This, of course, depends on how one looks at the data from the Washington Post/ABC poll I linked earlier today. The data on public perception of the VA scandal didn’t get much attention from the Post, but Business Insider’s Colin Campbell took a closer look at it and noted that the data on this looks overwhelmingly bad for Barack Obama. Eight in ten respondents assign at least some personal responsibility to Obama for the massive and systemic wait-list fraud that killed dozens of vets who couldn’t access medical care in Phoenix:
A new poll shows about 80% of Americans think President Barack Obama is “personally” responsible for at least some of the issues with the medical care provided to former soldiers by the Department of Veterans Affairs.
The Washington Post-ABC News poll, released Tuesday, found 38% of respondents viewed Obama responsible for a “good” or “great” amount of the VA’s woes; another 41% said Obama was responsible for “just some” of the controversy. That makes for 79% of voters who lay at least some of the blame for the scandal with the president.
Soon-to-be Hot Air associate editor Noah Rothman uses the same calculation at Mediaite:
Given that this poll of adults has a 3.5 percent margin of error, it is conceivable that every American thinks this scandal is a real and urgent problem. The opinion that the scandal is “serious” is shared by more than 95 percent of almost every critical subgroup; Republicans, Democrats, independents, liberals, conservatives, moderates, women, men, minorities, young people – everyone.
What’s more, this poll suggests that the administration has not escaped culpability for the scandal. 65 percent of respondents said they believed former VA Sec. Eric Shinseki “was right to resign” over the allegations. While 41 percent say President Barack Obama deserves only “some” blame for the scandal, 79 percent agree that Obama shares fault for the fiasco at the VA. Only 20 percent believe Obama deserves no blame for the failure of oversight at an expanding list of VA hospitals.
Anyone who thinks the political operatives in the White House are not terrified by those numbers is kidding themselves.
The Post’s news report on the poll calculates this differently, although agreeing with Campbell’s math on the seriousness of the scandal:
The VA scandal, in contrast, shows no partisan differences and reflects growing public outrage at reports of lengthy delays for treatment and falsification of records at some veterans’ facilities around the country. The new poll finds a near-unanimous verdict, with 97 percent of Americans describing the problems as serious and 82 percent calling them “very serious.”
The White House has scrambled to get on top of the situation and so far the public appears to put the responsibility for the problems elsewhere than with the president. About four in 10 Americans say the president deserves significant blame for the problems that have mushroomed into a major debacle for his administration, while six in 10 say he personally deserves just some or none of the blame.
The difference here is what constitutes the threshold for assigning personal blame to the President. The question is asked in a traditional all-most-some-none polling format, and traditionally that gets aggregated with all-most/some-none. That’s the calculation used by the Post to get a 38/60 rating. That’s a defensible, if not convincing, conclusion to draw on the political impact of the scandal on Obama personally. And I’d bet that the political operatives Noah mentions are grasping at this analysis with both hands and perhaps a leg or two as well.
However, 41% think Obama bears some personal responsibility for the scandal, while only 20% think Obama bears none at all. That’s not difficult to understand either, since Obama made a big deal about reforming the VA in his first presidential campaign and took credit for success at the VA later — success that was largely illusory. Claiming that 60% shrug off Obama’s personal responsibility for that failure misreads what “some” means in a literal as well as political sense. Clearly, among 79% of respondents, Obama does not escape personal responsibility for the VA’s failures and scandals, although it’s far from settled how badly that will damage him in the long run. Nor is that the real issue at hand at the VA, either, but the Post/ABC poll survey makes it one of the issues.
The real issue for the VA is the quality of care, and wait times are a critical component of that measure — but not the only one. The Wall Street Journal obtained internal documentation from the VA showing a wide disparity in outcomes across their centrally-managed single-payer system, with the death rate in Phoenix one of the worst:
But a detailed tabulation of outcomes at a dozen VA hospitals made available to The Wall Street Journal illustrates a deeper challenge: vastly disparate treatment results and what some VA doctors contend is the slippage of quality in recent years at some VA facilities.
Some of the discrepancies are stark, especially for an agency known for offering high-quality care in 50 states.
The rate of potentially lethal bloodstream infections from central-intravenous lines was more than 11 times as high among patients at the Phoenix facility than it was at top VA hospitals, data from the year ended March 31, 2014, show.
Those infections, called sepsis, can quickly cause multiple organ failure and kill an otherwise relatively healthy patient within days or even hours. The data don’t show what percentage of patients died as a result.
Among patients admitted to the hospital for acute care, the Phoenix VA Health Care System had a 32% higher 30-day death rate than did the top-performing VA hospitals, a finding flagged as statistically significant by the agency’s medical analysts.
By contrast, Boston’s VA hospital, considered among the system’s best, had a central-IV-line, bloodstream-infection rate that was 63% below the average of the top-performing hospitals. It also had a slightly better-than-average, 30-day mortality rate for acute care.
The VA responded that these metrics were intended only for internal review, not for “public consumption.” That raises even more questions. How long did VA executives know that Phoenix and other locations were so far below standard? Why did this not prompt an investigation? Did the long wait times contribute to the death rate?
Another question will be whether the VA disclosed this information to Congress. The WSJ report doesn’t mention that, but notes that the data came from a non-public system called SAIL. One has to assume that the relevant Congressional committees funded SAIL and knew its purpose. Did they request data from it to determine VA performance?
There are a lot more questions about the VA and its performance than Obama’s political damage and wait-list fraud. And there may be more people who need to provide answers than just those in the executive branch, too.
Update: Investors’ IBD-TIPP poll produces even worse results for Obama:
Just 29% think President Obama has done a good job managing the VA in the wake of the department’s patient-care scandal, according to the latest IBD/TIPP poll. 43% surveyed say he’s done a poor job and 22% rate his performance as only average.
Meanwhile, 63% say Obama was either disengaged (29%) or that he “knows more than he claims” (34%) about the scandal.
The White House has insisted Obama had only heard about the scandal — which involved chronic delays in care for veterans using the system, and attempts at several VA hospitals to cover up those delays — after it was reported in the press. However, news accounts and audits of chronic delays and suspicious bookkeeping date back years.
The public also overwhelmingly rejects the notion that money was the chief reason for the VA scandal.
Fully 70% of those surveyed in the June poll say poor management of available resources was the main problem at the VA; just 20% believe it was lack of money. These views hold true across the entire demographic and ideological range surveyed in the poll.
And yet …
The IBD/TIPP poll shows that the VA scandal has so far not hurt Obama’s overall approval ratings.
In fact, Obama’s job approval climbed slightly, rising from 42% in May to 44% in June. And 43% give him good marks on his overall performance, up from 38% in May.
Shinseki’s resignation may have taken the edge off the impact for Obama, but this could get ugly if more scandals arise.
People sometimes think that government or “nonprofit” operations will be run more honestly than for-profit businesses because the businesses operate on the basis of “greed.” But, in fact, greed is a human characteristic that is present in any organization made up of humans. It’s all about incentives.
And, ironically, a for-profit medical system might actually offer employees less room for greed than a government system. That’s because VA patients were stuck with the VA. If wait times were long, they just had to wait, or do without care. In a free-market system, a provider whose wait times were too long would lose business, and even if the employees faked up the wait-time numbers, that loss of business would show up on the bottom line. That would lead top managers to act, or lose their jobs.
In the VA system, however, the losses didn’t show up on the bottom line because, well, there isn’t one. Instead, the losses were diffused among the many patients who went without care — visible to them, but not to the people who ran the agency, who relied on the cooked-books numbers from their bonus-seeking underlings.
And, contrary to what Klein suggests, that’s the problem with socialism. The absence of a bottom line doesn’t reduce greed and self-dealing — it removes a constraint on greed and self-dealing. And when that happens, ordinary people pay the price. Keep that in mind, when people suggest that free-market systems are somehow morally inferior to socialism.
In a single-payer system run by the government, there are no regulators or competitive forces around to keep anyone honest. It’s not even greed as much as it is the ancient issue of power and corruption.