The VA Is a Mess—But Not Because of Who’s In Charge: New at Reason

The Department of Veterans Affairs is really hard to staff.

Its Veterans Health Administration (VHA) has 30,000 vacant clinical positions. Eligibility-claims processers are in such short supply, there remains a waiting list 75,000 veterans long. Appeals of eligibility denials have a backlog of more than 300,000 and take an average of 2.5 years to resolve. The VA even lacks undersecretaries to supervise those areas.

To top it all off, President Trump ousted former Secretary David Shulkin over differences about whether to pay for veterans to receive care from private providers, and his pick to succeed Shulkin—Rear Adm. Ronny Jackson, M.D.—recently withdrew his name from consideration over allegations of on-duty drunkenness, harassing female coworkers, and such and such.

This ongoing soap opera, however, keeps anyone from asking the right questions or proposing the right reforms.

Shortages and waiting lists at the VA are hardly surprising. Its health care system, the VHA, is the United States’ version of the U.K.’s single-payer National Health Service. It is an entirely socialist enterprise, where the government owns the means of production (hospitals, clinics, CT scanners, bedpans), employs the workers, decides how much everyone gets paid, and generally chooses how to allocate all those capital and human resources.

In other words, it’s a system without true prices—and that’s why it doesn’t work.

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