We’ve been following the VA waitlist/rationed health care scandal since it provides such a clear window into the priorities of so many the federal government’s bureaucrats, who we’ve argued chronically put their own interests above those they are intended to serve.
But the scale of those mispriorities is only just now becoming known. That is perhaps nowhere more clear than in the Congressional testimony prepared by a VA whistleblower from Atlanta, Scott Davis, who has put a number to how many applications for VA health care access that have been stalled for no good reason for years at the department’s national Health Eligibility Center in DeKalb County, Georgia. The Atlanta Journal-Constitution reports:
Whistleblower Scott Davis will tell the House Committee on Veterans’ Affairs that as many as 40,000 unprocessed health applications were discovered by HEC last year, primarily from veterans returning from Iraq and Afghanistan. His testimony is part of a Congressional hearing focused on VA whistleblower complaints and retaliation they’ve faced within the agency.
The HEC oversees enrollment and eligibility for veterans seeking to enter the VA health system nationwide. Last month, Davis told investigators with the VA inspector general’s office about mismanagement within the agency. Investigators are looking into allegations that more than 10,000 health applications from veterans may have been improperly purged from the HEC data system.
The AJC reported Davis’ story in an exclusive June 29. Just days after the article, he was contacted by the committee about testifying at tonight’s hearing. Other VA whistleblowers in the HEC office and in the Atlanta area have also contacted Davis since the AJC’s article ran.
Davis said one of those tipsters alerted him to the 40,000 unprocessed applications discovered in January 2013. He said the center is supposed to process applications within five days after they are received, but some of the 40,000 had been sitting for three years.
In the AJC’s original report, Davis previously described the VA’s priorities for processing these incoming applications to receive access to the VA’s health care services:
“We don’t discuss veterans,” Davis told the newspaper. “We do not work for veterans. That is something that I learned after working there. Our customer is the VA central office, the White House and the Congress. The veterans are not our priority. So whatever the initiatives are or the big ticket items that is what we focus on.”
As for what the VA’s bureaucrats at its Health Eligibility Center were doing instead of processing applications from veterans seeking medical care, Davis opened a window into the directions the Center received from the VA’s higher-ups in Washington D.C. in an interview with Fox News’ Neil Cavuto. TruthRevolt provides a partial transcript:
For example, I shared with your producer that we actually put incoming applications aside so we could focus on the ACA related applications that came in over last summer. That’s wrong. We should treat each veteran equally and focus on applications, as they come in, not because of special campaigns coming out of D.C.
“ACA related applications” refers to applications for individuals enrolling in the state or federal-government run “marketplaces” for health insurance established under the Patient Protection and Affordable Care Act (PPACA), which is popularly known as “ObamaCare”.
With such a large backlog of applications from veterans with recent service in Iraq or Afghanistan seeking medical care, there was no legitimate reason for diverting the staff of the Department of Veterans Affairs’ Health Eligibility Center away from processing those applications in favor of processing the applications of civilians buying health insurance through the Healthcare.gov “marketplace” or any of the state government-run exchanges.
We should also note that this alleged diversion of resources is something that could only have been ordered by individuals at the highest levels of the Obama administration – it’s not something that the VA’s bureaucrats would just go out and do on their own. As such, the unlawful misprioritization and waitlisting of 40,000 veterans’ applications for access to the VA’s health care services for over three years certainly didn’t happen by accident.
Something like that takes planning and coordination. A lot of it. And most importantly, the specific direction by individuals in authority to do it.
As we recently noted, Americans are still paying a heavy price for mistakes by the Internal Revenue Service. These include a “Seizure Fever” campaign that rewarded IRS employees based on how much money they had confiscated. The IRS also handed out billions in improper payments and fraudulent tax returns, paid millions in bonuses to IRS employees who were under disciplinary action, and targeted groups that advance the cause of lower taxes and limited government. All this, and more, would seem to be grounds to cut back a powerful agency that is clearly out of control. The response is more mission creep.
As Richard Rubin explains, “the Internal Revenue Service is about to get an unprecedented look at bank accounts and investments U.S. citizens hold abroad, through a law that is making it harder to hide assets from the tax collector.” The new law is the Foreign Account Tax Compliance Act (FATCA), which supposedly addresses “the inability of federal tax authorities to obtain clear information about financial accounts that U.S. citizens have outside the country.” This is important for American taxpayers, Rubin explains, “because unlike many other countries, it taxes citizens on their worldwide income regardless of where they actually live.”
FATCA allows the IRS to grab data from more than 77,000 financial institutions and 80 governments. Failure to report Americans’ accounts of more than $50,000 will slap the financial institution with a tax penalty of 30 percent. Nigel Green, founder of an institution with 80,000 expatriate clients, told MainStreet that FATCA brands Americans overseas as “financial pariahs” and that “FATCA’s costly and onerous regulations mean Americans are now typically deemed more trouble than they are worth.” And branding American businesses in international markets with “leprosy-like status” could hurt their global competitiveness and the U.S. economy.
So whatever the consequences, seizure fever is back on a wider scale than ever before. On the other hand, it never really left and was never restricted to big corporations. For more than 70 years the IRS has been getting workers’ money before the workers themselves, courtesy of paycheck withholding. The government’s needs remain number one. Workers aren’t even number two.
The Patient Protection and Affordable Care Act, which is often abbreviated as either PPACA or ACA, but which is most popularly known as “Obamacare,” is a very complicated law that stands as an prime example of how politicians will put the interests of their crony corporate contributors ahead of those of the American people.
As a case in point, one example of that may be found in the law’s provisions for a “risk corridor” program for health insurance companies that the Department of Health and Human Services approves to sell subsidized health insurance policies on state- or federal-government run “marketplaces.” What this provision in the law does for health insurers is to make up a large portion of any losses they have and to put a cap on their losses if the amount of money they have to pay out for their policyholders’ health care expenses is greater than the amount they collect in premiums. Those premiums are paid by both the policyholders and by the federal government, which directly pays Obamacare’s health insurers in the amount of the income tax credit subsidies for which the policyholders may be eligible.
The Wall Street Journal explains how Obamacare’s risk corridor program is intended to work in 2014:
The idea of risk corridors is to compensate insurance companies that end up with bigger costs than they expected. Under the law, they must sell policies equally to everyone, regardless of their medical history, so it’s possible some insurers could end up with an especially unhealthy pool of customers.
If an insurer’s actual claims in 2014 are at least 3% greater than the claims projected when the insurer set 2014 rates, the government must reimburse the insurer for half of the excess. If actual claims jump 8% beyond projected claims, the government covers 80% of the excess.
The money for the ACA’s risk corridor program is supposed to come from fees that are assessed by the federal government on all health insurance policies, which back in February 2014, the Congressional Budget Office projected would actually be a net positive for the U.S. Treasury, collecting $8 billion in fees more than would have to be paid out to bail out Obamacare health insurers from 2014 through 2016.
But things have changed. The implementation of the Affordable Care Act has gone badly enough where instead of reducing the federal government’s budget deficit, the U.S. Treasury will instead have to borrow money to bail out Obamacare’s health insurers.
The Orange County Register reveals how U.S. taxpayers were suddenly put on the hook for bailing out unprofitable health insurance companies because of the series of executive actions by President Obama to avoid the political consequences of implementing the Affordable Care Act as written. The latest was to arbitrarily rewrite the rules for the risk corridor program so that taxpayers would directly cover a portion of the much larger than expected losses at Obamacare’s crony health insurance companies — above and beyond the fees collected on each health insurance policy sold that were specifically established for that purpose under the PPACA:
President Obama, however, changed the equation for those companies with his repeated rewriting of Obamacare rules, such as his decision to extend the period in which consumers could keep insurance plans that would otherwise have been canceled under Obamacare’s requirements. That shifted the risk pool on the exchanges, putting fewer insurers on the profit side and more on the loss side.
Because of the ACA’s corporatist construction – wherein the government has made an implicit deal with the insurers that it will dictate their behavior but still preserve their bottom lines – the president had to atone for the increased burden, which he did by easing the risk corridor rules to provide insurers with an extra $8 billion in compensation.
Because there are no offsetting spending cuts to make up for that unplanned expenditure, taxpayers are essentially on the hook for an insurer bailout.
Don’t expect this to be a one-time-only affair. A recent survey of insurers by the House Oversight and Government Reform Committee indicates that payouts from the risk corridor program could exceed the available funds by $725 million to $900 million in the next year. The people footing that bill? We the taxpayers.
In essence, the rule change would allow the Department of Health and Human Services to reallocate money collected from other sources to bail out Obamacare’s money-losing health insurers. But since that other money has been authorized to support other things, in order to make good on those spending obligations, the federal government will have to borrow money to make up the difference, which is what puts U.S. taxpayers on the hook for the worst kind of corporate welfare.
The kind that endures for generations.
In celebration of the 237th anniversary of the signing of the United States’ Declaration of Independence from Great Britain, we thought it might be a good time to reflect on the portion of the Declaration that indicts King George III, whose policies ultimately led to the successful War of Independence for Britain’s 13 colonies in North America.
... The history of the present King of Great Britain [George III] is a history of repeated injuries and usurpations, all having in direct object the establishment of an absolute Tyranny over these States. To prove this, let Facts be submitted to a candid world.
He has refused his Assent to Laws, the most wholesome and necessary for the public good.
He has forbidden his Governors to pass Laws of immediate and pressing importance, unless suspended in their operation till his Assent should be obtained; and when so suspended, he has utterly neglected to attend to them.
He has refused to pass other Laws for the accommodation of large districts of people, unless those people would relinquish the right of Representation in the Legislature, a right inestimable to them and formidable to tyrants only.
He has called together legislative bodies at places unusual, uncomfortable, and distant from the depository of their public Records, for the sole purpose of fatiguing them into compliance with his measures.
He has dissolved Representative Houses repeatedly, for opposing with manly firmness his invasions on the rights of the people.
He has refused for a long time, after such dissolutions, to cause others to be elected; whereby the Legislative powers, incapable of Annihilation, have returned to the People at large for their exercise; the State remaining in the mean time exposed to all the dangers of invasion from without, and convulsions within.
He has endeavoured to prevent the population of these States; for that purpose obstructing the Laws for Naturalization of Foreigners; refusing to pass others to encourage their migrations hither, and raising the conditions of new Appropriations of Lands.
He has obstructed the Administration of Justice, by refusing his Assent to Laws for establishing Judiciary powers.
He has made Judges dependent on his Will alone, for the tenure of their offices, and the amount and payment of their salaries.
He has erected a multitude of New Offices, and sent hither swarms of Officers to harass our people, and eat out their substance.
He has kept among us, in times of peace, Standing Armies without the consent of our legislatures.
He has affected to render the Military independent of and superior to the Civil power.
He has combined with others to subject us to a jurisdiction foreign to our constitution and unacknowledged by our laws; giving his Assent to their Acts of pretended Legislation:
For Quartering large bodies of armed troops among us:
For protecting them, by a mock Trial, from punishment for any Murders which they should commit on the Inhabitants of these States:
For cutting off our Trade with all parts of the world:
For imposing Taxes on us without our Consent:
For depriving us, in many cases, of the benefits of Trial by Jury:
For transporting us beyond Seas to be tried for pretended offences:
For abolishing the free System of English Laws in a neighbouring Province, establishing therein an Arbitrary government, and enlarging its Boundaries so as to render it at once an example and fit instrument for introducing the same absolute rule into these Colonies:
For taking away our Charters, abolishing our most valuable Laws, and altering fundamentally the Forms of our Governments:
For suspending our own Legislatures, and declaring themselves invested with power to legislate for us in all cases whatsoever.
He has abdicated Government here, by declaring us out of his Protection and waging War against us.
He has plundered our seas, ravaged our Coasts, burnt our towns, and destroyed the lives of our people.
He is at this time transporting large Armies of foreign Mercenaries to compleat the works of death, desolation and tyranny, already begun with circumstances of Cruelty and perfidy scarcely paralleled in the most barbarous ages, and totally unworthy the Head of a civilized nation.
He has constrained our fellow Citizens taken Captive on the high Seas to bear Arms against their Country, to become the executioners of their friends and Brethren, or to fall themselves by their Hands.
He has excited domestic insurrections amongst us, and has endeavoured to bring on the inhabitants of our frontiers, the merciless Indian Savages, whose known rule of warfare, is an undistinguished destruction of all ages, sexes and conditions.
In every stage of these Oppressions We have Petitioned for Redress in the most humble terms: Our repeated Petitions have been answered only by repeated injury. A Prince whose character is thus marked by every act which may define a Tyrant, is unfit to be the ruler of a free people....
Did you ever get the feeling that today’s politicians use this list of grievances against tyranny as the checklist they should follow for defining their accomplishments?
Seventy-one years ago, on July 1, 1943, the federal government first started withholding income tax from workers’ paychecks. For the first time, the government would get workers’ money even before the workers did. As a freerepublic blogger noted on the 60th anniversary, that’s not exactly an occasion for celebration.
“Why is withholding so bad? Because it effectively masks the amount of income taxes American workers pay. Tax withholding introduced a new phrase into the American lexicon: ‘Take home pay.’ Today the average American has no idea how much they actually make, let alone how much they pay in income taxes.” But it was wonderful for the political class. “They manage to plunder your paycheck to fund their grand vote-buying schemes, and you barely notice.”
As Jonah Goldberg observed, “the unspoken assumption is that the government’s needs are more important than yours. Withholding means we are, in effect, working for the government before we are working for ourselves. Worse, since taxpayers are anesthetized to the pain of paying taxes, we’re becoming ever more disconnected from the product we are buying.”
When this all started in 1943 it was wartime and the government needed money. A “team of experts” that included economist Milton Friedman came up with the idea of withholding money from worker’s paychecks. This was supposed to be temporary but it didn’t turn out that way. It later occurred to Friedman that he was helping to make government too big, too intrusive and too destructive of freedom. Government is still that way in 2014 on the 71th anniversary of withholding, with no meaningful reform in sight. As Friedman also lamented, nothing is more permanent than a temporary government program.
On July 4 many motorists will be heading over the new span of the San Francisco–Oakland Bay Bridge for destinations across the state and beyond. One who won’t be joining them is Abolhassan Astaneh-Asi, professor of structural engineering, mechanics and materials at the University of California at Berkeley. The professor does not believe the structure is safe and therefore will not be using the bridge. The reasons emerged in an investigative article by Charles Pillar of the Sacramento Bee, the latest of many on the structure.
“Facing rising costs and increasing delays on a $6.5 billion bridge that was already years behind schedule and billions over budget,” Pillar wrote, “Caltrans sought advice about its options from a highly regarded expert in how metal fractures. He said some cracks can remain without compromising safety. Caltrans then changed its contract and decided to put aside the welding code. Its fracture-critical bridge could now have cracks.” If those cracks grow larger “all or part of the roadway could collapse.” In a seismically unstable area, Astaneh told Pillar, the cracks “present a looming threat to public safety.” And the cracked welds are just the latest in an expanding “litany of errors” that includes suspect foundation concrete, rusted tendons, broken anchor rods, and corrosion on cables.
As we noted in “The $6.4 Billion Bridge to No Accountability,” these problems were the subject of hearings by state senator Mark DeSaulnier. He charged that cost overruns and lingering safety issues had eroded public confidence and made Californians “adverse to taxes.” A Caltrans geologist called for a criminal investigation, but no such investigation took place. Instead the California Highway Patrol was to conduct an “administrative inquiry.” Caltrans bosses remain comfortably in place, but so do the safety issues.
Pillar asked Keith Devonport, a box-girder consultant who helped manage the project in China, if he would feel safe driving over the bridge. Devonport declined to answer, but Astaneh, the UC Berkeley structural engineering professor, “said he won’t use the new bridge.” Many older bridges nationwide are now considered unsafe, but the new span of the Bay Bridge was actually built that way, despite $5 billion in cost overruns. That’s what passes for “progress” in a state that remains adverse to accountability.
As a showcase for speechmaking and stonewalling, the ongoing hearings on the IRS targeting campaign have generated more heat than light. Fortunately, a few moments of clarity emerged in a June 23 hearing by the House Oversight Committee. Rep. Thomas Massie, an MIT grad, explained the probability of Lois Lerner’s hard drive failing in only ten days rather than a year was one in a thousand. IRS boss John Koskinen was not impressed, but Rep. Massie wasn’t done.
“No,” responded Koskinen. “I’m a big supporter of tax simplification. I support Chairman Camp’s attempt to move that dialog forward. I’m prepared to be as helpful as I can.”
One doubts that any IRS boss supports tax simplification, but taxpayers should take Koskinen at his word that a flat tax would make targeting campaigns much more difficult. Koskinen has been completely obstructionist about the targeting campaign now under investigation, complaining that an agency with a IT budget of $1.8 billion is underfunded. Likewise, Rep. Sandy Levin of the Ways and Means Committee is on record as having said that the two years of lost emails confirm that the IRS needs more funding for a more modern system.
That is the default position of statist politicians and bureaucrats alike: The tax code, government agencies, and government employees are all basically sound; all they need is more money. With the IRS claiming poverty while paying out big bonuses, taxpayers might remain skeptical about that, and about the mysteriously missing emails. On those, Rep. Massie’s probability figures likely understate the case. A ballpark figure for the odds that the loss was accidental is zero.
Rep. Massie is also a sponsor of legislation to prohibit the National Security Agency from conducting warrantless searches of Americans’ electronic communications. As Mary Theroux noted, the NSA has been grabbing every domestic communication. If the IRS will not produce the missing emails, investigators should get them from the NSA. That way the invasive and repressive hands of government can work together.
The way the Department of Veterans Affairs goes about providing health care to the veterans of the U.S. military, as it exists today, is an abject failure. In the words White House Deputy Chief of Staff Rob Nabors, the federal government agency is possessed by a “corrosive culture,” one that is characterized by “significant and chronic systemic failures.”
But when it comes to his recommendations to remedy the dysfunction that permeates throughout each of the Department’s administrative offices and the approximately 1,700 hospitals and treatment facilities it operates across the United States, it becomes clear that Nabors really doesn’t understand the VA’s real problem: it is a government-run monopoly that is incapable of attending to the real needs of the Americans it is meant to serve.
We know that’s the case because Nabors’ primary solution to address the VA’s massive deficiencies in providing timely medical care to veterans seeking it is to greatly increase the spending and size of the Department. That recommendation is reflected in a Senate-approved bill that would provide $500 million to hire more doctors and nurses to work at the VA’s treatment facilities.
The problem with that “solution” is that if spending more money to hire more staff was the VA’s real problem, the enormous spending increases over the previous 10 years, and especially since President Obama was sworn into office on January 19, 2009, would have kept it from getting so bad. The VA would already have addressed its crisis in providing timely care to U.S. veterans.
We find then that they have already tried that solution and failed. What the VA’s administrators did instead was to create an incentive system to hide their deficiencies and to enforce disciplinary measures against anyone who might expose it so that they could claim large bonus payments for themselves.
As the massive spending increases for the VA in recent years demonstrate, nothing about hiring additional doctors and nurses would fix the agency’s systemic integrity issues; that action would only add more people to the bureaucratic fiefdoms that already exist within the Department, where the corrupt administrators of that bureaucracy would benefit from the increased prestige and status from having authority over more people (the non-monetary kind of compensation that bureaucrats crave in addition to their benefits and bonuses).
Worse, think about where those doctors and nurses would be hired away from: the private sector. At the same time the U.S. health care system is reported to be experiencing shortages of physicians, surgeons and nurses, what possible benefit can there be for Americans to have such qualified health care providers sequestered away in the VA’s exclusive single-payer health care system?
What would make much more sense would be for the U.S. Congress to force the VA to rationalize the care it provides to U.S. veterans by specializing in providing the kind of medical care that U.S. veterans are much more likely to require than their civilian peers (such as for combat-related injuries, post-traumatic stress disorders, etc.), and to downsize its staff and operations accordingly to focus upon that achievable mission.
Better still, by focusing on providing that kind of specialized care, it would be possible to fully fold the succeeding parts of the Veterans Health Administration into the Department of Defense’s health care system. Hopefully, this would help provide fully continuous and seamless medical care to the veterans who need it most. In addition, the corrosive culture that defines the Department of Veterans Affairs could be fully replaced by the culture of accountability that is taken more seriously within the Department of Defense.
Instead of extracting qualified medical personnel out of the private sector to provide exclusive care at VA-operated facilities, the VA should provide vouchers that would allow veterans to directly receive general medical care from the multitude of private sector health care facilities where it is provided.
What is really interesting about this approach is that this kind of reform could be self-funding; it would not require more spending by the federal government. By decisively pruning back its ineffective bureaucracy to focus on providing specialized care for veterans, the money that is now being wasted on continuing to pay the salaries, benefits, and pensions of the VA’s most unfit administrators could instead be redirected to providing the medical care they have benefited from denying to America’s military veterans.
And the best part? Everybody who really matters, wins.
Believe it or not, there actually are people in the federal government whose job is to identify wasteful spending by the bureaucrats who operate federal government agencies. They work for an entity known as the Government Accountability Office (GAO), which publishes an annual report list the various types of wasteful activities that they’ve identified. The MacIver Institute’s Haley Sinklaire explains:
The GAO’s annual report recommends action be taken in order to reduce, eliminate, or better manage fragmentation, overlap, and duplication of programs and their goals in order to achieve costs savings or enhance revenue.
In their first three annual reports from 2011-2013, opportunities to reduce, eliminate, or better manage fragmentation, overlap or duplication; achieve cost savings; or enhance revenue were presented in 162 areas. The GAO also identified about 380 actions that both branches could take to improve programs and save taxpayer dollars.
One suggestion includes the elimination of the overlap of 117,000 individuals simultaneously receiving disability and unemployment benefits, which could save between $3.4 billion and $5.4 billion over a ten-year period.
But have any of the bureaucrats who run federal government agencies ever done anything about the waste identified by the GAO? It turns out that the folks at the GAO have been keeping track — and they have even posted an online application, the GAO’s Action Tracker, that lets anyone see whether the agencies they’ve cited have addressed the issues they’ve raised, partially addressed them, or haven’t addressed them at all. The screenshot below shows the results we obtained on June 25, 2014, when we looked just at the General Government category and checked to see what issues the GAO is scoring as only partially addressed:
Given that most of these issues specifically affect the IRS, which doesn’t seem to take the integrity its own operations very seriously these days, we don’t think that many of these items will be moved into the Fully Addressed column any time soon. But, let’s give the GAO some credit, unlike the watchdogs of the Department of Veterans Affairs, at least they’re doing something to follow up on the problems that have been brought to their attention while also making it public.
The U.S. Customs and Border Protection (CBP), a component of the Department of Homeland Security, deploys a budget of $12.9 billion, an increase of 6.45 percent from fiscal year 2013. CBP has an internal affairs division to deal with misconduct, but according to an investigation by McClatchy news service, CBP’s internal affairs division “is being investigated for falsifying documents, intentionally misplacing employee complaints and bungling misconduct reports as part of a cover-up to mask its failure to curb employee wrongdoing.”
The investigation deals with “recurring accusations that Customs and Border Protection personnel have abused migrants, including children, taken bribes and conspired with drug cartels.” One CPB official told Marisa Taylor and Franco Ordonez of McClatchy’s Washington bureau, “There were so many allegations of wrongdoing involving the internal affairs division you’d need a flow chart to sort them all out. It’s insane because this division is supposed to be looking into employee misconduct, yet it is being accused of the very same corruption it is supposed to be investigating.” The problems are not limited to the border region but showed up in Miami, Detroit, Dallas, Houston and San Francisco.
The Obama administration has removed James Tomsheck, a former Secret Service agent who has headed the CBP internal affairs division since 2006. But as Brian Bennett of the Los Angeles Times observed, Tomsheck was not fired. Rather, “He was given a temporary assignment in another job in Customs and Border Protection, which is the parent agency of the Border Patrol.” Bennett also noted a 2013 study by the Police Executive Research Forum that criticized CBP for lack of diligence in investigating incidents of deadly force. “Agency officials prevented lawmakers from seeing its conclusions,” but the study was leaked to reporters.
The CBP thus confirms that abuse of power and bureaucratic obstructionism do not stop with the IRS, NSA, EPA and VA. Indeed, in the federal government they have no borders.