I’ve been waiting all day for the deets so I could do a follow-up on my Breaking: post from last night. Unfortunately, not all of the details are yet known. According to Politico, the top-line number is $17bln. But the amount of the offset, and how it is done– the one detail which will determine if the deal can be written– is not specified, beyond saying some but not all of the money is offset. If enough of the cost is covered, and in an unobjectionable way to Republicans, perhaps we can get something done.
The balance of the details now known are at least tolerable, and in some cases reasonable. Five of the 17 billion is earmarked to hire new doctors; and an unknown, but limited, amount of money to provide out-of-VA-network medical services for vets who can’t get an appointment or live too far away. The major cost savings in this bill over the last one from the Senate is this limitation of spending. The bill further authorizes SecVA to start firing people to prevent this problem from occurring in the future. There is more bumf on sexual assault in the military, but the bill doesn’t actually do anything except order VA and DoD to prepare yet another useless report nobody will read, and authorizes active service personnel to use VA’s counseling centers, which latter part seems a good idea.
Uncle Bernie Sanders’ big win was getting cash to lease 27 new “major medical facilities.” One assumes Miller’s win was getting any offset at all as Democrats have wanted to treat this as “emergency spending” and just put it on the credit card without chopping any of their other priorities. We shall see if Miller’s win was big enough to actually get a deal done.
Folks, my attitude about this has changed over time. Taking care of our veterans is a primary duty, one of the rare things the feds do they actually ought to be doing, and I tend to approve of it pretty much without concerning myself regarding price. I considered price before, yes, but mostly because there is still a huge chunk of money devoted to things the feds shouldn’t be doing, and there’s no reason not to use the performance of duty as leverage to shut some of that down. Serendipity, do dah, do dah, do dah day, in other words. When the scandal first hit, my immediate reaction was to fire everybody in the entire Department of Veterans Affairs, from the Secretary on down to the Junior Sub-Assistant Janitorial Engineer for Disposable Trash Can Liners, and privatize the medical care system so most of the new hires would be (a very few) clerks verifying and paying medical bills, and not much more. In thinking that I was following the Medicare model. Medicare is the only thing anywhere near the medical care field the feds do which works even marginally, primarily because the actual medicine is done by private sector actors who know how. (Whether this will remain true after the inception of the IPAB in Obamacare remains to be see, but strikes me personally as unlikely.)
My opinion on this was changed after consulting other bloggers who happen to use the VA system– I do not– and whose opinions I respect even when I do not agree. They assure me they like the VA, and think it does a pretty good job at a reasonable price, so long as one doesn’t live in the areas where they were falsifying waiting lists. I am still leery. I don’t believe in asking the government to do things. They’re not all that bad at figuring out what to do, unless crony capitalism rears it’s ugly head, and they write decent regulations if you can keep the bureaucratic empire builders out of the game. But as far as doing anything– especially anything that can be found in yellowbook.com — well, they remind me of the old joke about an elephant being a mouse designed to government specifications. Still, I think taking care of vets has to rank pretty high, and I am loath to try to force something they don’t like. Therefore I am in agreement what we actually need is more VA, not less; and Sanders is heading in the right direction. I am still pretty fired up about using the need for more VA to chop some other government, however. I’ll wait and see how much is offset, and the way they went about it, before my approval of the deal will be unqualified.