In most human endeavors the natural inclination is to reward success and punish failure. The fact that the federal government works in rather the opposite way is just one of the ways it which it differs from the universe most of us inhabit. In Washington if you want a huge amount of money the best way to go about it is to fail. Case in point is the Department of Veterans Affairs.
The VA has long suffered from what, in the Army, we often referred to as the "happy loser syndrome." The VA has been failing for so long that not only does no one outside the VA expect it to succeed but failure, itself, has become the VA's corporate ethos.
So when negotiations foundered yesterday on a bill that is supposed to reform the VA, guess what it was over? That's right. Money. The White House has requested an additional $17.6 billion, billion, for the VA:
The Obama administration says it needs about $17.6 billion to hire thousands of doctors, nurses and other health professionals, lease new facilities and upgrade its computers to reduce a backlog of veterans awaiting care at VA hospitals and clinics. The administration's request does not include money to make it easier for veterans to get health care from private doctors, the biggest cost in Congress's bills.
This is not $17.6 billion in competition with the $20 billion or so already under discussion in Congress. This is $17.6 billion on top of the Congressional number:
[Acting VA Secretary Sloan] Gibson said the VA would use the $17.6 billion to hire 10,000 new clinical staff members, including 1,500 doctors. It would allocate $6 billion for infrastructure improvements, including building eight new medical facilities and leasing 77 more around the country.
The money would come on top of funds included in a separate bipartisan reform bill that both houses of Congress passed in June. That legislation is in a conference committee to work out differences.
Looking back at the past year of stories about the VA, a rational person would conclude that a) it is an agency in need of radical reform, b) it needs a thorough housecleaning, and c) the last thing it needs is more money. The fact is that the VA budget has grown at a much greater rate than civilian medical care expenses and the number of veterans requiring VA services declines each and every year. Keep in mind that the military that fought in Iraq and Afghanistan was smaller than the Cold War military. Does the VA need that incredible amount of money?
According to reports, the VA hospital in Albuquerque has eight cardiologists who between them see as many patients per week as a single private sector cardiologist would see in two days. The VA doctors get paid the same amount regardless of how many patients they see, so why should they work harder? Liberals may hate profits and the supposed greed it inspires, but profits would get those doctors working harder and could have saved the lives of sick veterans.
In the past few years, the VA has spent hundreds of millions of dollars on furniture instead of hiring more doctors because seeing more patients and delivering better patient care did not bring in more money. If anything, government agencies can best gain budget increases by having problems since politicians seem to think that problems can be solved by throwing more money at them. In reality, problems are solved by allowing markets to work and by getting the incentives right.
There is no rational way the VA could use the extra money requested by the administration. But there doesn't have to be. In Washington, failure rather than success guarantees that you will not only thrive but prosper.