (from) worst-functioning to best, it would look like this: individual insurance market, employer-based insurance market, Medicare, Veterans Health Administration.".....And that captures an important point.
People sometimes think that government or "nonprofit" operations will be run more honestly than for-profit businesses because the businesses operate on the basis of "greed."
But, in fact, greed is a human characteristic that is present in any organization made up of humans. It's all about incentives.
And, ironically, a for-profit medical system might actually offer employees less room for greed than a government system.
That's because VA patients were stuck with the VA.
If wait times were long, they just had to wait, or do without care. I
n a free-market system, a provider whose wait times were too long would lose business, and even if the employees faked up the wait-time numbers, that loss of business would show up on the bottom line.
That would lead top managers to act, or lose their jobs.
In the VA system, however, the losses didn't show up on the bottom line because, well, there isn't one.
Instead, the losses were diffused among the many patients who went without care -- visible to them, but not to the people who ran the agency, who relied on the cooked-books numbers from their bonus-seeking underlings.
And, contrary to what Klein suggests, that's the problem with socialism.
The absence of a bottom line doesn't reduce greed and self-dealing — it removes a constraint on greed and self-dealing.
And when that happens, ordinary people pay the price.
Keep that in mind, when people suggest that free-market systems are somehow morally inferior to socialism."
