Wonkbook: The outrage of the VA scandal

May 21

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Wonkbook’s Number of the Day: 20. That's, by one count, the number of states (plus the District of Columbia) to legalize same-sex marriage (17 plus D.C. by another count).

Wonkbook’s Chart of the Day: This map shows how April tied for the warmest one on record globally.

Wonkbook's Top 5 Stories: (1) White House worry over VA scandal; (2) FCC chair's day on the Hill; (3) yay, Obamacare competition!; (4) NSA reform disconnect; and (5) not quite the end of "too big to jail."

1. Top story: Paging the White House on the VA scandal?

White House sends aide to investigate deaths linked to VA center. "One of President Obama’s top aides is being dispatched to Phoenix this week to investigate deaths allegedly connected to a Department of Veterans Affairs medical center there, part of the administration’s efforts to contain growing outrage over delays in treatment and accusations of rigged recordkeeping at veterans hospitals....Republicans have seized on the VA allegations as potential fodder for this fall’s midterm elections, and several GOP senators have called for the resignation of Veterans Affairs Secretary Eric K. Shinseki." Juliet Eilperin and Ed O’Keefe in The Washington Post.

Explainers:

Can Rob Nabors fix the VA? Here’s what he needs. Justin Vaughn in The Washington Post.

Were 40 deaths preventable? "Is there evidence right now that the 40 deaths in Phoenix could have been prevented if veterans were seen sooner? No, this is sort of one of the most misrepresented facts about this story. There is a whistleblower who says that 40 people may have died while on this waiting list...that was kept off the books, and they received much delayed visits. There's no evidence that they died because they were waiting....There's no evidence yet that anyone on that list died because of those denied care visits." NPR.

And the allegations aren't totally new. "In a way these are new explosive revelations. They came with a whistleblower, a doctor who recently retired from the Phoenix hospital. But in a way these are old allegations. The idea that the VA has been manipulating data on wait times was in an inspector general's report in 2005, again in 2007, again in 2012....So it all goes to the question of accountability. A lot of these problems predate Secretary Shinseki. But now he's been in the chair for almost six years, so what has he done to solve these problems?" NPR.

Could one campaign-trail statement come back to bite Obama? "Running for president in May of 2008, then-Sen. Barack Obama delivered a stem-winder on mismanagement of veterans care under President George W. Bush, recalling the story of an 89-year-old South Carolina veteran who committed suicide after being repeatedly denied access to health care. 'How can we let this happen?' Obama thundered in front of a podium in Charleston, W.Va., that read, 'A Sacred Trust; Support our Veterans.' 'How is that acceptable in the United States of America? The answer is, it’s not. It’s an outrage. And it’s a betrayal, a betrayal of the ideals that we ask our troops to risk their lives for.' Well. Well." Major Garrett in National Journal.

It must be tough to be Shinseki right now. "'Mad as hell' simply might not be good enough. Allegations that dozens of veterans have died without receiving care have generated the largest scandal in the tenure of Veterans Affairs Secretary Eric Shinseki — and his response last week might not be sufficient for him to keep his job.' Shinseki made his pitch last week to stay, telling lawmakers he was 'mad as hell' and accepting the resignation of his top health deputy. But the allegations facing the VA are so damaging that lawmakers, pundits and newspapers are pressuring the retired four-star Army general to finally step down from the top post at the troubled agency." Jeremy Herb in Politico.

Video: Obama administration gets the Jon Stewart treatment. Talking Points Memo.

No panic button yet, but the White House is in worry mode. "Inside the White House, officials said that there was no political panic but that the issue was of serious, substantive concern — unlike, they said, a previous Republican uproar over extra scrutiny given to Tea Party groups by the Internal Revenue Service. White House officials described Mr. Obama as eager for the results of an investigation into the allegations by the department’s inspector general and a separate review of hospital practices being conducted by Mr. Nabors and Eric Shinseki, the secretary of the department. Jay Carney, the White House press secretary, declined to say when Mr. Obama might address the situation again publicly." Michael D. Shear and Jonathan Weisman in The New York Times.

White House to frustrated Dems: Don't worry, we've got this. "President Obama’s chief of staff reassured frustrated House Democrats on Tuesday that the White House will respond aggressively to the controversy at the Veterans Affairs Department. 'I think you're going to find very aggressive action within the administration,' Rep. Xavier Becerra (Calif.), head of the House Democratic Caucus, said after House Democrats met with White House chief of staff Denis McDonough. 'Denis McDonough made it very clear: The president is gonna be on this.'" Mike Lillis in The Hill.

Bill would let VA officials say, 'You're fired!' "The House of Representatives will vote this week on a bill to make it easier for the Department of Veterans Affairs to fire or demote senior executives, officials said on Tuesday.... The bill addressing the 'mess at the Veterans Administration' will 'try and provide the tools to the administration to hold senior managers accountable,' House Majority Leader Eric Cantor, a Republican, told reporters." Susan Cornwell in Reuters.

Explainer: Possible drawbacks of the VA firing bill. Josh Hicks in The Washington Post.

How the Senate might act, too. "Senators have begun to talk about legislation designed to help remedy the controversy engulfing the Department of Veterans Affairs, but it isn’t immediately clear when they might have a venue for that debate....The VA spending bill would appropriate an extra $5 million for an office of inspector general investigation into the secret wait lists, while imposing a moratorium on certain VA bonuses." Niels Lesniewski in Roll Call.

Long read: Cold calculations: How a backlogged VA determines the true cost of war. Greg Jaffe and Matt McClain in The Washington Post.

DICKERSON: Why the VA scandal is a real outrage. "If you’ve ever been seriously sick or helped a family member who is, you know how dark it can get....Now imagine if you experienced it with the inefficiency of the worst experience you’ve ever had with customer service. That’s what’s happening in some cases at Veteran Affairs clinics and hospitals around the country: People at their most acute moments of need are being ignored and forgotten. This is an outrage to be outraged about." John Dickerson in Slate.

GALSTON: What the scandal tells us about our fiscal situation. "The recent revelations about the Department of Veterans Affairs point to serious problems. But the root of the scandal is not what self-serving bureaucrats failed to do or tried to cover up; it is a federal budget that prevents us from meeting even the national needs on which our polarized political parties can agree....Democrats and Republicans agree that we must fully honor the debt we have incurred to the tiny fraction of the population that does the fighting for the rest of us. Yes, the budget for the VA has risen sharply since 2002. But the number of returning veterans has risen even faster." William A. Galston in The Wall Street Journal.

Top opinion

CHAIT: This summer's climate change politics will be worse than Obamacare's. "The scientific consensus is stronger and more urgent than ever, while the political consensus is weaker than ever. Republicans are not even considering the notion of asking Americans to spend money to mitigate climate change, and are increasingly uncertain about the notion of even saving money to mitigate climate change. And into this simmering pot of reflexive opposition and anti-empiricism Obama will plop a highly ambitious and not very cuddly scheme to clean up the power-plant sector. It has already drawn strong opposition from the major business lobbies. It is likely to become the major point of conflagration of Obama’s second term." Jonathan Chait in New York Magazine.

PETHOKOUKIS: Was not massively helping underwater homeowners a massive mistake? "What if Washington had pushed massive relief for underwater homeowners? Now former Obama Treasury Secretary Timothy Geithner doesn’t think something like a principal reduction scheme would have helped much....Mian and Sufi disagree.... Imagine a plan like the ones Feldstein, Hubbard, and Mayer proposed along with a Fed that was far more active in supporting spending starting in 2008. And now imagine no TARP and no stimulus. Under which scenario does the economy perform better?" James Pethokoukis in American Enterprise Institute.

O'BRIEN: No, David Brooks, we don't need less democracy. "Conservatives have lost a few elections, and now some of them think democracy is broken....Okay, this isn't exactly what they've said. But it's close enough. David Brooks, for one, thinks that we've become 'neurotically democratic.' That we need to pivot from our system of checks and balances to a system of 'elite Simpson-Bowles-type commissions to push populist reforms' if we're going to avoid being disrupted by innovative one-party states like China....The truth, as boring as it may be, is that Winston Churchill was right: Democracy is the worst form of government except for all the others....Our problem isn't too much democracy. It's too little. " Matt O'Brien in The Washington Post.

J. BERNSTEIN: To lift the poor, you can't avoid taxing the rich. "It’s tempting to think — and hope — that attacking inequality doesn’t mean we have to hurt those at the top. This idea has become a central response from conservatives to the current debate inspired by Thomas Piketty’s book and proposal for a wealth tax....This argument isn’t a purely conservative one, either. Many liberals and moderates would no doubt prefer a kinder and gentler way to help the poor. But it doesn’t exist." Jared Bernstein in The New York Times.

McARDLE: Those Chevy Volts won't save the planet. "This isn’t some easy fix that consists of buying somewhat more expensive products while keeping our way of life essentially the same. America’s outsized carbon emissions are not mainly due to the fact that we drive huge sport utility vehicles. Our outsized carbon emissions are mainly due to the fact that we produce a lot of fossil fuels and a lot of stuff....If we want to keep the climate from warming further, then we have something much more important to do than buy Volts: find a stable, cheap renewable resource...or figure out an engineering solution that can take greenhouse gasses out of the atmosphere, or keep the planet from warming anyway." Megan McArdle in Bloomberg View.

HEALEY: Even tough net-neutrality rules wouldn't 'regulate' the Internet. "The most vocal opponents of the Net neutrality rules the Federal Communications Commission put out for public comment on May 15 have been the critics who say the rules won't actually assure the Net's neutrality. But the draft has also drawn a searing response from conservatives and libertarians, who ask why we need government to protect the neutrality produced by the free market. That's a fair question. But some critics go further, arguing that some tech executives and their allies want the FCC to 'regulate the Internet.'...Except that's not what's happening. " Jon Healey in the Los Angeles Times.

'Frozen' interlude: This baby is not happy with a song from "Frozen."

2. Just about no one in D.C. is happy with the FCC right now — or telecom and Internet companies

FCC chairman's long day on Capitol Hill. "The top U.S. telecommunications regulator, Tom Wheeler, received an earful from lawmakers concerned about his pending decisions on Internet-traffic rules, spectrum auctions and cable-industry consolidation. Two House Democrats used an appearance before Congress...to call for hearings into proposed acquisitions by AT&T Inc. (T) and Comcast Corp. (CMCSA)....AT&T’s bid....for $48.5 billion comes three months after Comcast proposed a $45.2 billion acquisition of Time Warner Cable Inc. Just as Wheeler begins vetting those deals, he’s also facing criticism for a rewrite of rules governing Web traffic that may open the door to regulating what Internet service providers can charge." Todd Shields in Bloomberg.

Can net-neutrality advocates breathe easier? Maybe. "On Tuesday, the nation's top telecom regulator told House lawmakers what consumer advocates have been longing to hear for weeks: that the Federal Communications Commission could move to block the rise of Internet fast lanes. FCC Chairman Tom Wheeler said the agency recognizes that Internet providers would be disrupting a 'virtuous cycle' between the demand for free-flowing information on one hand and new investment in network upgrades on the other if they started charging companies like Google for better access to consumers. What's more, he said, the FCC would have the legal authority to intervene." Brian Fung in The Washington Post.

But Wheeler still faces a legal dilemma. "But Wheeler is in a tough spot legally. When the D.C. Circuit Court of Appeals struck down the old rules, it said the commission had gone too far by trying to cut off all pay-for-priority deals. Using the current legal authority, the FCC essentially must allow at least some 'fast lanes' or its rules will just get thrown out again....Liberal advocacy groups are urging the FCC to rely on a stronger legal authority." Brendan Sasso in National Journal.

Another reason Congress isn't happy with telecom right now. "Federal Communications Commission Chairman Tom Wheeler expressed concern during a congressional hearing over the growing practice of programmers blocking access to their websites during fights with pay-TV and broadband providers. Asked by Rep. Peter Welch (D-Vt.) if such incidents are a sign of the 'cable-ization' of the Internet, a reference to the television blackouts that often occur when networks are unable to strike new distribution agreements, Wheeler said it is something 'we should all worry about.'" Joe Flint in the Los Angeles Times.

Hate your soon-to-merge cable company? You're not alone. "The blockbuster telecom and cable mergers of late would also unite some of the most frustrated customers in the nation. AT&T bid for DirecTV on Sunday. That followed Comcast’s effort to swallow Time Warner Cable. Spurred by these mega-deals, rumors are spreading of other corporate deals among Internet service providers and cable firms. But virtually all of the companies involved in these marriages rank at the bottom in a new customer satisfaction survey, behind even healthcare providers and airlines." Cecilia Kang in The Washington Post.

Explainer: Economics explains why you may hate your cable company. Matthew Yglesias in Vox.

Other tech reads:

FCC chairman says he will probe peering arrangements. Edward Wyatt in The New York Times.

Animals interlude: This cat is also sick of "Frozen."

3. Yay, competition! How it could help keep Obamacare premiums in check

How much would lower competition cut premiums? One study says a lot. "That's the conclusion of a new report from economists Leemore Dafny, Christopher Ody and Obamacare architect Jonathan Gruber. If every insurer that had sold individual policies in 2011 participated in Affordable Care Act insurance marketplaces this past year, average premiums for a benchmark exchange health plan would have been 11.1 percent lower in 2014, the economists found. Big insurance companies generally took a cautious approach to the new exchanges in 2014....If this new research...is correct, then more insurers entering the exchanges in future years could serve as a check on rate increases." Jason Millman.

Ask for more insurers and you shall receive — in many places. "In Washington state, four insurers plan to sell for the first time on the exchange next year, including UnitedHealth. In Virginia, a local health plan owned by a hospital and physicians in Lynchburg has proposed to join Aetna Inc., Kaiser Permanente and WellPoint Inc. in 2015. And in Indiana, the health exchange’s offerings may double to eight companies. While the three states offer the first glimpse of a movement by insurers to embrace the exchanges, the heightened competition may not be enjoyed everywhere." Alex Wayne in Bloomberg.

Background reading: Another report found fears of skyrocketing premiums mostly unfounded. Robert Wood Johnson Foundation.

Not all the big premium-increase proposals you hear about will survive. "Next year, the CBO expects the average price for a benchmark plan to increase by $100, but rates will vary by state and the geographic regions within them. In Arizona, Indiana, Virginia and Washington state, insurers have already submitted rate proposals, with most seeking premium hikes....Most states won’t finalize their rates until later this summer and early fall after a series of negotiations with insurers. The Affordable Care Act requires that state insurance commissioners or the federal government review rate increases of more than 10 percent in the individual and small group market." Tony Pugh in McClatchy Newspapers.

Other health care reads:

How big a factor will Obamacare be in the midterm elections? Scott Horsley in NPR.

Obamacare feels the negative-ad avalanche. Peter Overby in NPR.

Alert: ER visits are jumping as Obamacare kicks in. Jeffrey Young in The Huffington Post.

Medicare may be overpaying hospitals for short-term stays. Susan Jaffe in Kaiser Health News.

At this Obamacare facility, workers don't have much of a workload. Andrew Johnson in National Review.

Skateboarding interlude: Tony Hawk jumps a MINI.

4. Why NSA reform could be in danger

A breakthrough in NSA call-data collection reform negotiations? "Last-minute negotiations over the details of a congressional surveillance bill have resulted in restrictions around the National Security Agency’s massive repository of analysed call data. Intense closed-door talks between lawmakers and Obama administration and intelligence officials that wrapped up Tuesday afternoon have finalised the language of the USA Freedom Act. The bill is expected to receive a vote on the House floor on Thursday." Spencer Ackerman in The Guardian.

Hmm, maybe not. Now privacy advocates are jumping ship. "A fragile consensus over a legislative measure to revamp the National Security Agency's phone data surveillance program began to fray on Tuesday following changes to the definition of a key term, which critics said could significantly broaden the government's access to data. The amended bill released Tuesday by House leaders is still expected to pass the chamber later this week. But a sudden revolt by privacy advocates suggests the floor debate likely will be more contentious. The issue centers on the definition of the term used to describe the search terms for phone databases or other large data sets, called a 'selector.'" Siobhan Gorman in The Wall Street Journal.

A House Republican has a backup plan. "A tea-party lawmaker is offering an amendment to protect a government-surveillance reform bill from being hollowed out due to pressure from the Obama administration and national-security hawks. Rep. Justin Amash filed an amendment Monday that would take a key section of the USA Freedom Act — which aims to effectively end the government's mass collection of Americans' phone records — and strap it onto the National Defense Authorization Act." Dustin Volz in National Journal.

Other privacy reads:

The Bahamas wants to know why the U.S. NSA is recording its calls. Ryan Devereaux in The Intercept.

Science interlude: How does the heart pump blood?

5. The end of 'too big to jail'? Not so fast

Mixed signals in the punishment of Credit Suisse. "For the most part, the bank will be doing business as usual. The guilty plea the federal government extracted from the bank on Monday was intended to send a clear signal that global financial firms are not 'too big to jail.' Still, the government went out of its way to make sure the conviction was not too costly for Credit Suisse....The government’s concern with minimizing the collateral consequences almost gives the impression that this was a guilty plea without all the guilt — the equivalent of a diet in which you don’t have to stop eating your favorite foods. And...it remains to be seen whether there will be a change in how the government deals with corporate misconduct." Peter J. Henning in the New York Times.

Senators were not totally impressed. "The two top US senators who led the investigation into Credit Suisse’s decades-long tax evasion schemes expressed concerns on Tuesday about the Justice Department’s criminal indictment of the bank. Senators Carl Levin and John McCain welcomed the $2.6bn fine of the bank announced Monday but said more needed to be done. Levin and McCain led the permanent subcommittee on investigations team that uncovered much of the wrongdoing at the bank." Dominic Rushe in The Guardian.

Other business/economic reads:

Tax extenders bill remains snagged over amendments. Michael Catalini in National Journal.

The housing makeover is downsizing the GDP growth outlook. Kathleen Madigan in The Wall Street Journal.

Fed nominee Fischer clears key procedural hurdle in Senate. Howard Schneider in Reuters.

Music interlude: Watch this adorable toddler sing.

Wonkblog roundup

No, David Brooks, we don’t need less democracy. Matt O'Brien.

How to get people saving in America again? Obamacare for retirement accounts. Lydia DePillis.

Foreign investors are making housing more expensive. Should we tax them for it? Emily Badger.

How much lower could Obamacare premiums be with better competition? Jason Millman.

Here’s how much your high school grades predict your future salary. Jonnelle Marte.

Proposed telecom and cable mega-deals would merge the country’s most frustrated customers. Cecilia Kang.

Et Cetera

Republicans receive Senate boost in primary outcomes. Philip Rucker and Robert Costa in The Washington Post.

Obama to protect 500K acres, make largest national monument of his tenure. Juliet Eilperin in The Washington Post.

Senators aim to divide Obama appointees over global warming. Clare Foran in National Journal.

Same-sex marriage is now legal across the Northeast. John Bacon and Richard Wolf in USA Today.

Boehner leaves door open to future vote on defense immigration act. Kristina Peterson in The Wall Street Journal.

Kids, eat your whole grains — or not. Mary Clare Jalonick in the Associated Press.

Wildfires pose new budget challenges. David Rogers in Politico.

Got tips, additions, or comments? E-mail us.

Wonkbook is produced with help from Michelle Williams and Ryan McCarthy.

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