Freedom Line Blog

Recently, Yuval Levin wrote a characteristically sober and insightful post about the structural problems afflicting not just the Veterans Affairs hospital system, but the VA itself.

Amid other obstacles to reform, Levin explains why certain veterans groups share some of the blame for the VA’s managerial mess.

It is impossible to overstate the political power of the veterans’ interest groups over the VA. The simplest way to describe it is that they get everything they want, period. There are many powerful interest groups in Washington, but because their domain is carefully limited and politically and culturally sensitive, the vets’ groups have a kind of command of their arena that I don’t think any other sort of interest group approaches. And this is a big part of the reason why the VA is so dysfunctional, because it is not subject to congressional or administrative oversight in the usual sense. It answers fundamentally to the vets’ groups. They often informally review its annual budget request before it goes to OMB. They are uniquely involved in drafting budgets on the congressional side. They are considered a necessary signoff on every major decision. Their firm opposition to something is the end of the story. Their priorities are the VA’s priorities. And yet they are very well positioned to treat failures that result from their own distorting power over the system as reasons to increase their power.

Every successful interest group enjoys a certain amount of leverage to get what it wants, but the power exercised by veterans’ organizations that Levin describes is itself a scandal in need of reform. Somewhere the public’s commitment to serve those who served all got hijacked by lobbyists imposing policy choices that are clearly having deleterious effects on retired and disabled veterans. Any reform of the VA department needs to include whatever measures are necessary to uproot this latest case of regulatory capture.

As I noted here at CFIF when she first became chair of the Democratic National Committee, Rep. Debbie Wasserman Schultz (D-FL) is to demagoguery what Harold Stassen was to presidential campaigns: an avid, enthusiastic participant in the game, but not very effective at it.  Yuval Levin yesterday at NRO blitzed her for a recent example of her barely skilled mendacity.  The same day, at Michelle Malkin’s site, Doug Powers made mincemeat of another of the congresswoman’s lamest hits.

Stay tuned for more of the same from this left-wing prevaricator.  Because she be illin all the time, except instead of not being able to walk straight, she just can’t talk straight.

Over at The Corner, the incomparable Yuval Levin has a great explainer on why President Obama’s accomodationist tone on health care in yesterday’s White House speech to the National Governors Association was a headfake. He notes:

Speaking to a group of governors yesterday, the president said he would support legislation that would allow states to opt out of some of Obamacare’s requirements (including the individual mandate, the employer mandate, and the state exchanges) if they show they can achieve exactly the same results in some other way. Obamacare itself actually already contains such a provision, but it would allow states to apply for such waivers starting in 2017—after these mandates and requirements have been in place for three years. Obama now says he would let states apply for waivers in 2014, when the new rules begin.

This change of heart, like the one regarding the CLASS Act, is a concession to the fact that the law’s requirements are understood by many state officials (of both parties) as immensely burdensome and problematic. But like the one regarding the CLASS Act, it is also not an actual concession in practice. The states would be required to show that their alternative policies would provide the same or greater insurance benefits to the same or greater number of people, presumably as assessed by HHS. So it allows no flexibility regarding ends, and therefore very little flexibility regarding means. In fact, while it would allow conservative-leaning governors essentially no freedom to move in the direction of greater competition and more consumer-driven health care (which conservatives tend to see as the actual path to reducing costs and therefore insuring more people while improving quality) it would give liberal-leaning governors significant freedom to move in the direction of more government control. Indeed, as the New York Times notes today, while the approach Obama supports would not allow for many consumer-driven reforms it “might allow interested states to establish a single-payer system in which the government is the sole insurer.”

Yuval Levin notices an interesting trend in the various plans coming out of the Obama Debt Commission.  When the proposals are added together there seems to be a consensus building towards overhauling federal healthcare entitlement spending.  If done correctly, it could be a moment for conservatives to inject market principles like choice and opportunity into the system.

There is growing agreement in American politics that the challenge of our time is cleaning up the horrible mess created by the Great Society—the mess that is our approach to domestic discretionary spending but above all the mess that is our health-care entitlement system. That is the essence of our debt and deficit problems.

The question is whether we can deal with that mess by keeping the basic structure of the Great Society entitlements while trimming significantly elsewhere and massively raising taxes, or whether we must deal with it by fundamentally reforming those Great Society entitlements while trimming significantly elsewhere and spreading the tax burden more widely but less heavily to encourage growth and innovation. The latter is fairly obviously the answer to that question—given demographic and economic realities, and given the kind of country the American public wants to live in—but it will take a little time before that really sinks in. It is a very good thing, though, that the question is now being asked.

Reforming (or rather, transforming) the Great Society into a fiscally sustainable, free market-guided, consumer-driven system would be the kind of bipartisan project worthy of the era President Barack Obama and his congressional counterparts find themselves.  Solving that puzzle would establish the president’s sought for legacy while enacting the kind of policy changes the Rep. Paul Ryan (R-WI) and other conservative intellectuals champion.

H/T: National Review Online