More aging and seriously injured veterans plus already existing issues with wait-times and a tightening supply of doctors, as well as other medical professionals, equals a VA healthcare system that cannot serve veterans who are entitled to government provided medical care. Clearly, the math predicated the ever-growing problem with the medical system that is supposed to serve America’s warriors. In the case of the VA wait-time scandal, the laws of economics demonstrated what has been realized in the real world.
Arbitrarily setting a wait-time goal of two weeks, however, failed to serve as an incentive to do better, because “the incentive” was based on a bad assumption, i.e. the problem was an efficiency (human) versus resource issue, and failed to consider the real problems with the VA. According to psychological theory (behavioralism), we can expect an incentive to encourage the behavior that is more readily rewarded, i.e. the easiest thing to do to get the incentive. Failing to take into account human behavior and the lack of sufficient resources, the financial incentive could not have been effective under the current circumstances.
Because incentives tied to meeting wait-time goals could be achieved by manipulating paperwork and administrators used added pressure, including social pressure, to “punish” a failure to meet wait-time goals, it encouraged a system that has around 57,000 individuals whose care has been delayed with another 64,000 left entirely neglected. Although the incentives were canceled in the light of the controversy, they were not the cause. If the VA is to address this ongoing issue with wait-times, it must stop trying to use the easy business solution of avoiding the problem by deploying pressure tactics; instead, it must face the resource issue and find solutions that help provide more affordable, more accessible care to veterans.
In broader terms, both policymakers and business leaders need to learn from the VA’s error in judgment. When there is a potential conflict of interest created by an incentive, whether financial, social, or emotional, the mechanisms of economics and human nature dictate we can expect corruption, whether intentional or not. More importantly, our society needs to start recognizing when the assumptions being made by economists invalids the real world application of their thinking as well as the limits of what economics incentives can do to achieve a goal in the real world.
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