June 6, 2014

Rearranging Deck Chairs of the Health System

Moves to address two massive federal failures won’t be enough.

Congress moved comparatively swiftly this week to address the fallout from two separate federal failures. Both Health and Human Services and Veterans Affairs are under new leadership now, but the problem with both is deeper.

The resignation of Kathleen Sebelius as HHS secretary earlier this year paved the way for a relatively fast confirmation of former Obama budget director Sylvia Mathews Burwell as her successor. The vote wasn’t even close – 78-17. While many Republicans voted for her, they didn’t seem at all confident in what Senate Minority Leader Mitch McConnell called “a new captain for the Titanic.”

Burwell will still have to sort out a number of problems that have plagued the ObamaCare rollout, with new issues stemming from the failure of exchanges in several states as well as the possibility that subsidies going to millions of taxpayers were incorrectly calculated, meaning those taxpayers may receive a rude surprise next April when they get a smaller refund or owe more than expected. She promises to recover federal money lost on state exchanges, but we’re not holding our breath.

Meanwhile, the widening VA death-panel scandal prompted the Senate to reach a grand bipartisan compromise on reform. Republicans received important concessions allowing veterans who live more than 40 miles away from VA facilities to seek care at private facilities that accept Medicare, as well as expanded powers for the VA Secretary to demote or fire officials tied to the scandal. Democrats picked up 26 major medical facilities in 18 states and Puerto Rico – creating smaller areas where the 40-mile zone would be in effect – and $500 million more to hire new doctors and nurses.

“This is not a perfect document,” said Sen. John McCain (R-AZ), but he urged quick passage. “Let’s not get hung up on certain other aspects of our differences that most people would view as gridlock in this body.”

Yet neither of these actions – confirming Burwell or “reforming” the VA – address the root cause of the problem: government involvement in health care. Sen. Richard Burr (R-NC) sensed this in February when a VA reform bill failed to achieve cloture in the Senate. “Veterans waiting for their disability claims to be processed know all about frustrations and delays at the VA,” said Burr, “and adding more individuals to an already broken system doesn’t seem wise.” The same principle holds true regardless of the government health care delivery system, whether VA or ObamaCare.

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