Thursday, May 22, 2014

VA Issues ... Rationing, Waste, Lack of Customer Care and "Big Brother" Government Control .... Vouchers Would Solve the Problem ... ObamaCare's Headed the Same Way as the VA

The following editorial, albeit lengthy, is too good to quote only in brief excerpts. Thus, please take the time to digest its contents fully with respect to government knows best "help" and the broader meaning of the various VA and related ongoing issues being covered in the media. Politics sucks.

Our veterans and the rest of We the People deserve better service and overall value (received benefits in relation to the cost thereof) from those who purport to serve us. Much better.

Had enough yet of Big Brother government knows best control, waste and utter neglect of the best interests of We the People and our veterans? Troubled by the fact that gross incompetence by government officials goes unpunished and can't even be punished, given today's bloated and costly bureaucracy and public sector union rules?

Vouchers, anyone? Freedom to choose? Individual control? Market based health care?

The Government Health-Care Model is subtitled 'The Veterans scandal shows where ObamaCare ends up:'

"President Obama addressed the Veterans Affairs scandal on Wednesday, saying he's waiting for an Inspector General "audit" of what went wrong. And the press corps is debating whether VA Secretary Eric Shinseki should be fired. These are sideshows. The real story of the VA scandal is the failure of what liberals have long hailed as the model of government health care.

Don't take our word for it. As recently as November 2011, Paul Krugman praised the VA as a triumph of "socialized medicine," as he put it: "What's behind this success? Crucially, the V.H.A. is an integrated system, which provides health care as well as paying for it. So it's free from the perverse incentives created when doctors and hospitals profit from expensive tests and procedures, whether or not those procedures actually make medical sense."

Ah, yes, the VA lacks the evil profit motive. What the egalitarians ignore, however, is that a government system contains its own "perverse incentives," such as rationing that leads to treatment delays and preventable deaths, which the bureaucracy then tries to cover up. This isn't an accident or one-time error. It is inherent in a system that allocates resources by political force rather than individual consumer choices. The VA is ObamaCare's ultimate destination.


The VA operates on a "global budget" that Congress sets each year to provide veterans a guaranteed level of benefits. All veterans are entitled to free preventive screenings, immunizations, lab services and EKGs. Most are required to pay little to nothing out of pocket for medical appointments, hospital care and drugs.

All of this creates an ever-growing demand for more services, but in a world of inevitably limited resources. As in every government-run system, the only way the VA can provide universal, low-cost health care is by rationing. At the VA, this means long waiting lists to see doctors and get the "free" treatment veterans are entitled to.              
So it's no surprise that allegations are spilling out that VA facilities keep secret waiting lists to hide queues that exceed the government's targets. A retired doctor at a veterans hospital in Phoenix last month charged that staff concealed months-long delays for as many as 1,600 veterans, allegedly resulting in 40 preventable deaths. Excessive wait-times have also been reported in Fort Collins, Durham, Cheyenne, Austin and Chicago, among others.

A new Inspector General report is all but certain to reaffirm the conclusions from its 2005, 2007 and 2012 reports. To wit, VA centers fudge their data. The VA has consistently boasted in its performance reviews that more than 90% of patients receive appointments within 14 days of their "desired date." Yet according to the IG's 2012 report, the measures "had no real value" because the VA "does not have a reliable and accurate method of determining whether they are providing patients timely access" to care.

VA officials claim backlogs are due to difficulty hiring and retaining staff, but that's another problem endemic to government health care. Compensation is often too low to attract doctors, particularly in high-demand specialties like physical therapy and gastroenterology. While VA medical centers can refer patients for private consultations to reduce backlogs, they rarely do.

Last year the IG reported that the VA had given $1.02 million in September 2011 to a medical center in Columbia, South Carolina, for private colonoscopies to address a backlog of 2,500 patients. But in January 2012—by then the wait list had grown to more than 3,800—the Columbia VA's business office instructed staff not to "send out anymore non-VA care GI requests for endoscopy until further notice" since they were "attempting to internalize" procedures.
The Columbia VA referred only 100 patients between January and March 2012 to outside physicians and spent just $275,000 of the $1.02 million on private colonoscopies. Yet in-house colonoscopies decreased. As a result, the IG found that 52 patients who were later diagnosed with GI malignancies received delayed treatment.

Call it another "perverse incentive." Maintaining long backlogs can help VA centers procure more funding. Like other government institutions, VA centers have a financial incentive to keep services in-house.

The inevitable liberal defense—it's coming, we guarantee it—will be that Congress isn't spending enough money. Yet as the nearby charts show, funding soared by 106% to $57.3 billion in 2013 from $27.7 billion in 2003. Yet over the same period the number of VA patients has increased by only 30%. Congress rubber-stamps the VA's requests for more funding, and Mr. Obama's budget this year requests $2 billion more.

Yet throwing more money at the VA hasn't improved accountability, and neither have Congressional attempts at reform dating to the 1980s. In 2009, President Obama signed legislation that he promised would ensure "better access to the doctors and nurses" and "promote accountability." Yet according to the Center for Investigative Reporting, the VA has settled more than $200 million in wrongful death claims since 9/11. The Cox Media Group calculates the VA's malpractice tab at $845 million over the last decade.

House Republicans on Wednesday passed legislation to streamline dismissal for malfeasant VA staff and are calling for Mr. Shinseki's head. Yet rearranging the deck chairs won't fix the VA's core problem, which is that a government-run system inevitably leads to wait lists and reduced access to quality care.

The modern VA is a vestige of the flood of veterans coming out of World Wars I and II, but it is as unnecessary as a health-care system dedicated solely to police or firefighters. The best solution is to privatize the system. At the very least veterans ought to receive vouchers that allow them to seek subsidized care from private providers that removes the VA as the choke point. Why are politicians punishing veterans with inferior government health care?"

Summing Up

Government care?

Are you kidding me?

Is this the best we can do?

Are you kidding me?

Big Brother sucks.

Politics does too.

Let freedom reign.

Let individuals decide for themselves in a free and privatized market.

Vouchers make sense.

That's my take.

Thanks. Bob.

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