The Department of Veterans Affairs was back in the news this spring--and, as usual, the news wasn't good. In March, Donald Trump fired VA Secretary David Shulkin, who had come under fire for misusing public money. His proposed replacement, White House physician Ronny Jackson, then withdrew his nomination after reports emerged of his being drunk on the job, handing out painkillers to staffers, and indulging in other bad behavior. In May, responding to perceived systemic care problems, the House and Senate passed the VA Mission Act to allow veterans more access to private-sector doctors and hospitals.
Reporters were ready to put these stories "in context." They reminded audiences that the VA was, as the New York Times put it, "one of the largest, most complex and troubled cabinet agencies in the federal government." Other outlets described it as "scandal ridden" and subject to "scathing reports" of dangerously long wait times and substandard care. In an episode explaining the Jackson scandal, the Daily, the Times's popular daily news podcast, repeated the claim that "forty veterans died while they were waiting for medical care" at the Phoenix VA.
But here's a different story about the VA, from the exact same time period, that major media outlets didn't bother to report: In March, researchers at the nonprofit research organization RAND published a study revealing the gross inadequacies of New York State's health care system to effectively treat veteran patients. A month later, RAND found that the quality of VA care was generally better than private health care. These were just the latest of scores of studies that have come to the same conclusion for nearly two decades now.
How can this be? How can we all know that the VA health system is a disaster, when study after study shows the opposite--that when it comes to actually providing care for nine million veterans, it outperforms the competition?
The answer is that studies like the RAND report are virtually ignored by the press. This isn't just a Fox News problem. Consumers of neutral and even left-leaning news sources are largely unaware of the many studies showing the general excellence of America's largest integrated health care system, and the country's only true example of socialized medicine.
As the U.S. continues to debate what to do about its unsustainable health care system--and as conservatives continue to push for "free market" solutions, including privatizing the VA itself--the fact that a government-owned and -operated system is outperforming the private sector should be a major story. If VA care is as good or better than the alternative, how would pushing vets into private-sector care make them better off? But that question rarely gets asked, because too many people are unaware that the premise guiding these policies--that the private sector inevitably outperforms government--is false.
Why is that? In trying to understand why media coverage Of the VA so often winds up giving the public a deeply and dangerously distorted picture, we've identified five general sources of the problem. These patterns apply more broadly to the ways in which many journalists cover other government agencies as well. Understanding them is a crucial first step toward having a media that better performs its job of keeping Americans informed about the workings of government.
The first and most profound way in which coverage of government programs so often creates a distorted picture is the failure of news organizations to ask the "Compared to what?" question. Suppose, for example, that some Republicans in Congress call attention to unacceptable wait times for new patients seeking a first appointment at the Phoenix VA. The chairman of the House Veterans Affairs Committee further claims, as did Representative Jeff Miller in 2014, that "there could be as many as forty veterans whose deaths could be related to delays in care." Finally, it's revealed that some VA employees tried to juke the stats to hide how long some veterans were waiting to see a doctor.
That all sounds bad. But just how bad is it? Do these facts prove, as many have argued, that we should privatize the VA, or outsource more veteran care to the private sector? Engaging with these questions depends on learning how these facts compare to what's going on throughout the rest of the U.S. health care system. Once we ask the "Compared to what?" question, it turns out that this isn't particularly a story about the VA. To begin with, as other RAND research has concluded, VA wait times for new patients are actually shorter than the times found in studies of the private sector. Indeed, according to a Commonwealth Fund study, one in four Americans reported having to wait six or more days for an appointment with their primary care physician, even when they were "sick or needed care."
What about those forty veterans who reportedly died while on a VA wait list? In the private sector, too, people die all the time while having a pending doctor's appointment. Sometimes, this is malpractice; most often it isn't. Remember, many people also die while having an appointment to see their dentist. In the case...